bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of SARS-CoV-2 Specific Memory B cells to Delineate Long-Term COVID-19 Immunity
Authors: Thieme Constantin , Abou-el-Enein Mohamed , Fritsche Enrico , Anft Moritz , Skrzypczyk Sarah , Doevelaar Adrian-Atila-Nicolas , Elsallab Magdi , Brindle Nicola , Paniskaki Krystallenia , Seibert Felix , Witzke Oliver , Westhoff Timm , Stervbo Ulrik , Heine Guido , Roch Toralf , Babel Nina
Published: January 2021

Background: The ongoing COVID-19 pandemic, caused by the novel
coronavirus SARS-CoV-2, represents a serious worldwide health concern. A
deeper understanding of the immune response to SARS-CoV-2 will be
required to refine vaccine development and efficacy as well as to
evaluate long-term immunity in convalescent patients. With this in mind,
we investigated the formation of SARS-CoV-2 specific BMEMORY cells from
patient blood samples. Methods: A standard flow cytometry-based protocol
for the detection of SARS-CoV-2 specific B cells was applied using
fluorochrome-coupled SARS-CoV-2 spike (S) full-length protein. Cohorts
of 26 central European convalescent mild/moderate COVID-19 patients and
14 healthy donors were assessed for the levels of SARS-CoV-2 S- specific
BMEMORY cells. Results: Overall B cell composition was not affected by
SARS-CoV-2 infection in convalescent patients. Our analysis of
SARS-CoV-2 specific BMEMORY cells in samples collected at different time
points revealed that S-protein specific B cells remain in peripheral
blood at least up to 6 months after COVID-19 diagnosis. Conclusions:
Detection of SARS-CoV-2 specific BMEMORY cells may improve our
understanding of the long-term adaptive immunity in response to
SARS-CoV-2, allowing for an improved public health response and vaccine
development during the COVID-19 pandemic. Further validation of the
study in larger and more diverse populations and a more extended
observation period will be required.
Pedagogy empowered by technology
Authors: Supple Briony , Fennell Claire
Published: January 2021

With the increasing ubiquity of web-based tools to facilitate learning and teaching, educators across universities worldwide are now required to prepare and deliver online programs. This requirement may be part of, or in addition to their face-to-face delivery workloads, or as part of migrating programs to be delivered ‘purely online’. In moving towards these new approaches to teaching and learning, there are a number of competing and significant challenges facing staff:

There is no one universal definition of online learning;

Existing workload models represent traditional forms of content delivery;

Prestige of research over teaching still largely exists across the sector (Bradwell, 2009; Keengwe & Kidd, 2010; HEA, 2014; OECD, 2005; O’Connor, 2009; Woodley, Funk & Curran, 2013).

With digital skill-building very much on the Irish national agenda for higher education (National Forum, 2015), institutions are now facing important decisions around how best to support staff and foster cultural change towards new technologically-enhanced learning paradigms.

This position paper draws on research undertaken at local, national and international levels and is focussed around providing an underpinning for the following:

a) Working definitions of what constitutes various forms of online delivery

b) Policy documentation around workload models

c) Recommendations for future directions.

This paper aims to provide a reference point for academics, sessional staff and heads of school regarding current best practice and recommendations for online teaching and learning in higher education.
Desmoid-type Fibromatosis
Authors: Crago Aimee M. , Loftus Timothy M.
Published: January 2021

Desmoid-type fibromatosis is a rare disease that does not have metastatic potential. It can be locally aggressive or regress spontaneously. For this reason, and because many of these tumors are inoperable or surgery is associated with significant morbidity, nonoperative treatment modalities are now more commonly employed to manage these lesions. Active observation, ablative therapies, and systemic treatments such as doxorubicin-based chemotherapy or sorafenib can be prescribed to minimize morbidities associated with the disease and surgical intervention. A thorough understanding regarding desmoid biology and the relative indications for multimodality therapies is essential to triage patients for appropriate interventions.
This review contains 5 figures, and 29 references.
Key Words: active observation, β-catenin, desmoid, familial adenomatous polyposis, fibromatosis, soft tissue tumors
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 58 references.
Key words: Intracerebral hemorrhage; intracranial hemorrhage; intraparenchymal hemorrhage; hemorrhagic stroke; hypertensive hemorrhage; spontaneous intracerebral hemorrhage; ICH; cerebral bleeds
Gastrointestinal Bleeding
Authors: Ziebell Christopher M.
Published: January 2021

Gastrointestinal bleeding occurs when a pathologic process such as ulceration, inflammation, or neoplasia leads to erosion of a blood vessel. Bleeding can occur in the upper gastrointestinal tract (50%) or the lower gastrointestinal tract (40%) or may be obscure (10%), meaning that no definitive source is identified. Gastrointestinal bleeding is common, with major bleeding leading to 1 million hospitalizations every year in the United States. This review details the pathophysiology of gastrointestinal bleeding and the stabilization and assessment, diagnosis, treatment, and disposition and outcomes of patients with gastrointestinal bleeding. Situations requiring special consideration are also discussed. Figures show how gastrointestinal bleeding occurs when a pathologic process causes erosion of the mucosa and exposes a submucosal blood vessel; an ulcer with a raised, red, variceal spot; a Mallory-Weiss tear; the formation of varices; vascular ectasia; treatment of esophageal varices with balloon tamponade; and a wireless capsule. Tables list the major causes of gastrointestinal bleeding, terms relating to gastrointestinal bleeding and their definitions, Blatchford score, substances that interfere with occult blood testing, clinical factors differentiating gastrointestinal bleeding placed in descending order of likelihood ratio, and a summary of American College of Radiology recommendations for angiography in nonvariceal gastrointestinal bleeding.
This review contains 8 figures, 15 tables, and 107 references.
Key Words: gastrointestinal bleeding, inflammation, occult blood testing, UGIB, LGIB, Blatchford score, angiography, wireless capsule endoscopy (WCE)
Asthma
Authors: Nsour Haitham , Dixon Anne E.
Published: January 2021

Asthma is one of the most common diseases in developed nations. A pathognomonic feature of asthma is episodic aggravations of the disease; these exacerbations can be life-threatening and contribute to a significant proportion of the public health burden of asthma. In the emergency department, successful management of asthma exacerbations requires early recognition and intervention before they become severe and potentially fatal. This review summarizes the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes for asthma. Figures show the management of asthma exacerbations in the emergency department and hospital, pooled odds ratio comparing inhaled corticosteroids and oral corticosteroids with oral corticosteroids alone following emergency department discharge, and an asthma discharge plan at the emergency department. Tables list current asthma prevalence among selected demographic groups in the United States, risk factors for fatal asthma exacerbations, differential diagnosis of asthma exacerbations, and dosages of drugs for asthma exacerbations.

This review contains 3 figures, 16 tables, and 88 references.
Key Words: Asthma, allergic bronchopulmonary aspergillosis, gastroesophageal reflux disease, sinus disease, breathlessness, shortness of breath
DEMO REVIEW - Menopause
Authors: Reed Susan D.
Published: January 2021

The female reproductive system matures in a continuous, natural process from menarche to menopause as the finite numbers of oocytes produced during fetal development are gradually lost to ovulation and senescence. Menopause is defined as the permanent cessation of menses; by convention, the diagnosis of menopause is not made until the individual has had 12 months of amenorrhea. Menopause is thus characterized by the menstrual changes that reflect oocyte depletion and subsequent changes in ovarian hormone production. However, hormonal changes, rather than the cessation of menstruation itself, cause the manifestations that occur around the time of menopause. Therefore, a woman who has undergone a hysterectomy but who retains her ovaries can experience normal menopausal symptoms as oocyte depletion leads to changes in estrogen levels, even though cessation of menstruation occurred with surgery. This review covers definitions, natural menopause, menopausal transition and postmenopausal symptom management, and premature ovarian insufficiency. Figures show stages of reproductive aging, serum concentrations of hormones during menopausal transition and postmenopause, hormonal changes associated with reproductive aging, symptoms of menopausal transition and menopause, treatment algorithm(s), and Women’s Health Initiative findings: risks and benefits of estrogen alone and estrogen plus progestin by age group: 50 to 59, 60 to 69, and 70 to 79 years. Tables list target tissues, physical manifestations, and menopausal symptoms; selective estrogen receptor modulators used in postmenopausal women; differential diagnosis and evaluation of common menopausal symptoms; estrogen doses; progestogen dosing for endometrial protection; nonhormonal pharmaceutical hot flash therapies; and pharmacologic therapy for genitourinary atrophy.
This review contains 6 highly rendered figures, 7 tables, and 119 references.
Diagnosis of Dyslipidemia
Authors: Brunzell John D. , Failor R Alan
Published: January 2021

Disorders of lipoprotein metabolism, in conjunction with the prevalence of high-fat diets, obesity, and physical inactivity, have resulted in an epidemic of atherosclerotic disease in the United States and other developed countries. The interaction of common genetic and acquired disorders of lipo­proteins with these adverse environmental factors leads to the premature development of atherosclerosis. In the United States, mortality from coronary artery disease (CAD), particularly in persons younger than 60 years, has been declining since 1970; however, atherosclerotic cardiovascular disease remains the most common cause of death among both men and women.

This review contains 6 figures, 12 tables, and 47 references.
Keywords: dyslipoproteinemias, hepatic lipase,  hyper­lipoproteinemia, hypoalphalipoproteinemia, lipoprotein,
Global Aspects of Chronic Kidney Disease
Authors: Modi Gopesh K , Jha Vivekanand
Published: January 2021

Chronic kidney disease has a high prevalence and a high mortality rate worldwide. Although diabetes and hypertension are common, unique causes of kidney disease may occur driven by infections, exposures, or genetic susceptibilities. Certain agricultural areas in particular have a high incidence of tubulointerstitial kidney disease of unclear etiology. Risk factors may include heat stress, pesticides, heavy metals, and other environmental toxins. Furthermore, countries have disproportionately different prevalence of renal replacement therapy, which seems to correlate in part to the type of health coverage. The future challenges for the nephrology community worldwide will be dealing with the growing number of patients with end-stage kidney disease, the fragmented healthcare in some countries, shortage of kidney transplantation programs, and deficient registries to appropriately assess the prevalence of kidney disease.
This review contains 4 figures, 3 tables, and 54 references.
Key Words: acute kidney injury, chronic kidney disease, end-stage renal disease, epidemiology, ethnic background, HIV-associated nephropathy, noncommunicable diseases, renal replacement therapy, screening, socioeconomic status
Bipolar Disorders and Their Clinical Management, Part I: Epidemiology, Etiology, Genetics, and Neurobiology
Authors: Maletic Vladimir , DeMuri-Maletic Bernadette
Published: January 2021

The concept of bipolar disorders has undergone a substantial evolution over the course of the past two decades. Emerging scientific research no longer supports the notion of bipolar disorder as a discrete neurobiologic entity. Most likely, there are a number of different biotypes with similar phenotypical manifestations. Advancements in genetic research suggest that bipolar disorders have a polygenetic pattern of inheritance, sharing common genetic underpinnings with a number of other psychiatric disorders, including schizophrenia, autistic spectrum disorder, and major depressive disorder. Contemporary etiological theories are discussed in some detail, inclusive of the role of immune disturbances, oxidative stress, and changes in neuroplasticity and neurotransmission, which underpin functional and structural brain changes associated with bipolar disorders. Contemporary epidemiologic research and understanding of disease evolution are discussed from the perspective of its clinical relevance. Our review provides a succinct summary of relevant literature.
This review contains 4 figures, 2 tables, and 80 references.
Key Words: bipolar disorders, endocrine disturbances, epidemiology, genetics, glia, immunity, neurobiology, neuroplasticity, neurotransmitters
Premenstrual Syndrome
Authors: Berga Sarah L , Spencer Jessica B
Published: January 2021

Premenstrual syndrome (PMS) is a recurrent constellation of affective and physical symptoms that begin during the luteal phase of the menstrual cycle and resolve completely or almost completely during the follicular phase. Symptoms range in severity from mild to severe. The pathophysiology of PMS is discussed in this chapter, and potential causes are listed in a table. The diagnosis and differential diagnosis are reviewed. To warrant medical attention, evaluation, and intervention, premenstrual symptoms must be recurrent and sufficiently severe to interfere with daily work and social activities. Mild cases of PMS can be treated with lifestyle modification (e.g., good sleep patterns, regular exercise) and nonpharmacologic therapy (e.g., bright-light therapy, stress management, behavioral therapy). More severe cases warrant aggressive intervention, with pharmacologic therapy and even surgery in women who respond very well to a gonadotropin-releasing hormone (GnRH) agonist and have completed childbearing.

This review contains 1 figure, 5 tables and 51 references
Key Words: Premenstrual syndrome, premenstrual dysphoric disorder, selective serotonin reuptake inhibitors, anxiogenic progesterone metabolites, estrogen, progesterone.
The Puerperium
Authors: Kleinman Sarah , Ricciotti Hope A
Published: January 2021

The puerperium starts after the birth of a baby and continues until 6 to 8 weeks postpartum. Several recent interventions in management have been shown to improve outcomes. Delayed cord clamping, the practice of waiting for a period of time after a baby is born before clamping and cutting the umbilical cord, can increase hemoglobin levels, improve iron stores, and increase birth weight in newborns. Rooming in, the practice of mothers and newborns staying together, improves infant sleep and breast-feeding without affecting maternal sleep. Immediately after birth, significant physiologic and anatomic changes occur. Thromboembolic events are more common in the postpartum state than during pregnancy, but the majority of women do not require specific thromboprophylaxis but should be encouraged to walk after birth. Women who have not been previously immunized for influenza; tetanus, diphtheria, pertussis (Tdap); and rubella should be offered these immunizations. Women with uncomplicated pregnancies may engage in exercise within days after delivery. Pelvic floor physical therapy performed during pregnancy and postpartum may assist in maintaining or regaining muscle tone of the pelvic floor and may prevent or treat urinary incontinence. Perinatal depression affects one in seven women. Baby blues, which include mood swings, anxiety, tearfulness, and insomnia, should resolve by 2 weeks after delivery. Patients should be screened for depression using a standardized, validated tool and appropriate treatment initiated. All women should undergo a comprehensive postpartum visit within 6 weeks of delivery.
 
This review contains 2 figures, 4 tables and 34 references
Key words: delayed cord clamping, hemodynamic changes, perinatal depression, postpartum, puerperium, rooming in, skin-to-skin contact
Psychiatric Diseases in Pregnancy
Authors: Ludgin Jennifer , Sverdlov Deanna , Norwitz Errol R.
Published: January 2021

The exacerbation of pre-existing psychiatric conditions and the development of a new-onset psychiatric disorder during pregnancy directly affects the care of pregnant women. Depression and anxiety are highly prevalent in reproductive age women and may be exacerbated in the perinatal and postpartum periods. Post-traumatic stress disorder is another common condition seen in this population and may worsen under the stress of pregnancy, delivery, and childrearing. Substance abuse is also pervasive in this population, requiring obstetricians to have a thorough understanding of how to manage and treat pregnant women with dependence disorders. Psychiatric conditions and substance abuse often co-exist. These and other disorders present significant risk to the mother and fetus. It is essential therefore for obstetric care providers to understand how to screen for, diagnose, and treat psychiatric disorders during pregnancy and in the postpartum period.
This review contains 4 tables, and 58 references.
Keywords: perinatal depression, postpartum depression, postpartum psychosis, anxiety in pregnancy, substance abuse in pregnancy, post-traumatic stress disorder in pregnancy, eating disorders in pregnancy, pregnancy screening
Fetal Infections I: Viral Infections
Authors: Diouf Khady , Tuomala Ruth , Nour Nawal M
Published: January 2021

Viral infections in pregnancy can lead to significant maternal and fetal morbidity and mortality. They can have varying effects on pregnancy outcomes including spontaneous abortion, intrauterine growth restriction, intrauterine fetal demise, and fetal infection. Compared to infections acquired in the second or third trimester, infections in the first trimester usually carry a lower risk of transmission to the fetus, but may be more detrimental since they are acquired during the period of organogenesis. Although not all fetal infections lead to congenital defects, infants can be severely affected at birth and develop disease manifestations throughout the first few years of life. Most viral infections do not have effective treatment strategies when diagnosed during pregnancy, but prenatal screening for certain viruses may play an important role in educating pregnant women. Immunization strategies may also aid in preventing disease acquisition for some of these viral illnesses.
This review contains 4 tables, 10 figures and 56 references.
Keywords: CMV, congenital transmission, fetal viral infection, herpes virus, mother to child transmission, parvovirus, placenta, protozoa, rubella, teratogenicity, toxoplasmosis
Prepubertal Vulvovaginitis
Authors: Huhmann Kimberly , Thieu Hong-Thao
Published: January 2021

Vulvar and vaginal irritation/redness and vaginal discharge are common referrals to the pediatric and adolescent gynecologist. In nearly 75% of cases the etiology of the pre-pubertal patient’s signs and symptoms is non-specific and resolves with proper vulvar hygiene. Infections, ulcerations, labial adhesions, foreign bodies, constipation, voiding dysfunction, and trauma are other causes of vulvar and vaginal complaints. Gathering a detailed history and performing a thorough physical exam help to determine the etiology and best treatment. Staphylococcal aureus and Streptococcus pyogenes infections are frequently isolated on vaginal cultures and treated with organism specific antibiotics. Ulcerations are usually from a self-limiting viral infection (EBV, CMV, influenza) and heal with supportive cares—acetaminophen and sitz baths. Labial adhesions recede with topical estrogen cream in up to 89% of cases and rarely need surgical separation. When vulvovaginitis persists despite hygiene measures and no evidence of infectious etiology assessment and treatment of constipation and voiding dysfunction can provide relief of symptoms.
This review contains 1 table and 28 references.
 Key words: Vulvovaginitis, vulvar hygiene, vagina hygiene, vaginal infection, labial adhesions, vulvar trauma, genital ulcer, vaginal foreign body, constipation, pre-pubertal voiding dysfunction
Invasive Prenatal Diagnosis
Authors: Zayhowski Kimberly
Published: January 2021

Despite recent advances in genetic technologies that are making invasive prenatal diagnosis less common, amniocentesis and chorionic villus sampling (CVS) remain an integral part of prenatal care. A multitude of tests, including a variety of genetic tests, can be performed using samples collected from either procedure. Although invasive testing has limitations, many genetic conditions can only be diagnosed through invasive techniques during pregnancy. Invasive testing continues to assist patients and providers in making informed decisions regarding the care of pregnancies. This review details amniocentesis and chorionic villus sampling with a focus on genetic testing, describing why the tests are performed, the way in which they are performed, and the associated limitations and complications of the procedures. 
This review 5 figures, 3 tables, and 26 references.
Keywords: prenatal diagnosis, amniocentesis, chorionic villus sampling, genetic testing, genetic counseling, invasive prenatal testing, pregnancy, aneuploidy
Cancer of the Endometrium
Authors: Young Kim B.
Published: January 2021

Endometrial cancer is the most common gynecologic cancer in women. Most patients are in the early stages at diagnosis and have a favorable prognosis. Minimally invasive hysterectomy is the cornerstone of management. The optimal approach to surgical assessment of lymph nodes is controversial. A minority of early-stage patients have tumors with high-risk features that warrant further treatment, usually vaginal brachytherapy. Patients with advanced disease generally require multimodality treatment to achieve the best outcomes. Selected patients desiring future childbearing can be treated with fertility-sparing options. Routine immunohistochemistry on tumor specimens looking for expression of mismatch repair proteins is an effective method to screen for Lynch syndrome.
 
This review contains 4 figures, 3 tables and 30 references
Key Words: adenocarcinoma, chemotherapy, endometrial cancer, lymphadenectomy, Lynch, Progestin, radiation, sentinel, uterus
Pediatric Abdominal Emergencies
Authors: Bullard-Berent Jeffrey , Kornblith Aaron
Published: January 2021

Pediatric abdominal emergencies represent a diverse group of conditions affecting children of all ages and are a common cause of emergency department visits. The challenge for emergency physicians is discerning which child presenting with the common complaints of abdominal pain, nausea, vomiting, and diarrhea has an abdominal emergency. The emergency physician must use a thorough history, developmentally appropriate examination skills, and integration of his or her knowledge base to arrive at the correct diagnosis. This review evaluates the most common pediatric abdominal emergencies organized by chronicity from birth to adolescents: midgut volvulus, infantile hypertrophic pyloric stenosis, incarcerated inguinal hernia, ileocecal intussusception, Meckel diverticulum, and appendicitis. Readers will understand common presentations as well as the evaluation and treatment options for each diagnosis.  

This review contains 7 figures, 6 tables and 61 references

Key words: abdominal pain, appendicitis, hernia, hypertrophic pyloric stenosis, intussusception, Meckel diverticulum, midgut volvulus
Pediatric Hematologic And Oncologic Emergencies
Authors: Milligan Rebecca , Mendelson Jenny
Published: January 2021

Hematologic and oncologic emergencies that afflict children and adolescents are important for emergency medicine physicians to recognize. Pediatric patients can present with a previous formal diagnosis and have a complication related to their disease or with new symptoms that suggest a hematologic or oncologic process. Oncologic treatments can also lead to life-threatening complications. Recognizing these emergencies is very important for emergency physicians to prevent further morbidity. This review covers common patient presentations, diagnosis, and treatments for hematologic and oncologic emergencies.
 This review contains 6 figures, 7 tables and 48 references
Key words: hematology, hemophilia, immune thrombocytopenia, neutropenic fever, oncology, pediatric, sickle cell anemia, tumor lysis syndrome, von Willebrand disease
Open Eyebrow Correction
Authors: Gardenier Jason , Driscoll Daniel
Published: January 2021

The open brow lift is a powerful tool for facial rejuvenation of the upper third of the face which can address rhytids, upper eyelid hooding, and brow ptosis. With a history dating back over a hundred years, a variety of techniques have been described including coronal, pretrichial, mid-forehead, direct supraciliary, and transpalpebral brow lifts. These vary in terms of invasiveness and the ideal approach is determined by patient age, sex, symmetry, and anterior hairline characteristics. While endoscopic techniques became popular in the 1990s based on novelty, smaller incisions, less post-scar numbness, and a perception of less invasive nature, this technique’s popularity has diminished recently and less invasive open approaches have become more popular. Recent years have seen the numbers of all forms of brow lift become less common as neuromodulators, such as botulinum toxin, allow for chemical denervation of brow depressor muscles. This has become a truly non-invasive way to address minor forms of aging of the forehead and brow. However, for advanced cases, open brow lift remains a powerful technique which should remain in the arsenal of the plastic surgeon.
This review contains 3 figures, 2 tables, and 39 references.
Keywords: cosmetic surgery, facial plastic surgery, facial aging, brow ptosis, rhytids, facial nerve, supraorbital nerve, supratrochlear nerve
Facial Fractures
Authors: Bojovic Branko , Buta Martin
Published: January 2021

The understanding and management of craniofacial fractures have evolved through remarkable innovations in high-resolution imaging, surgical and fixation techniques, endoscopy, biomaterials and implants, bone grafting, new and refined classification frameworks, and algorithms for intervention. The concept of facial buttresses first described forty years ago now serves as a guide to reconstruction of the underlying skeleton to re-establish the height, width, and projection of the face. With the advent of 3D computed tomography and intraoperative imaging, surgeons have expanded the armamentarium for surgical planning and navigation, especially beneficial for accurate repair in complex cases. All of these advances have improved patient outcomes and raised expectations for functionally and aesthetically acceptable results. A brief overview of the assessment and management of facial fractures is presented.
This review contains 1 figure, 4 tables, and 43 references.
Key words: facial fracture, facial trauma, plastic surgery, orbital, maxillofacial, injury, Le Fort, malocclusion, skeletal buttress
Facial Transplantation
Authors: Aycart Mario A , Pomahac Bohdan
Published: January 2021

Although significant advances in craniofacial and microsurgical reconstructive techniques have allowed for the reliable reconstruction of complex head and neck defects, there are limitations to conventional therapy. In the past decade, the medical community has witnessed the growth and evolution of facial transplantation in becoming a clinical reality for the most severely disfigured individuals. Despite recent advances and promising short-term results, the risk-benefit trade-off is still evolving as more experience is gained. This chapter provides a comprehensive overview of indications, recipient evaluation, and immunosuppression. The latest outcomes’ data including functional outcomes, costs, quality of life, complications, and deaths from the emerging field of facial transplantation are also reviewed.

This review contains 11 figures, 5 tables and 92 references
Key Words: Facial Transplantation, Vascularized composite allotransplantation, Composite tissue transplantation, Reconstruction Microsurgery, Craniofacial Surgery, Transplant Surgery, Immunosuppression, Functional Outcomes
Gynecomastia and Congenital Anomalies of the Breast
Authors: Smith J. Michael , Broyles Justin M.
Published: January 2021

Breast and chest wall appearance is an important component of an individual’s body image that can have a profound impact on their psychological well-being. Given the inherent complexity of breast embryogenesis, multiple anomalies exist that differ with respect to their clinical management and reconstructive approach. In this review, the authors outline fundamentals of breast embryology, pathophysiology of common congenital breast and chest wall anomalies, and potential reconstructive solutions. It is the aim of this chapter to provide readers with a broad yet concise overview of the spectrum of congenital breast and chess wall disorders to aid in the proper diagnosis and management of affected patients.
This review contains 7 tables, and 4 figures, and 31 references.
Keywords: breast embryology, pediatric breast reconstruction, gynecomastia, juvenile hypertrophy, polythelia, athelia, Poland syndrome, congenital breast
Medical and Surgical Treatment of Vasculitic and Autoimmune Ulcers
Authors: Bekeny Jenna C. , Zolper Elizabeth G. , Kotha Vikas S. , Fan Kenneth L. , Deane Benedict Mitnick Carol , Evans Karen K.
Published: January 2021

Chronic wounds of autoimmune and vasculitic etiologies, collectively referred to as “atypical ulcers”, are complex and heterogeneous. Evidence for a standardized approach remains deficient. Diagnosis requires a thorough history, physical exam, and investigative studies including serologic tests and wound biopsies. Management must be multidisciplinary and tailored to the individual patient and the unique characteristics of their wound. Medical therapy to stabilize the underlying disease is the most important aspect of therapy. Surgical intervention is often not appropriate and even contraindicated in some scenarios such as pyoderma gangrenosum. When medical therapy and local wound care fail and surgical intervention is deemed appropriate, inflammation must first be controlled with medical intervention before surgical intervention can be considered.
This review contains 5 figures, 2 tables, and 26 references.
Keywords: ulcer, wound healing, autoimmune diseases, vasculitis, pyoderma gangrenosum, scleroderma, rheumatoid nodule, immunosuppressive agents, rheumatology, patient care team
Wounds in Patients with Cancer
Authors: Clemens Mark W. , Blumenauer Brian J. , Francis Ashleigh M. , Olenczak Jonathon B. , Selber Jesse C. , Kapur Sahil K.
Published: January 2021

Reconstructive surgery plays an integral role in helping restore form and function in patients with complex oncologic wounds. The intricate process of wound healing can be adversely affected by exposure to chemotherapeutic and radiation therapies. Assessment of available donor tissue quality, previous radiation therapy, vascular status, and donor site morbidity are essential when determining the most appropriate reconstructive approach for definitive wound management. The timing of reconstruction in relation to chemotherapy or radiotherapy regimens influences wound healing. Additionally, the timing of reconstruction is important in order to avoid delaying additional adjuvant therapies. Optimizing nutritional status is critical for improved patient outcomes in the oncologic patient population. At times, palliative efforts by means of surgical debulking are required of a reconstructive surgeon as advanced cancers can leave patients with disfiguring, fungating masses.
This review contains 9 figures, and 44 references.
Keywords: wounds in cancer, wounds in the cancer patient, oncologic wounds, oncologic wound healing, oncologic wound management, wound complications, effect of chemotherapy on wound healing, effect of radiation therapy on wound healing, oncologic reconstruction
Treatment of Diabetic Foot Infections
Authors: Aoki Shimpo , Bayer Lauren R , Orgill Dennis P
Published: January 2021

Thirteen percent of diabetic patients will develop a foot ulcer, often associated with infection, vascular disease and biomechanical changes. Limb salvage offers the potential to restore function but does not correct the underlying metabolic disturbance. We review the surgical approach to diabetic foot infections including debridement, skin grafts, local flaps and a variety of new technologies. A comprehensive multidisciplinary approach is beneficial to optimize outcomes. The full range of reconstructive options available to plastic surgeons may be used in the treatment of diabetic foot ulcers.
This review has 5 figures, 2 tables, and 20 references.
Key words: Diabetic Foot Infection (DFI), Diabetic Foot Ulcer (DFU), Diabetes Mellitus (DM), wound care, foot infection, bacterial infection, surgical management, neuropathy, surgery of the lower extremity, deformities
Reconstruction of the Abdominal Wall with Mesh II: Ventral Hernia Repair
Authors: Ross Samuel W. , Heniford B. Todd , Augenstein Vedra A.
Published: January 2021

Incisional and Ventral hernia repair (VHR) is one of the most common surgical procedures in the world, and over the last two decades this field has enjoyed exponentially advances thanks to improvements in operative technique and biomechanical science. Truly complex hernias which are multiply recurrent, have active infections, loss of domain, presence of stomas, require component separation or panniculectomy, or have other exacerbating factors are truly challenging to manage operatively, and the multidisciplinary operations to repair them have become known collectively as abdominal wall reconstruction (AWR). Herein, we describe the surgical history of AWR, the current state of surgical techniques and mesh science, as well as novel areas for advancement of the field in the future. In particular, a focus on patient specific clinical outcomes such as hernia recurrence, wound complications, and quality of life has been made with regards to mesh position and selection. Our goal is to provide a comprehensive review of the state of the literature and our recommendations for AWR, for the Plastic, General, and Hernia surgeon alike.
This review contains 7 figures, 3 tables, and 79 references.
Keywords: ventral hernia repair, incisional hernia, abdominal wall reconstruction, mesh, pre-peritoneal hernia repair, pre-operative optimization, clinical outcomes, mesh position, surgical site infection, robotic hernia repair
Osteoarthritis of the Thumb Basilar Joint
Authors: Straszewski Andrew J , Moriatis Wolf Jennifer
Published: January 2021

Osteoarthritis of the thumb basilar joint is a common pathology treated by hand surgeons, and this is the leading cause of degenerative pain in the hand. Multi-factorial etiologies, including occupational stresses, gender, hormone milieu, and altered biomechanics, may play roles in the development of thumb carpometacarpal (CMC) joint arthritis.  Patients present with aching pain, synovitis, weakened pinch and grip, and in late disease, adduction deformity and web space contracture. Physical examination and plain radiography are the mainstay of diagnosis, with little utility for advanced imaging.  A multitude of options exists for conservative treatment: physical therapy, splinting, anti-inflammatories, and injections.  With the failure of conservative therapies, surgical management is dictated by disease severity and provider preference.   The thumb CMC joint hosts a variety of treatment options that have evolved over time: arthroscopy, osteotomy, arthrodesis, trapeziectomy alone, or with combinations of ligament reconstruction and tendon interposition.  No superiority has been shown amongst the many base of thumb treatment modalities, though trapeziectomy alone demonstrates a lower complication rate.
This review contains 5 tables, 3 figures, and 61 references.
Keywords: hand osteoarthritis, base of thumb, anatomy, arthroplasty, silicone, arthrodesis, tendon reconstruction, biomechanics, tendon interposition, outcomes
Parasomnias
Authors: Im KyoungBin
Published: January 2021

Parasomnias have long been recognized as part of sleep-related disorders or diseases in the mental disorders classification system such as Diagnostic and Statistical Manual of Mental Disorders. Nevertheless, many parasomnia symptoms are considered as a transient deviation from the norm in otherwise normal subjects due to disrupted status of consciousness. Sleep states are classified as rapid eye movement (REM) sleep and non-REM (NREM) sleep; similarly, parasomnias are classified as NREM-related parasomnias and REM-related parasomnias. NREM-related parasomnias share common pathophysiology of arousal-related phenomenon out of slow-wave sleep. Although listed as REM parasomnia disorders, nightmares and sleep paralysis are still considered comorbid symptoms or signs of other sleep disorders or mental disorders. Only REM sleep behavior disorder (RBD) is considered a relatively homogenous disease entity among all parasomnia diagnoses. Although RBD is the most newly added disorder entity in parasomnias, it is the most rigorously studied parasomnia such as RBD is strongly and clearly associated with concomitant or future developing neurodegenerative disease.
This review contains 1 figure, 4 tables, and 18 references.
Key Words: confusional arousals, dream enactment, pseudo-RBD, REM sleep behavior disorder, sleep-related eating, sleep terror, sleepwalking
Neurostimulation
Authors: Aaronson Scott , Croarkin Paul
Published: January 2021

Neurostimulation modalities in psychiatric practice and research efforts use magnetic and electric fields to modulate neuronal functioning. Physicians have used these modalities since ancient history, but most modern brain stimulation treatments developed after the inception electroconvulsive therapy in 1937. Noninvasive brain stimulation generally refers to treatments that do not require surgery, such as electroconvulsive therapy, repetitive transcranial magnetic stimulation, and transcranial current stimulation. Conversely, deep brain stimulation and vagal nerve stimulation are the two most researched invasive brain stimulation modalities for psychiatric disorders. Treatment with repetitive transcranial magnetic stimulation has been shown to be effective for the treatment of resistant major depressive disorders but is less rapid acting and may be optimal for a different patient population as compared to electroconvulsive therapy. Research focused on transcranial direct current stimulation continues to expand, but its role in clinical psychiatric practice is currently not well defined. Despite mixed and, in some cases, disappointing results, invasive brain stimulation techniques such as deep brain stimulation and vagal nerve stimulation will likely continue to have an important role for certain treatment-resistant populations in psychiatric practice. This review examines the development, basic physiologic mechanisms, and evidence base of neurostimulation modalities in psychiatry.
 
This review contains 4 figures, 6 tables and 38 references
Key Words: deep brain stimulation, invasive, neurostimulation, noninvasive, transcranial direct current stimulation, transcranial electrical stimulation, transcranial magnetic stimulation, treatment-resistant depression, vagal nerve stimulation
Collaborative Care Models in Psychiatry
Authors: Gainer Danielle M. , Fischer Karley B. , Nouri Parvaneh K.
Published: January 2021

Integrated care models allow a team of providers to interact in a systematic manner, producing cost-effective and superior outcomes for patients. The collaborative care model (CCoM), one type of integrated care, has emerged as one approach with over 80 randomized controlled trials to support its efficacy. In this model, a behavioral health provider offers evidence-based, brief interventions but also serves as a liaison between the patient, medical providers, and the psychiatric consultant. The team also monitors outcomes through a registry and provides a stepped care approach to adjust interventions collaboratively, as needed. If the barriers to integrated care implementation are surmounted, psychiatrists working as consultants in this model can provide care in an efficient and sustainable manner.
This review contains 5 figures, 5 tables, and 48 references.
Key Words: barriers to implementation, behavioral health provider, collaborative care, cost-effective, integrated care, psychiatric consultant, cost-effective, registry, stepped care
Resource Management: Parity and Access to Care
Authors: East Destry L. , Peirson Ryan P.
Published: January 2021

The current structure of our mental health parity laws are a combination of multiple bills at the national and state levels which have been passed since the original Mental Health Parity and Addiction Act of 2008 (MHPAEA). With the MHPAEA only employer-provided insurance programs that covered 50 or more employees and covered mental health services were required to have parity between mental health and physical health coverage. With the passage of the Affordable Care Act in 2010 and its essential benefit mandate (which required the coverage of mental health services) the MHPAEA broadened its reach to include smaller health plans and some Medicaid plans. Reforms in Medicare, CHIP and Tricare also have included parity between mental health and physical health coverage. Despite these changes there is still work needed in regards to state parity laws and better access to care.
This review contains 5 figures, and 25 references.
Key Words: Parity, Mental Health, Access, Coverage, MHPA, MHPAEA, NQTL, Essential Health Benefits
Time Is on Our Side: Age as a Diagnostic and Pathologic Clue in Pediatric Movement Disorders
Authors: Dy Marisela E. , Aravamuthan Bhooma R. , Waugh Jeff L.
Published: January 2021

Pediatric movement disorders encompass a heterogeneous array of neurologic symptoms and syndromes and may be acquired or inherited. Movement phenomenology and age at symptom onset provide important clues in identifying the underlying etiology and establishing a diagnosis. Movement disorders are classified as hyperkinetic (increased movement) or hypokinetic (reduced amplitude and/or rate of movement). In children, hyperkinetic movement disorders are substantially more common than hypokinetic disorders; in adults, a mix of hyper- and hypokinetic disorders is the norm. We present a framework for evaluating a child with abnormal movements and describe a broad range of pediatric movement disorders: chorea, neurotransmitter-associated syndromes, tic disorders, stereotypies, primary dystonias, and dystonic cerebral palsy. Recently described genes associated with pediatric movement disorders, such as ADCY5-related dyskinesia, NKX2.1-associated chorea and dystonia, and the primary dystonias (DYT2 and DYT26), are highlighted. The developmental regulation of neurotransmitter metabolism, a dynamic process that leads to dramatic shifts in neurotransmitter availability in childhood and adolescence, is also reviewed. The myelination and maturation of long-range neuronal networks are described, and the timing of these changes is related to the timing of childhood movement disorders. Incorporating age and timing into a framework for assessing abnormal movements in children has the potential to improve both clinical and research approaches to these disorders. Understanding the genetic and pathophysiologic bases of abnormal movements may aid clinicians in rapidly recognizing and distinguishing these disorders. Recognizing the clinical specificity and age dependency of abnormal movements in children may guide researchers in identifying the molecular underpinnings of these disorders. 
Key words: Movement disorders, gene expression, childhood development, childhood hyperkinetic disorders
Migraine: Psychiatric Comorbidities
Authors: Smitherman Todd A , Black Anna Katherine , Walters Pellegrino A Brooke
Published: January 2021

Psychiatric disorders often co-occur with migraine, and these comorbid conditions compound disability and are risk factors for medication overuse and migraine progression. For these reasons, attention to psychiatric comorbidities in clinical practice is of paramount importance. Assessment of depression, anxiety, and sleep disorders is recommended, focusing on the core cognitive and emotional symptoms of the comorbidities and using measures validated among medical patients. Pharmacologic treatment of migraine and comorbid psychiatric conditions is challenging owing to a lack of agents with proven efficacy for both conditions, side effect profiles that may exacerbate one condition, and potential drug interactions. Existing data suggest that migraineurs with psychiatric symptomatology can obtain positive outcomes with appropriate preventive medications, behavioral interventions for headache or the comorbid condition, or a combination thereof.
Keywords: anxiety, comorbidity, depression, insomnia, migraine, pharmacotherapy, relaxation, stress management
Medical Management of Neurogenic Bladder
Authors: Cameron Anne P , Stoffel John T
Published: January 2021

In the management of neurogenic bladder (NGB), the goals are first and foremost to protect the upper tract from damage. The second treatment goal is to maintain urinary continence, but all the while maintaining the patient’s quality of life. These goals are achieved by treating most patients with NGB in a targeted fashion based on urodynamic findings. Medical therapy optimization and appropriate bladder drainage are the cornerstones of NGB management. Detrusor overactivity, poor bladder compliance, and incontinence related to these are best initially managed with antimuscarinic agents,; however, there is an increasing role for the new beta3 agonists. In the event these therapies fail, botulinum toxin is often the next choice; however,  is an expensive treatment, and some patients may be treated with combination drug therapy. Nocturnal polyuria is also extremely common in this group of patients and is quite bothersome. After other risk factors have been excluded, medical treatment with desmopressin may be a suitable alternative.

This review contains 3 highly rendered figures, 2 tables, and 85 references
Key words: adrenergic alpha blockers, antimuscarinics, botulinum toxin, desmopressin, imipramine, mirabegron, multiple sclerosis, neurogenic bladder, spinal cord injury