bluuebunny/crossref_metadata_2025_split huggingface dataset:
Congenital Heart Disease
Authors: Pittsenbarger Zachary , Roben Emily 
Published: January 2021

Congenital heart disease (CHD) is common, affecting approximately 8 in 1000 live-born children, and encompasses a broad range of diagnoses and presentations. CHDs can include inborn derangements in almost any aspect of the hearts structure of function, but the most common type of congenital heart disease are structural lesions of the heart that affect the normal pattern of blood flow. These structural lesions can present with varied symptoms and physical exam signs that are rooted in their underlying blood flow patterns often lead to one of four groups of diseases based on blood flow patterns. Overcirculation, systemic outflow obstruction, systolic failure, and cyanosis are the four groups used as descriptive classifications of structural CHD. CHD findings can be present prenatally, in the newborn nursery, and well child office visits, but very often present to the EDs without any cardiac history when the lesion progresses to a point of crisis when the cardiac output is no longer meeting the body’s perfusion demands. Early presentations of CHD frequently are related to closure of the ductus arteriosus and may benefit from early treatment with prostaglandin E. Lab tests, radiology studies, and exam findings may be suggestive of certain types of lesions, but the gold standard to determine the type of CHD is an echocardiogram. Once the diagnosis of CHD is suspected, consultation with a pediatric cardiologist is highly recommended to arrange the timely evaluation of the child and prompt initiation of therapies if needed to mitigate the disease progression.

Key words: Congenital heart disease, overcirculation, systemic outflow obstruction, systolic failure, and cyanosis, ductus arteriosus
Wide Complex Tachycardia
Authors: Green Gary , Graglia Sally 
Published: January 2021

Wide-complex tachycardias (WCTs) should always alert the emergency physician to a potentially immediate or rapidly developing, life-threatening scenario. The approach to these patients should follow general emergency medicine principles. The review covers the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes of WCT. Figures show a basic electrocardiogram (ECG) tracing, an ambulatory monitoring strip of a patient with recurrent presyncope showing repetitive monomorphic ventricular tachycardia, a 12-lead ECG of a rapid wide QRS tachycardia due to an antidromic atrioventricular reciprocating tachycardia in a patient with Wolff-Parkinson-White (WPW) syndrome, an example of pacemaker-mediated tachycardia, ventricular tachycardia occurring in the context of QT prolongation consistent with torsades de pointes, a 12-lead ECG in a patient with WPW syndrome showing a rapid, irregular ventricular rate and wide QRS complexes of atrial fibrillation with a short refractory period, an ECG representative of tricyclic antidepressant overdose, and an algorithm for identifying patients with systolic heart failure and left ventricular ejection fraction less than or equal to 35% who are candidates for an implantable cardioverter-defibrillator. Tables list causes of regular WCT, causes of prolonged QT interval, common medications with potential QT prolongation activity, pharmacologic treatment options for stable patients with WCT, Kindwall and colleagues’ criteria for ventricular tachycardia, Brugada and colleagues’ criteria for ventricular tachycardia, Vereckei and colleagues’ aVr algorithm for the diagnosis of ventricular tachycardia, and a comparison of self-reported sensitivities, specificities, and test accuracies of the algorithms presented by Kindwall, Brugada, and Vereckei and their colleagues.

Key words: prolonged QT interval, supraventricular tachycardia, ventricular tachycardia, wide-complex tachycardias

This review contains 8 highly rendered figures, 8 tables, and 59 references.
Penetrating Neck Trauma
Authors: Kellogg Adam R. , Davis B. Witkind 
Published: January 2021

Penetrating neck injuries are approximately 1% of all traumatic injuries in the US, yet the case fatality rate approaches 10%. All emergency physicians need to be able to expediently differentiate those requiring emergent interventions from those with less serious injuries. Initial management of penetrating neck injuries focuses on identification of patients requiring early airway management or emergent surgical evaluation. Due to bleeding, anatomic distortion, hemodynamic instability, or potential airway violation patients with penetrating neck trauma should be presumed to have difficult to manage airways. The emergency physician must be prepared to perform cricothyrotomy, and even tracheostomy, should orotracheal intubation attempts fail. Diagnosis of injury in the stable patient with evidence of violation of the platysma has moved away from the traditional zone based approach and now focuses on structured physical exam and the use of MDCTA. Further diagnostic testing may be required dependent on the results of the MDCTA and should be at the direction of a surgeon.

Keywords:
Penetrating Neck Trauma, Laryngotracheal Trauma, Carotid Artery Injury, Airway Management, Cricothyrotomy, Surgical Airway, CT Angiography
Practicing Evidence-Based Medicine (SAGHE)
Authors: Barnett Michael , Choudhry Niteesh 
Published: January 2021

Today, a plethora of resources for evidence-based medicine (EBM) are available via alert services, compendia, and more. In theory, a clinician researching a topic or looking for information regarding a clinical decision should easily find the literature or synopses needed. However, the real challenge lies in recognizing which resources (out of hundreds or possibly thousands) present the best and most reliable evidence. As well, evidence from research is only part of the decision calculus, and the clinician, not the evidence, makes the final decisions. Medical decision analysis attempts to formalize the process and reduce it to algebra, but it is difficult or impossible to represent all the components of a decision mathematically and validly let alone do so in “real time” for individual patients. This review discusses these challenges and more, including how to ask answerable questions, understand the hierarchy for evidence-based information resources, critically appraise evidence, and apply research results to patient care. Figures show the total number of new articles in Medline from 1965 to 2012, a “4S” hierarchy of preappraised medicine, percentage of physician and medical student respondents with a correct or incorrect answer to a question about calculating the positive predictive value of a hypothetical screening test, a nomogram for Bayes’s rule, an example of nomogram use for pulmonary embolism, and a model for evidence-informed clinical decisions. Tables list selected barriers to the implementation of EBM; Patient, Intervention, Comparison, and Outcome (PICO) framework for formulating clinical questions; guides for assessing medical texts for evidence-based features; clinically useful measures of disease frequency and statistical significance and precision; definitions of clinically useful measures of diagnostic test performance and interpretation; definitions of clinically useful measures of treatment effects from clinical trials; summary of results and derived calculations from the North American Symptomatic Carotid Endarterectomy Trial (NASCET); and selected number needed to treat values for common therapies.
This review contains 6 highly rendered figures, 9 tables, and 28 references.
Disorders Involving the Pharynx and Upper Esophagus
Authors: Mashimo Hiroshi 
Published: January 2021

A wide variety of disorders can affect the pharynx and upper esophagus, such as inherited or acquired structural abnormalities, malignancies, and inflammation secondary to a number of etiologies including bacterial, yeast and viral infections, irradiation, and gastroesophageal reflux disorder. Laryngoceles and peritonsillar abscess can also lead to pain and dysfunction. However, this review will focus on the main motility disorders that affect the pharynx and upper esophagus, namely oropharyngeal dysphagia, disorders associated with globus pharyngeus, and Zenker’s diverticulum. Figures show the anatomy of the three stages of normal swallow, various findings on functional endoscopic evaluation of swallowing, electromyography of the cricopharyngeal sphincter and submental muscles, and Zenker’s diverticulum. Tables list causes of oropharyngeal dysphagia, neuromuscular control of the pharyngeal phase (with identified cranial and cervical spinal nerve roots), pathophysiology of oropharyngeal dysplasia, diagnostic tests for oropharyngeal dysplasia, behavioral treatments to improve swallow and reduce aspiration, and potential overlapping causes of impaired upper esophageal sphincter relaxation.

This review contains 4 highly rendered figures, 6 tables, and 40 references

Key words: Oropharyngeal dysphagia; Globus; Upper esophageal sphincter dysfunction; Swallowing disorder; Dysphagia; Zenker’s diverticulum; Swallow assessment; Globus pharyngeus
Viral Hepatitis Other Than A, B, or C
Authors: Anwar Nadeem , Sherman Kenneth E. 
Published: January 2021

Viral hepatitis is a global, although variably distributed, health problem associated with significant morbidity and mortality. Infection with a hepatitis virus leads to acute inflammation and liver cell damage (hepatocyte injury). Such infection may be symptomatic or subclinical and may result in disease resolution, death from fulminant hepatic failure, or development of a chronic disease state. Whereas the chronic infection with hepatitis B and C accounts for a global burden of more than 500,000,000 cases, the global death rate from all types of hepatitis is approximately 1 million people annually. This review focuses on the virology, epidemiology, clinical features, diagnosis, treatment, and prevention of hepatitis D and hepatitis E, as well as other viruses associated with hepatitis. Figures show the global distribution of hepatitis D infection, elevation of anti–hepatitis D virus antibodies in hepatitis B/hepatitis D virus coinfection, geographic distribution of hepatitis E virus by genotype, factors significant in the pathogenesis of hepatitis E, and pattern of antibody elevation in hepatitis E. The table lists proposed diagnostic criteria for hepatitis E virus.
This review contains 5 highly rendered figures, 1 table, and 42 references.
Key words: hepatitis D, hepatitis D virus, hepatitis E, hepatitis E virus, non-A hepatitis, non-B hepatitis, non-C hepatitis, viral hepatitis
Liver Failure in the Critical Care Setting
Authors: DellaVolpe Jeffrey , Al Khafaji Ali 
Published: January 2021

Acute liver failure (ALF) can be challenging to manage due to the effect of liver failure on other organs and the severity of illness that ensues. Both the practicing surgeon and the intensivist should be aware of the manifestations, workup, and management implications as ALF is not uncommon to many intensive care settings. ALF precipitates a severe multiorgan dysfunction syndrome in a majority of cases, with high rates of complications and an elevated risk of death. Management requires a systemic approach in addition to the collaboration of a multidisciplinary team with an emphasis on early recognition, prompt management of complications, and timely transfer to a transplant center. In the absence of spontaneous recovery, transplantation is the only definitive management option and may not always be feasible or immediately available. The continuing search to develop alternatives is essential.
This review contains 2 figures, 9 tables and 70 references
Keywords: acetaminophen, acute liver failure, cerebral edema, coagulopathy, hepatitis, jaundice, N-acetylcysteine, transplantation
Anemia: Production Defects Generally Associated with Marrow Aplasia or Replacement
Authors: Berliner Nancy , Gansner John M 
Published: January 2021

This review focuses on anemia resulting from production defects generally associated with marrow aplasia or replacement. The definition, epidemiology, etiology, pathogenesis, diagnosis, differential diagnosis, management, complications, and prognosis of the following production defects are discussed: Acquired aplastic anemia and acquired pure red cell aplasia. Figures depict a leukoerythroblastic blood smear, a biopsy comparing normal bone marrow and bone marrow showing almost complete aplasia, and a marrow smear. A table lists the causes of aplastic anemia.
This review contains 3 figures; 1 table; 108 references.
Stress Urinary Incontinence I: Nonsurgical Management
Authors: Lozo Svjetlana , Botros Sylvia M 
Published: January 2021

Conservative management of stress urinary incontinence (SUI) is generally offered as first-line treatment. Such treatment options include behavioral therapy, pelvic floor muscle therapy, vaginal devices, pharmacologic therapy, and urethral bulking agents. Weight loss management is an example of an effective behavioral strategy in obese patients. Pelvic floor physical therapy alone or under the supervision of skilled providers can significantly improve SUI; however, long-term effects are harder to maintain. Pessaries, vaginal cones, and vaginal inserts have been widely used for treatment of SUI and are beneficial in patients who are motivated to use them. Currently in the United States, there is no FDA-approved medication for the treatment of SUI. Conversely, the European Union has approved and used duloxetine. Urethral bulking agents are indicated for patients with intrinsic sphincter deficiency and sometimes used in patients who are not able to undergo surgical procedures for SUI or who have failed said procedures. Three materials are currently FDA approved for urethral bulking in the United States. Many options exist for the nonsurgical management of SUI.
This review contains 5 tables and 47 references
Key words: Stress Urinary Incontinence, conservative treatment, urethral bulking, pelvic floor exercises, incontinence pessaries.
Pediatric Pain and Postoperative Management
Authors: Frost Elizabeth A.M. 
Published: January 2021

Both assessment and management of pain in children present challenges for perioperative physicians, including surgeons, anesthesiologists, intensivists, and pediatricians, among others. Several reports have indicated that pediatric pain is undertreated postoperatively compared with pain in adults, resulting in both severe physical consequences, such as the development of chronic pain and complex regional pain syndromes, and significant psychological distress, such as nightmares and reversal of learned behavior. Moreover, chronic pain in childhood has been shown to heighten the risk for mental health problems in adulthood. Children with chronic pain (n = 14,790) reported higher rates of lifetime anxiety disorders (21.1% versus 12.4%) and depressive disorders (24.5% vs 14.1%) as adults. Although many evidence-based practice guidelines for pain management in younger people have been developed, adherence is often less than complete.
The perioperative physician should be aware of barriers in pediatric pain management and be able to address them, thus improving pain management and patient outcome. Some of the problems in dealing with pediatric pain management include a realization of the controversies as to the age at which children feel pain, how pain can be assessed from the newborn to the adolescent, how the level of education and involvement of parents impact the situation, and a general knowledge of available pain treatments for the pediatric population.
Key words: complications, opioids, pediatrics, postoperative pain, regional techniques
Head and Neck Blocks for Headache and Facial Pain
Authors: Khelemsky Yury , Zayed Adham 
Published: January 2021

Since medications and interventions may not yield adequate efficacy for many patients with headache and facial pain, the management of these complex conditions often requires a multidisciplinary and multimodal effort. As part of a multifaceted approach, different procedures may have utility in alleviating pain for a variety of pathologies. This article reviews practical considerations for performing occipital nerve blocks, trigeminal nerve blocks, cervical medial branch blocks, cervical epidural steroid injections, sphenopalatine ganglion blocks, and trigger-point injections. Although there is growing evidence for the utility of these varied procedures, further research is warranted to clearly define which patient groups may derive the greatest benefit from these interventions, as well as optimal approaches to enhance their effectiveness.
Most recent advances covered (3-5):

1. Greater occipital blocks performed with lesser occipital blocks are a useful therapy to complement conservative management to reduce length, frequency, and duration of migraine headache.
2. Cervical medial branch blocks may be helpful for not only for neck pain, but for headache, however, more research is needed in this area.
3. Although dry needling is effective for myofascial pain, injection of local anesthesia may provide longer lasting relief.
Upper Extremity Compartment Syndrome
Authors: Kirsch Jacob M , Lee Simon , Lawton Jeffrey N 
Published: January 2021

Acute compartment syndrome (ACS) of the upper extremity is a surgical emergency resulting from decreased perfusion pressures and tissue hypoxia. Variable clinical presentation and physical examination findings produce unique challenges for physicians. Concomitant injuries can often further complicate the clinical picture. Prompt evaluation and diagnosis are essential to maximize functional outcomes and minimize potentially devastating sequelae. Emergent decompression of the involved fascial compartments is required to reestablish the vascular pressure gradient necessary for adequate tissue perfusion and oxygenation. An understanding of the epidemiology, pathophysiology, clinical diagnosis, pertinent anatomy, and surgical management of ACS is essential for the upper extremity surgeon.

This review contains 15 figures, 3 tables and 74 references
Key words: acute compartment syndrome, arm, compartments, fasciotomy, forearm, fracture, hand, surgical decompression, trauma, upper extremity
Reconstructive Approaches to Nasal Defects
Authors: Garg Ravi K , Bentz Michael L. 
Published: January 2021

Nasal reconstruction is commonly performed for treatment of defects arising from excision of nonmelanoma skin cancers, although other tumors, trauma, or infection may also result in significant nasal deformities necessitating corrective surgery. Patients being evaluated for nasal reconstruction should have a functional assessment of airflow through both the internal and external nasal valves to determine the need for reconstructive maneuvers that will maintain or improve the nasal airway. Aesthetic considerations relate to which nasal subunits are missing and how local, regional, and sometimes free tissue transfer can be used to optimize the final appearance of the nose. Reconstruction must incorporate a plan for reestablishing nasal lining, support, and cover depending on which elements are missing. Postoperative considerations include the need for nasal splints and interventions to optimize nasal scarring and contour such as scar massage, steroid injection, and laser treatments. Patients who are not good candidates for autologous nasal reconstruction may be considered for prosthetic reconstruction.
This review contains 13 figures and 67 references
Key words: Nasal reconstruction, Nasal airway, Mohs surgery, Skin cancer, Nasal aesthetic subunits, Facial flaps, Skin graft, Forehead flap, Nasal cover, Nasal lining, Nasal support, Prosthetic rehabilitation
Intellectual Disability
Authors: Tate Jodi , Vinquist Kelly 
Published: January 2021

Individuals with an intellectual disability are one of the most underserved populations in the United States. They have higher rates of medical and psychiatric comorbidity when compared to the general population and face considerable healthcare disparity. Challenging behavior such as physical or verbal aggression is the most common reason why this population interfaces with the mental healthcare system. Understanding and correctly diagnosing the underlying etiology of challenging behaviors requires comprehensive evaluations along with awareness of the key variables that contribute to the occurrence of these behaviors. The differential diagnosis of challenging behavior is wide and includes mental illness, medical illness, pain, side effects from medications, behavioral phenotype of underlying syndrome, behavioral/functional, deficit of skills, and/or developmentally appropriate behavior.
This review contains 1 figure, 6 tables and 83 references
Key words: behavioral phenotype, challenging behaviors, etiology, intellectual disability, mental retardation, mental illness, psychiatric disorders
Clinical Management of Psychotic Disorders
Authors: Epping Eric 
Published: January 2021

Psychotic disorders constitute a spectrum of mental illnesses that include symptoms of hallucinations, delusions, and/or disorganized thinking and behavior. Although some psychoses are short-term and reversible conditions, schizophrenia is the prototypical illness, which often develops in young adulthood and is typically chronic in its course. A complete medical and psychiatric evaluation is necessary to evaluate patients presenting with psychotic symptoms and to differentiate primary from secondary causes. Treatment of psychosis includes treatment of identifiable causal conditions, acute management of potentially harmful behaviors, prescribing antipsychotic medication, and psychotherapeutic and psychosocial interventions. A variety of antipsychotic medications are available for treatment, which must be individualized to maximize symptom reduction and to minimize short-term and long-term side effects. Long-acting injectable medications are available to improve medication adherence. In some cases, medications to counteract side effects may need to be prescribed. In more severe cases, electroconvulsive therapy may be indicated. Psychotherapy such as cognitive-behavioral therapy can reduce the severity of hallucinations and delusions. Integrated care that also includes family psychoeducation, skills training, and/or assertive community treatment is an essential part of a comprehensive multidisciplinary treatment program for the management of patients with psychotic disorders.
This review contains 5 Figures, 10 tables, and 33 references.
Key words: antipsychotic, dopamine, psychosis, psychosocial treatment, schizophrenia serotonin