bluuebunny/crossref_metadata_2025 huggingface dataset:
Kidney Disease in Pregnancy
Authors: Vellanki Kavitha , Hou Susan
Published: January 2021

Pregnancy-induced changes in renal hemodynamics play an important role in favorable maternal and fetal outcomes. Renal plasma flow and glomerular filtration rate (GFR) increase by approximately 50% in normal pregnancy, leading to a decrease in both blood urea nitrogen and serum creatinine when compared with prepregnancy levels. Hence, serum creatinine–based formulas are not accurate in calculating estimated GFR in pregnant patients. The most compelling risk for pregnant women with moderate to severe chronic kidney disease is the risk of rapid progression of underlying kidney disease; the mechanisms for such decline are yet to be elucidated. The rule of kidney disease not progressing when serum creatinine is less than 1.4 mg/dL does not apply to women with lupus nephritis. New-onset lupus is an indication for kidney biopsy during pregnancy because diffuse proliferative lupus nephritis requires prompt treatment and first-line treatments are teratogenic. Infertility is common in women on dialysis and is usually reversed after successful kidney transplantation. Pregnancy outcomes have improved over the years with increasing intensity of hemodialysis in end-stage kidney disease patients. Pregnancy post–kidney transplantation should be planned and teratogenic medications discontinued before conception.
Immunosuppression
Authors: Gabardi Steven , Kim Miae
Published: January 2021

The primary objective of clinical immunosuppression following renal transplantation is to prevent rejection while limiting the toxicities of the immunosuppressive agents. A balance between over- and underimmunosuppression can be difficult to accomplish and has significant ramifications if not achieved. The major sequelae of underimmunosuppression are cellular and antibody-mediated allograft rejection, whereas overimmunosuppression can give rise to complications such as infection and malignancy. Local protocols and national/international guidelines have been established to aid in the streamlining of immunosuppressive regimens; however, the development of the most appropriate immunosuppressive therapy in an individual transplant recipient is highly dependent on a practitioner’s experience, preexisting medical conditions/medications, and donor characteristics. Despite the success seen by our individualized immunosuppressive regimens in improving short-term outcomes, late graft loss and the morbidity associated with long-term immunosuppression remain major concerns. To improve outcomes in renal transplantation, it is imperative that clinicians be aware of the specific advantages and disadvantages of the available immunosuppressants, as well as the potential for adverse drug reactions and drug-drug interactions commonly seen with these agents. 

This review contains 5 figures, 5 tables and 92 references
Key Words: immunosuppression, pharmacodynamics, pharmacokinetics, renal transplantation
Kidney Disease in the Cancer Patient
Authors: Magee Colm , Redahan Lynn
Published: January 2021

The spectrum of kidney disease in the cancer patient is wide. Kidney dysfunction can result from the cancer itself or its treatment. The presentation in this population is varied and may manifest as acute kidney injury (AKI) or chronic kidney disease. In addition, other manifestations of kidney disease can include proteinuria, hypertension, and electrolyte disturbances. As new cancer treatments emerge, the range of therapy-associated renal syndromes increases. This chapter deals predominantly with causes and management of renal dysfunction that are specific to the cancer patient, including those caused by hypercalcemia; hepatorenal syndrome; the use of interleukin-2 (IL-2) and bisphosphonate; glomerular, tubular, interstitial, and vascular diseases; multiple myeloma (MM); and tumor infiltration. The chapter also examines postrenal causes of AKI, electrolyte disorders, and hematopoietic stem cell transplantation (HSCT). Tables provide the features of kidney disease in the cancer patient, the pathogenesis of hypercalcemia, strategies for preventing and managing AKI with IL-2 therapy, laboratory findings with hemolytic-uremic syndrome/thrombocytopenic purpura, the causes of acute tubular necrosis in MM, a summary of electrolyte disturbances in the cancer patient, indications for HSCT, and a summary of the management of patients with post-HSCT AKI. The chapter is also enhanced by ultrasound and computed tomographic scans, histology images, and an illustration of tumor lysis syndrome.
This chapter contains 105 references, 8 tables, 4 highly rendered figures, and 5 MCQs.
Infective Endocarditis
Authors: O'Gara Patrick T.
Published: January 2021

Infective endocarditis is a microbial infection of a cardiac valve or the mural endocardium caused by bacteria or fungi. Forms of this infection include subacute bacterial endocarditis (SBE) and acute bacterial endocarditis (ABE). Etiology and epidemiology are discussed. There is a section on pathogenesis followed by specific clinical presentations, including endocarditis associated with parenteral drug abuse as well as prosthetic valve endocarditis (PVE). Diagnosis and cardiac complications of endocarditis, treatment, recommendations for prophylaxis, and prognosis are addressed. There are several figures showing manifestations and anatomic relations from the infection. Tables describe microorganisms that cause native valve endocarditis, the etiology of PVE, the Duke criteria for diagnosis of infective endocarditis, antimicrobial therapy for endocarditis in adults, guidelines to prevent endocarditis, and recommendations and regimens for endocarditis prophylaxis.
This chapter contains 99 references.
Clinical Management of Anxiety Disorders
Authors: Vas Shona , Dave Pooja N
Published: January 2021

Anxiety disorders are characterized by excessive fear and anxiety accompanied by associated behavioral disturbances that cause significant impairment in social and occupational functioning. Anxiety is a complex mood state that involves physiologic, cognitive, and behavioral components. This review describes the five anxiety disorders most commonly diagnosed in adults: social anxiety disorder, panic disorder, agoraphobia, generalized anxiety disorder, and specific phobia. Diagnostic criteria for these disorders are presented along with empirically supported psychological and pharmacologic treatment approaches. Decades of evidence have indicated that for anxiety disorders of mild to moderate severity, cognitive-behavioral therapy (CBT) should be first-line treatment. CBT interventions for anxiety, including psychoeducation, cognitive restructuring, exposure, applied relaxation/breathing retraining, and skills training, are presented with descriptions of how they may be adapted to particular diagnoses, along with data for their efficacy. Data suggest that selective serotonin and norepinephrine reuptake inhibitors are pharmacologic treatments of choice for anxiety and may be used in combination with CBT for moderate to severe symptoms. d-Cycloserine is an emerging treatment that may enhance outcomes in anxiety disorders by optimizing exposure therapy through the facilitation of fear extinction.
This review contains 7 figures, 12 tables, and 105 references.
Key words: agoraphobia, anxiety, generalized anxiety disorder, panic disorder, phobias, social anxiety disorder
Neurogastroenterology
Authors: Pfeiffer Ronald F.
Published: January 2021

Contrary to what one may assume, neurology and gastroenterology are similar to each other in many ways. A process found in one system can also affect the other, whether it be gastrointestinal (GI) dysfunction present in neurologic diseases or neurologic dysfunction present in GI diseases. Several disorders from both fields of medicines are highlighted in this review, ranging from stroke, Parkinson disease, and multiple sclerosis (MS) as examples of GI dysfunction in neurologic disease, to celiac disease and inflammatory bowel disease as examples of neurologic dysfunction in GI disease. Rare disorders such as Whipple disease (WhD), chronic acquired hepatocerebral degeneration (CAHD), and Wilson disease (WD) should also be considered for their neurologic dysfunctions as manifested extraintestinally. Tables give an overview of clinical features of the various disorders presented in this review.
 
This module contains ­4 highly rendered figures, 9 tables, 349 references, and 5 MCQs.
The Cognitive Psychology of Diagnostic Errors
Authors: Benishek Lauren E. , Weaver Sallie J. , Newman-Toker David E.
Published: January 2021

Health care involves complex decision making, often under uncertain, ambiguous, and time-sensitive conditions. Clinicians typically face the greatest uncertainty when making diagnostic decisions; common, undifferentiated symptoms paired with increasing prevalence of complex comorbidities, continuously and rapidly evolving scientific evidence, and often fragmented information systems are just a few of the hurdles clinicians must navigate as part of daily diagnostic decision making. In this review, the current state of the science concerning the cognitive psychology of diagnostic errors is discussed, including models of diagnostic reasoning, common errors: heuristics and biases, and practical implications and interventions. Figures show a conceptual model for diagnostic errors; diagnostic and therapeutic cycles; relationships among heuristics, biases, premature closure, and diagnostic errors; Reason’s (2000) Swiss cheese model; and tradeoffs versus improvements in diagnostic performance as illustrated by the receiver operating characteristic curve. Tables list important reasons for understanding the foundational cognitive models of diagnostic reasoning; a glossary of key diagnostic error–related definitions; three models of cognitive decision making; a summary of clinical reasoning models; steps of diagnostic decision making; examples of diagnostic errors resulting from representativeness, availability, and anchoring and adjustment; categories of countermeasures for error reduction interventions; examples of cognitively, systems-, and patient-focused countermeasures for selected biases; a summary of cognitively focused countermeasures to cognitive bias; key problem “classes” where problem- or context-specific solutions might be applied; types of system-focused countermeasures; and patient-focused countermeasures to avoid diagnostic error.
 
This review contains 5 highly rendered figures, 12 tables, and 120 references.
Atypical Parkinsonian Syndromes: Tauopathies
Authors: Park Hee Kyung , Litvan Irene
Published: January 2021

Atypical parkinsonian disorders, which include two common proteinopathies, tauopathies and α-synucleinopathies, are clinically characterized by a progressive parkinsonism that typically does not respond to levodopa therapy and usually associates with early postural instability, falls, and other atypical features not observed in Parkinson disease. Tauopathies refer to neurodegenerative diseases in which there is an abnormal accumulation of hyperphosphorylated tau. The most frequent tauopathies are progressive supranuclear palsy and corticobasal degeneration. Better recognition of the expanding phenotypes of these disorders has led to the development of new diagnostic criteria. Furthermore, better knowledge about the pathogenesis (cell-to-cell transmission of pathologic tau) has resulted in advances in novel disease-modifying therapies that target tau. This review addresses the basic concepts of and recent issues in tauopathies, including their clinical phenotypes, genetic features, biomarkers, and novel experimental therapies. 
Key words: atypical parkinsonian disorders, corticobasal degeneration, progressive supranuclear palsy, proteinopathies, tauopathies
Nutritional Support in the Patient with Traumatic and Nontraumatic Brain Injury
Authors: Magnuson Woodward Barbara , Cook Aaron M.
Published: January 2021

The multiple metabolic alterations following neurologic injuries create several unique challenges for clinicians providing nutrition support. The hypermetabolic and hypercatabolic state following traumatic brain injury (TBI) has been well studied over the past three decades. This review discusses several unique issues to incorporate into the nutrition support plan for both acute traumatic and nontraumatic brain injuries. The initial energy expenditure assessment varies drastically among the different neurologic injuries, from the lowest with anoxic brain injury and spinal cord injury to the highest with traumatic subdural hemorrhagic injury. Measuring energy expenditure with indirect calorimetry becomes a critical component of the assessment due to wide-ranging metabolic needs and effects from various drug therapies. An excess or a lack of adequate nutrition support clearly results in worse neurologic and nutrition status outcomes. The nutrition status and preexisting comorbidities of the neurologically injured patient further compound the complexity of the nutrition plan. Anticipating and correcting for refeeding syndrome in the malnourished stroke patient or alcoholic hypermetabolic TBI patient avoid further metabolic, cardiac, and ventilator complications. Fluid balance must be continuously monitored and hyperglycemia avoided to prevent cerebral edema. Planning and implementing an aggressive nutrition support regimen inclusive of drug therapy, appropriate fluid status, electrolyte replacement, and close glucose monitoring incorporate the expertise of several health care disciplines to ensure optimal outcomes from the critical care setting. Nutrition support plans become one of the primary focuses during recovery following a neurologic injury. Proper swallow assessments and techniques to recognize dysphagia and avoid aspiration and its complications with pneumonia become paramount during the stroke rehabilitation phase. Due to the variety of acute neurologic injuries, health care providers must address each of the distinctive issues for an individualized nutrition support therapy to ensure optimal outcomes and minimize complications
This review contains 1 figure, 4 tables, and 58 references.
Dysmenorrhea in the Adolescent
Authors: Evans Rebecca H. , Knill Courtney N.
Published: January 2021

As a common medical issue for adolescents both in the United States and worldwide, dysmenorrhea is a leading cause of visits to primary care providers and gynecologic specialists. The prevalence of dysmenorrhea in women is highest in the adolescent population affecting 20-90% of females in this age group. Primary dysmenorrhea is the most common form of dysmenorrhea and is defined as painful menstruation in the absence of pelvic pathology. Secondary dysmenorrhea is explained by an underlying pathology such as endometriosis or genital tract obstruction. The differential diagnosis of dysmenorrhea includes other etiologies of pelvic pain such as gastrointestinal, genitourinary, or other gynecologic pathologies. Symptoms refractory to first and second line treatments warrant further evaluation and management. As the second most common cause of pelvic pain in adolescents after primary dysmenorrhea, endometriosis may manifest itself differently in adolescents when compared to adults. Non-steroidal anti-inflammatory agents (NSAIDS) are first line medical management for dysmenorrhea. Hormonal agents are second line medical management though are often initiated concomitantly with NSAID therapy. Complex imaging and surgery are reserved for refractory cases of pelvic pain. This document outlines the recommended evaluation and management of adolescents with dysmenorrhea and highlights important medical advances that have contributed to treatment.
 
This review contains 5 figures, 8 tables, and 34 references.
Keywords: dysmenorrhea, pelvic pain, endometriosis, menstruation, menses, Premenstrual Syndrome, tranexamic acid, menstrual suppression, menstrual disorders
Surgical Management of Stress Urinary Incontinence
Authors: Patterson Danielle
Published: January 2021

Stress urinary incontinence (SUI) is a prevalent and distressing condition that affects up to 50% of women over their lifetime. If nonsurgical treatments are not effective, surgery is highly successful. Preoperative evaluation includes at minimum a thorough history and physical examination, urinalysis, demonstration of SUI, assessment of urethral mobility, and measurement of postvoid residual urine volume. The midurethral sling is the most studied surgical procedure for urinary incontinence and is safe and highly effective. With the recent concern about permanent mesh in urogynecologic surgery, many patients might choose a laparoscopy- or robot-assisted Burch colposuspension or fascial sling.

This review contains 5 figures, 5 tables and 38 references
Key words: intrinsic sphincter deficiency, mesh, midurethral sling, minimally invasive surgery, preoperative evaluation, retropubic colposuspension, stress urinary incontinence, urethral bulking, urodynamic testing
Patient with Thoracic (Spinal) Pain
Authors: Cheng Jianguo , Cho Yoon-Jeong
Published: January 2021

Although less common than cervical or lumbar pain, thoracic pain is not an uncommon presentation in pain clinics. Thoracic pain may be nociceptive, neuropathic, mixed, or idiopathic. It can originate from bony structures, facet joints, intervertebral disks, or muscles and fascia. In addition, pain from the diaphragm, cervical spine, chest, and abdominal viscera may be referred to the thoracic region. Some of the conditions that should be kept in the differential include ankylosing spondylitis, Tietze syndrome, costochondritis, diffuse idiopathic skeletal hyperostosis, Scheuermann kyphosis, thoracolumbar junction syndrome, osteoarthritis, rheumatoid arthritis, vertebral compression fractures, facet arthropathy, and primary cancer and metastatic disease of the spine. This review focuses on thoracic pain of spinal and musculoskeletal origin. However, it is imperative not to overlook visceral pain because it may be associated with a life-threatening condition.
Key words: ankylosing spondylitis, costochondritis, diffuse idiopathic skeletal hyperostosis, Maigne syndrome, sacroiliitis, Scheuermann kyphosis, slipping rib syndrome, thoracolumbar junction syndrome, Tietze syndrome
Complex Regional Pain Syndrome: The Worst Pain Known to Humankind
Authors: Chopra Pradeep
Published: January 2021

Complex regional pain syndrome (CRPS) is the worst pain known to humankind. It has been classified as pain worse than cancer pain, amputation of a digit, or labor pain. The difference is that CRPS is a chronic condition that lasts for many years. As in all medical conditions, the essential piece to diagnosis of CRPS is based on the clinical history and physical examination. The diagnosis of CRPS depends on the following: pain, color and temperature asymmetry, swelling, and nail and hair growth changes. The intensity of the pain is far more than expected from the inciting injury and in some cases from immobilization. The pain spreads to a wider area than the original site. It may spread to the opposite side and even to the whole body, including the viscera. The pain is unrelated to any physical activity but does increase significantly with using the body part. A color differential between the affected and the unaffected side is often very obvious but may not be present continuously. A temperature differential of 1.1ºC between the affected and the unaffected side is considered significant. The color and temperature differential is not as obvious in the torso or the axial skeleton as in CRPS of the abdomen, perineum, or chest wall. The swelling is much more evident in the initial stages of the condition and can vary from a small area of pitting edema to large diffuse swelling to the point of skin becoming thin and glossy and even breaking down. Hair changes may consist of darker, coarser hair or light and sparse hair. Nails may be brittle, discolored, and ridged. There is no gold standard test to diagnose CRPS. Testing may be done to rule out another possible diagnosis.
Phantom Limb Pain
Authors: Chang Chien George C , Bautista Alexander , Candido Kenneth D.
Published: January 2021

Phantom limb is a complex pain phenomenon that is perceived by patients after a limb has been amputated. Many patients have the persistent perception that the particular limb that was lost is still present. This phenomenon, which may be painful and nonpainful, may develop immediately after amputation or in years following the incident. This phenomenon should not be confused with residual limb pain, formerly described as “stump pain,” which is pain that resides in the residual limb attached to the body. Phantom limb pain (PLP) is described similarly to other neuropathic pain conditions as burning, gnawing, stabbing, pressure, aching, squeezing, and knifelike. PLP is associated with a myriad of symptoms and considered one of the most challenging chronic pain conditions. The underlying mechanism of this phenomenon can be supraspinal, spinal, and peripheral. PLP remains a very challenging condition to treat. The therapies are similar to those of any other neuropathic pain states. A multimodal approach that includes interventional therapy, pharmacotherapy, rehabilitation, surgery, and preemptive analgesia working together improves success. 
Key words: Amputation, amputee, central sensitization, mirror therapy, neuropathic pain, phantom limb pain, residual limb pain
The Patient with Complex Regional Pain Syndrome
Authors: Chang Chien George C , Odonkor Charles A , Harden Robert Norman
Published: January 2021

Complex regional pain syndrome (CRPS) is a multisymptom syndrome involving aberrant pathophysiology of the peripheral, autonomic, and/or central nervous systems. The central feature is severe, often debilitating pain. This is accompanied by a collection of sensory, motor, autonomic, skin, and/or bone abnormalities. A key feature is allodynia, where otherwise innocuous stimulation will cause pain and hyperalgesia. The patient will present with varying degrees of pain, allodynia, hyperalgesia, swelling, and color and temperature changes. There are often changes in motor function, such as muscle stiffness or even involuntary movements. Regional osteopenia, changes to hair and nail growth, and dystrophic cutaneous changes may occur. The Budapest criteria have been twice validated and are used to diagnose CRPS. A patient-centric clinical approach is important in the treatment of CRPS. Key domains to be addressed in the management of CRPS include rehabilitation and pain management with adjunct psychological therapy. It is important that these interventions happen concurrently within the continuum of care. With the guidance of a physician, physical therapist, occupational therapist, and neuropsychologist, rehabilitative training programs are designed to address motor, sensory, and cognitive deficits.
Key Words: Budapest criteria, complex regional pain syndrome, reflex sympathetic dystrophy, sympathetically mediated pain
Complementary and Alternative Medicine: Is It Alternative or Mainstream for Managing Low Back Pain?
Authors: Rana Maunak V. , Agarwal Deepti , Anantamongkol Utchariya
Published: January 2021

Although long an integral part of the health systems of societies all around the globe, the role of complementary and alternative medicine (CAM) in Western medicine has become better defined over the past few years, especially in multidisciplinary pain management. Many patients have expressed dissatisfaction at conventional treatments of therapy, medications, and procedures. Often they have sought adjunctive treatments to make up for deficits in efficacy and to minimize unwanted side effects. CAM has been a source to fill the void. Additionally, physical modalities that promote the mind-body connection in pain states have emerged in common practice. Of the physical modalities helpful in the concurrent management of pain, yoga has emerged as one of the most effective options. The medical literature has identified acupuncture as efficacious and safe and determined that it may have benefit as a sole therapy or in conjunction with traditional interventions. Although nutraceuticals and marijuana have received lay press exposure and interest, as pain therapeutics, the mechanism of action of these agents needs to be more precisely elucidated and regulatory bodies need to ensure quality control and dosage safety in society.  
This review contains 4 figures, 1 table and 118 references
Key Words: acupuncture, lower back pain (LBP), medical marijuana, nutraceuticals, transcutaneous electrical nerve stimulation (TENS)
Patients with Metastatic Breast Cancer Who Had Radical Mastectomy Complicated by Lymphedema
Authors: Fox Charles J. , Kaye Alan D. , Cornett Elyse , Koyyalamudi Veerandra , Thompkins Terin
Published: January 2021

The past few decades have seen a shift in breast cancer surgery to a more conservative approach from radical mastectomy to breast-conserving therapy and from axillary node dissection to minimally invasive sentinel node biopsy. The adoption of more conservative surgical approaches was taken with the aim of reducing morbidity after surgery and improving long-term functional capacity. This review outlines complications that can arise in treating breast cancer and the therapies that can be used to treat patients with these conditions.
This review contains 3 tables and 47 references.
Key words:  breast cancer, biopsy, chemotherapy, endocrine therapy, lymphedema, lymphatic drainage, mastectomy, radiotherapy
Patient with an Ankle Sprain
Authors: Trescot Andrea
Published: January 2021

Ankle sprains are a very common injury, suffered by approximately 25,000 patients per year, and affect all age groups, including children, athletes, and the elderly. The recognition of the type of ankle sprain (medial, lateral, syndesmotic) affects early and late management of ankle sprains. Also discussed are the acute diagnosis and treatment of ankle sprains, as well as the consequences of chronic ankle instability, which may include serious conditions such as complex regional pain syndrome and chronic ankle instability. Surgical and nonsurgical treatment, evaluation, prognosis, and prevention are also discussed.
Key words: ankle pain, ankle sprain, chronic ankle instability, complex regional pain syndrome, cryoneuroablation, high ankle sprain, lateral ankle sprain, medial ankle sprain,
Approach to the Patient Presenting with Chest Pain
Authors: Nagurney John Tobias
Published: January 2021

Caring for the emergency department patient with chest pain represents an important challenge to the emergency physician. Chest pain is the second most common presentation among all emergency department patients, accounting for approximately 6 million visits per year in the United States. Chest pain may represent a benign condition or a time-critical life threat; symptom overlap between benign and serious conditions can make an accurate chest pain diagnosis challenging. This review covers the pathophysiology, assessment, stabilization, diagnosis and treatment, and disposition and outcomes of chest pain. The figure shows an algorithm outlining the approach to the patient with chest pain. Tables list critical and noncritical diagnoses in patients presenting with chest pain: history, physical examination, and bedside testing; risk factors or associations for acute coronary syndrome, pulmonary embolism, and aortic dissection; characteristics of the chest pain story to diagnose acute coronary syndrome; ABCDEs of resuscitation for patients with unstable vital signs; critical and noncritical diagnoses in patients presenting with chest pain: history, diagnosis, and treatment; prevalence of pulmonary embolism in patients classified as low or high probability for this diagnosis by Wells score, modified Geneva score, and gestalt; commonly recognized pitfalls in the workup and diagnosis of chest pain in the emergency department; critical diagnoses in patients presenting with chest pain: history, disposition, and outcome; and summary of current recommendations.
This review contains 1 highly rendered figure, 11 tables, and 54 references.
Key words: acute coronary syndrome, acute myocardial infarction, anginal pain, aortic dissection, cardiac-related pain, chest pain, coronary artery disease, non–ST segment elevation myocardial infarction, pulmonary embolism, ST segment elevation myocardial infarction
A Comprehensive Review of Wound Healing
Authors: Mehrzad Raman , Liu Paul  Y
Published: January 2021

Unhealed wounds are a largely hidden epidemic, affecting 6.5 million Americans and costing about $25 billion a year, with numerous patients affected. Unhealed wounds result in lower quality of life and limit many all-day activities for patients. Despite this large socioeconomic burden, there have been only a few meaningful advances in the science of wound care. Wounds represent a cross section of many medical disciplines—diabetes, trauma, hypertension, vascular insufficiency, and rheumatologic diseases—and a multidisciplinary approach is typically needed. In this review, we provide an overview of wound healing, its pathophysiology, different types of wounds, and the current state of therapeutic art.
 
Key words: chronic wounds, infection, inflammation, mathematical modeling, ulcers, wounds
Wrist Fractures and Dislocations
Authors: Lipira Angelo B , Kasukurthi Rahul K , Huang Jerry I
Published: January 2021

Wrist injuries are common and encompass a wide variety of pathologies. This review discusses key concepts related to the evaluation and management of wrist injuries, including bony and ligamentous injuries of the carpus, fractures of the distal radius and ulna, and associated conditions. Pertinent anatomy and biomechanical principles are briefly reviewed, followed by more detailed discussions of evaluation and management of specific injury types based on best available evidence. A diagnostic approach including the history, physical examination, and imaging is reviewed for each injury type. Common surgical approaches, fixation methods, and reconstructive techniques are then described within each section. Numerous illustrations, radiographs, and cadaveric photographs are included.
This review contains 32 figures, 2 tables and 76 references
Key words: carpal, carpus, distal radius, fracture, ligament, lunotriquetral, scaphoid, scapholunate, wrist
Classification in Psychiatry
Authors: Black Donald W.
Published: January 2021

Classification in psychiatry has ancient roots but mainly took form in the 19th and 20th centuries. European and American psychiatrists brought to the fore careful observation and description of clinical course. Formal attempts to classify patients took root after World War II based on the exigencies of the time. The DSM-I was published in 1952 and summarized all the diagnoses in psychiatry. Diagnostic criteria were introduced in the DSM-III in 1980 to introduce reliability to the diagnostic process, and a multiaxial system was introduced to aid in the comprehensive assessment of patients, later dropped in the DSM-5. Dimensional measures were introduced to aid with patient assessment, although many categories were reformulated based on research findings. In the DSM-5, the diagnoses are listed in order of clinical importance. Residual categories exist for those who do not meet the criteria for a more specific disorder. Although the DSM-5 has been criticized, criteria-based diagnoses will persist until a system can be created based on etiology. 
This review contains 2 tables, and 23 references
Keywords: classification in psychiatry, diagnostic criteria, DSM-5, Feighner criteria, International Classification of Diseases, Kraepelin
Attention-Deficit/Hyperactivity Disorder in Children and Adolescents
Authors: Delgado Sergio
Published: January 2021

Attention-deficit/hyperactivity disorder (ADHD) is the most common and thoroughly researched neuropsychiatric disorder affecting children and adolescents. The prevalence of ADHD ranges from 8 to 12% in school-age children, and 70% of these individuals continue to meet DSM-5 criteria for the disorder in adolescence. ADHD is more commonly diagnosed in boys compared with girls. ADHD is chronic, with prominent symptoms and impairment in family, social, and academic functioning. ADHD is often associated with comorbid disorders, including disruptive, mood, and anxiety disorders, and can increase the risk of developing substance use disorders. The diagnosis of ADHD requires a comprehensive clinical assessment, including a detailed history, clinical interview, and collateral information, and is clinically established by review of symptoms and impairment and having established a developmental history of the symptoms. The biological underpinning of the disorder is supported by genetic, neuroimaging, neurochemistry, and neuropsychological data. Treatment should attend to developmental milestones of the child and include family and individual psychosocial interventions. Psychosocial interventions in combination with medication are helpful for ADHD and comorbid problems. Pharmacotherapy, including psychostimulants, noradrenergic agents, alpha agonists, and antidepressants, plays a fundamental role in the treatment and management of ADHD.
This review contains 2 figures, 9 tables, and 114 references.
Key words: attention, attention-deficit/hyperactivity disorder, comorbidity, hyperactivity, impulsivity, learning, nonstimulants, psychosocial, psychostimulants, treatment
Neurobiology of Mood Disorders
Authors: Uzunova Genoveva , Nezgovorova Vera , Schlussel Danya , Hollander Eric
Published: January 2021

Mood disorders (major depressive disorders [MDDs] and bipolar disorders [BDs]) are common psychiatric conditions and major causes of morbidity and mortality worldwide. Their neurobiology is extensively studied, and major advances have been made in understanding the neuroanatomic, neurochemical, synaptic plasticity, and genetic correlates. In this review, we discuss the major neuroanatomic regions in the brain affected in mood disorders and brain structural and functional alterations, the main hypotheses for the neurobiology, the major neurotransmitters and neuromodulators implicated, the synaptic plasticity changes, the role of stress and the hypothalamic-pituitary-adrenal axis, the importance of circadian rhythms, and the role of genetics. We discuss differences in the neurobiology between MDDs and BDs and connect the knowledge of neurobiology to therapeutics. We discuss the main classes of medications, such as antidepressants for treatment of MDD and mood-stabilizing drugs for treatment of BD, and neuromodulation therapies such as transcranial magnetic stimulation. We point to unanswered questions and future directions, such as elucidation of the role of atypical neurotransmitters in mood disorders, the need for better understanding of the genetics and interactions between the immune and central nervous systems, and the development of biomarkers and personalized therapeutics based on the neurobiology. Notably, there are discrepancies in the current scientific knowledge and many unanswered questions in the neurobiology due to the different ages of patients, disease stage, presence of medications, and other comorbidities. It is notable, however, that mood disorders have a clearly established biological basis with alterations in the immune and central nervous systems that affect synaptic plasticity, neural circuits, and larger-scale brain networks and communicate with the autonomic nervous system.
This review contains 5 figures, 4 tables and 62 references
Key words: antidepressant, bipolar disorder, epigenetics, hypothalamic-pituitary-adrenal axis, immune system, limbic system, major depressive disorder, mood stabilizer, neurotransmitter, synaptic plasticity, transcranial magnetic stimulation
Alcohol Use Disorders and Clinical Management
Authors: Thompson Alexander , Rohlf Daniel , Cocozzella Joseph
Published: January 2021

Alcohol use disorder (AUD) is the current DSM-5 designation for problematic and pathologic alcohol use. AUDs have a high prevalence in the United States and are commonly treated in psychiatric practice. They are associated with a wide variety of medical and psychiatric comorbidities. Effective treatment depends on tailoring treatment setting, behavioral psychotherapies, and psychotropic interventions to the individual patients. Three medications are Food and Drug Administration approved for the treatment of AUDs: naltrexone, acamprosate, and disulfiram. Several other medications (anticonvulsants and baclofen) have been studied, but their role in treating AUDs is uncertain. Naltrexone and/or acamprosate should be considered first-line medications for patients without contraindications. Disulfiram can be considered a second-line or first-line treatment in patients with appropriate support or those who prefer it. All patients who are diagnosed with AUDs should be referred to mutual support groups (i.e., Alcoholics Anonymous).
This review contains 3 figures, 8 tables, and 38 references.
Key words: acamprosate, Alcoholics Anonymous, AUDIT, brief interventions, disulfiram, gabapentin, naltrexone, topiramate, 12 step
Neurobiology of Addiction
Authors: Gogliettino Alex , Potenza Marc , Yip Sarah , Zakiniaeiz Yasmin , Zhai Zu Wei
Published: January 2021

Addiction is a disorder characterized by poorly controlled substance use despite negative health and social consequences. Additionally, the only behavioral addiction recognized in the main text of the DSM-5, gambling disorder, presents similarly to many substance addictions with respect to the underlying neurobiology and poorly controlled gambling despite negative consequences (e.g., financial, familial problems). This review first provides an overview of the diagnostic criteria for addictive disorders—both substance and nonsubstance—and subsequently reviews the extant literature examining epidemiology, including global prevalence and co-occurring disorders, as well as differences in addicted and nonaddicted groups with respect to genotype, brain function, and neurochemical systems. Last, the prognosis, quality of life, and current treatment strategies for addictions are discussed. The review also includes tables and figures to supplement the text, summarizes important points, and provides visual representations of tasks used to study cognitive aspects of addictions and addiction pathophysiology.
This review contains 5 figures, 6 tables, and 81 references.
Key words: brain function, cognitive function, epidemiology, functional magnetic resonance imaging, genetics, neurochemistry, positron emission tomography, treatment
Overview of Psychotherapy in Psychiatry
Authors: Cowan Allison , Welton Randon
Published: January 2021

Psychotherapy continues to be an integral part of psychiatric practice. The rich, interesting history of psychotherapy in medicine and psychiatry set the background to current practice. Psychoeducation provides patients with necessary information and forms the basic building block for all other psychotherapies. Supportive therapy, cognitive-behavioral therapy, and psychoanalytic/psychodynamic psychotherapies constitute the core of the therapeutic styles, but dialectical behavioral therapy, eye movement desensitization and reprocessing, interpersonal psychotherapy, motivational interviewing, hypnosis, and group psychotherapy are also practiced in current psychiatry. Key therapeutic tenets from each of these disciplines are incorporated into the medical practice of psychiatry. 
This review contains 5 figures, 13 tables, and 68 references
Key words: cognitive-behavioral therapy, current psychiatric practices, dialectical behavioral therapy, psychiatrist as therapist, psychoanalytic psychotherapy, psychodynamic psychotherapy, psychoeducation, psychotherapy, supportive psychotherapy
Part 2: Borderline Personality Disorder and Its Clinical Management
Authors: Biskin Robert , Paris Joel
Published: January 2021

The treatment of patients with borderline personality disorder (BPD) has changed significantly over the past 25 years. The previous therapeutic pessimism about BPD treatment outcomes has become more optimistic with the development of a variety of specialized psychotherapies that have been shown to reduce self-harm, suicidality, and health service use as well as improve overall psychopathology. Dialectical behavior therapy was the first evidence-supported treatment, but it has been joined by mentalization-based psychotherapy and a variety of other treatments. Several common factors, including structured treatment approach, are likely important in the effectiveness of these treatments compared with unstructured comparators. Pharmacotherapy serves a more limited role in the treatment of BPD due to many methodological issues in the research and a lack of replication of studies. Judicious and rational use of pharmacotherapy is discussed, as well as suggestions for improving accessibility to specialized psychotherapies through the development of stepped care models. Improving access to care for patients with BPD, throughout all age groups, remains an important next step.
This review contains 2 figures, 1 table, and 47 references.
Key words: borderline personality disorder, dialectical behavior therapy, mentalization-based treatment, personality disorder, pharmacotherapy, psychotherapy, self-harm
Medical Expulsive Therapy
Authors: Silva Mark , Mikkilineni Nina , Shah Ojas
Published: January 2021

Medical expulsive therapy (MET) for ureteral stones involves the administration of pharmaceutical agents to facilitate passage of stones by ideally increasing the rate of passage and reducing time for expulsion. Several medications have been studied for this use. The most commonly studied off-label medications include α1-antagonists and calcium channel blockers. This article reviews the data available for the use of MET and controversies in the use of medications to aid stone passage based on more recent randomized controlled trials and meta-analyses. Based on the latest guidelines, α-blockers have been the most studied medication type and may have some benefit in the passage of distal ureteral stones greater than 4 mm in size.
This review contains 2 figures and 34 references.
Keywords: α1-antagonists, α-blockers, calcium channel blockers, medical expulsion therapy, phosphodiesterase inhibitors, ureteral stones
Pathophysiology and Treatment of Hyperoxaluria
Authors: Chirackal Robin S , Lieske John C
Published: January 2021

Humans cannot degrade oxalate. Thus, oxalate that is generated in the liver and/or absorbed from the intestine must be eliminated by the kidneys. Among genetic causes, primary hyperoxaluria (PH) type 1 is the most common and occurs due to deficiency of hepatic peroxisomal alanine glyoxalate aminotransferase. PH2 is caused by deficiency of lysosomal glyoxalate reductase or hydroxypyruvate reductase, whereas PH3 results from deficiency of mitochondrial 4-hydroxy-2-oxoglutarate aldolase. Enteric hyperoxaluria is caused by excessive colonic oxalate absorption due to any type of fat malabsorption. The diagnosis of hyperoxaluria is based on the history, 24-hour urine studies, and genetic testing. Early diagnosis and timely intervention are essential. To treat PH, adequate fluid intake, inhibitors of calcium oxalate crystallization (citrate or neutral phosphorus), and pyridoxine-in responsive patients are all important. Intensive dialysis and prompt kidney or combined kidney-liver transplantation are essential to minimize systemic oxalosis if renal failure occurs. Dietary modifications (low fat, low oxalate, and adequate calcium) are key for enteric hyperoxaluria. Calcium can be used as an oxalate binder. Newer modalities including oxalate degrading bacteria, oral oxalate decarboxylase preparations, and inhibitory ribonucleic acids are all under investigation.

This review contains 9 figures, 6 tables, and 90 references.
Key Words: bariatric surgery, calcium oxalate, dialysis, enteric hyperoxaluria, fat malabsorption, genetic testing, kidney stone, nephrolithiasis, oxalate, oxalate decarboxylase, Oxalobacter formigenes, primary hyperoxaluria, pyridoxine, transplantation, urolithiasis
Surgical Treatment of Female Stress Urinary Incontinence: Pubovaginal Slings
Authors: Gomelsky Alex , Islam Tameem , Karaman Umar R
Published: January 2021

Autologous tissue has been used for pubovaginal sling construction for over a century. Compared with synthetic materials, fascial harvest carries additional and expected morbidity. However, by the nature of its definition, the use of autologous tissues is not associated with a significant immunogenic or any foreign body response. Randomized controlled trials have demonstrated and confirmed the durability of these procedures when compared with both colposuspensions and synthetic midurethral sling procedures. In light of the recent FDA warning regarding the use of synthetic materials for stress incontinence and pelvic organ prolapse surgery, the role of the autologous sling may be more prominent going forward. As such, the autologous pubovaginal sling remains a standard of care for the management of female stress urinary incontinence.
 
This review contains 6 figures and 30 references
Key words: autologous rectus fascia, complications, outcomes, pubovaginal sling, randomized controlled trials, stress urinary incontinence
Female Bladder Exstrophy Repair
Authors: Baumgartner Timothy S. , Gearhart John P.
Published: January 2021

This chapter details the latest surgical advances and outcomes in the modern surgical management of female classic bladder exstrophy to include patient selection for closure, operative considerations, and outcomes. In addition, it addresses the most common pitfalls and challenges encountered when accomplishing each of the major surgical interventions. This chapter also reviews the incidence, embryology, and anatomic considerations when approaching the treatment of the exstrophy patient.
 This review contains 4 figures, and 36 references. 
Key Words: bladder exstrophy, congenital defect, embryology, epispadias, pelvic floor, reconstruction, sexual function, urinary continence
Endovascular Procedures For Lower Extremity Vascular Disease
Authors: Davies Mark G.
Published: January 2021

The application of endovascular procedures to lower extremity vascular disease is now established as the first-line intervention and has supplanted conventional open surgical approaches for most common vascular diseases. This new review details several common endovascular techniques and therapies used in the lower extremity arterial and venous systems by vascular surgery providers. The author's comprehensive approach to each procedure includes preprocedure “basics,” technical steps, adjunct therapies, troubleshooting, and postprocedure outcomes and considerations. There are three treatment algorithms, six figures, and 78 references in this chapter. As endovascular therapy for patients with lower extremity disease evolves, the algorithms for patient treatment are likely to evolve in concert.
Injuries to the Peripheral Blood Vessels
Authors: Fox Charles J.
Published: January 2021

Contributions from the armed conflicts of the 20th century have defined the standards for vessel ligation or repair of arterial and venous injuries. Since the Vietnam War, there has been considerable modernization in the battlefield medical environment, and forward surgical capability, expeditious evacuation and new and effective resuscitation strategies have provided the foundation for innovation and progress. Lessons learned during current US military operations continue to advance the practice of vascular trauma surgery, and these techniques are directly translated to surgical practices in trauma centers around the world. This review covers mechanisms and sites of extremity vascular injury,  initial assessment,  management, and special considerations. Figures show an avulsion injury, in which an artery is stretched, an algorithm for the workup of a patient with a potential extremity vascular injury, an algorithm for the management of complex extremity trauma, exposure of the axillary artery, exposure of the brachial artery, exposure of the femoral artery, medial exposure of the proximal and distal popliteal arteries, the two-incision technique for lower leg decompression in compartment syndrome, and incisions for forearm decompression in compartment syndrome.

This review contains 11 figures, 6 tables, and 84 references