bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complications of Transfusions
Authors: Scott Courtney L. , Boydston Elaine A. 
Published: May 2024

Abstract
An understanding of the potential complications of blood transfusion is important in order to make informed decisions regarding the risks and benefits. Non-hemolytic transfusion reactions may include febrile, allergic, or anaphylactic responses. The resultant complications can range from symptomatically mild to fatal. Hemolytic transfusion reactions are one of the most feared transfusion reactions and result from an ABO or antibody incompatibility leading to hemolysis. These reactions may be acute or delayed, and if recognized early, are often non-fatal. Infectious complications have decreased over the last several decades as testing capabilities have improved, although these risks are still present. The most common cause of transfusion-related mortality is due to transfusion-related acute lung injury (TRALI), thought to be caused by donor antigens that activate recipient neutrophils. The result is an ARDS-like condition, and the treatment is supportive. Other transfusion complications are related to the blood volumes transfused, including citrate toxicity, hyperkalemia, acidemia, and hypothermia.
Anticoagulants, Antithrombotics, and Antiplatelet Drugs
Authors: Torres Patrick , Ghabra Hussam 
Published: May 2024

Abstract
The perioperative management of anticoagulants requires a very focused and dedicated approach, weighing both risks and benefits for each individual patient. Multidisciplinary team cooperation is required to estimate the individual patient risk of thrombosis versus the risk of bleeding, to determine the timing of interruption of anticoagulation, and to decide if bridging therapy is needed (for very high-risk patients). This chapter reviews the basics of hemostasis, the most commonly used antiplatelet agents and anticoagulants, including their mechanism of action, and a focused overview of perioperative management of anticoagulation. Table 310.1 summarizes the medications discussed in this chapter.
Adrenal Disease
Authors: Romanov Evgeney , Noguera Edward 
Published: May 2024

Abstract
Theadrenal glands are in the retroperitoneum in the medial aspect of the upperpole of each kidney. The fully matured adrenalgland is about 5cm by 3 cm and is 1 cm think. The right gland is pyramidal and the left is oval shaped. Anatomically, the adrenals have a cortex anda medulla. The medulla secretescatecholamines and, functionally, is part of the sympathetic nervoussystem.
Biochemistry of Normal Body Metabolism
Authors: Torres Felipe Vasconcelos , Rossi Raquel Montagner 
Published: May 2024

Abstract
This chapter discusses the highlights of normal body metabolism. The difference between catabolic and anabolic processes is explained. Anabolic reactions are synthetic and occur in postprandial states, while catabolic reactions are defined by breakdown and are predominant during fasting. There is a close interaction between organs and tissues in order to maintain a constant and adequate supply of nutrients, as well as to store energy for future use. Some organs will be more dependent on glucose, while others are more versatile and can use different molecules as fuel. The role of the liver as one of the major regulators of body metabolism for carbohydrates, lipids, and proteins is discussed. Finally, there is a brief discussion on cellular respiration and on the definition of respiratory quotient.
Protein Function as Immunoglobulins and Hormones
Authors: James Dominika Lipowska , Jowza Maryam 
Published: May 2024

Abstract
All living things depend on proteins for their existence. Proteins are some of the most structurally complex biological molecules, whose three-dimensional configuration is inherently correlated with their function. Proteins serve a wide array of physiological processes within the human body; they not only are the primary building blocks of many tissues, but also serve as hormones coordinating physiological activities, as well as carrying immune function as immunoglobulins. Protein hormones are specific proteins involved in cell signaling and communication. They are secreted by endocrine organs and are involved in regulation of many biological processes such as growth, metabolism, sexual development, and procreation. Protein hormones vary in size and structure and as such can be divided into amines, peptides, proteins, and glycoproteins. Immunoglobulins, otherwise known as antibodies, are immunologically specialized plasma proteins produced by B cells, which are essential to proper function of humoral immunity. Antibodies serve two main immunological functions: recognition and identification of pathogens and their destruction. There are five distinct antibody classes, which differ in structure and function: IgG, IgM, IgA, IgE, IgD. Structure of immunoglobulins is based on their peptide chain amino acid sequences and defines their role and antigen-binding specificity. Each antibody is capable of recognizing specific antigens. Pathogen neutralization may occur via antibody mediated processes such as cellular lysis, phagocytosis, opsonization, and complement activation.
Sleep
Authors: Goldstein Mark A. , Goldstein Myrna Chandler 
Published: May 2024

Abstract
Good quality and quantity of sleep are of the utmost importance for the development of adolescents. However, large numbers of adolescents are not obtaining sufficient sleep. There is a sizeable body of research that has found that adolescents with sleep issues have worse outcomes for physical, mental, social, and academic performance than their peers who obtain appropriate sleep. The use of electronic media including computers, smartphones, and tablets has a profound effect on sleep. Adolescents with disturbed sleep may have anxiety issues as well as depression. In addition, sleep issues may lead to adolescent substance use, and the use of substances may lead to sleep problems. Other issues for adolescents with sleep disturbances include increased risks for obesity, mood disorders, suicidal ideation, drowsy driving, and poor academic performance.
Obesity
Authors: Goldstein Mark A. , Goldstein Myrna Chandler 
Published: May 2024

Abstract
Obesity is a global issue in adolescents, especially in high-income countries such as the United States. Factors such as limited physical activities, disrupted sleep, increased screen time, and even remote learning during the COVID-19 pandemic have exacerbated the situation. Adolescents may develop high blood pressure, type 2 diabetes, and diminished self-esteem if they have obesity. Studies have determined that obesity is a risk factor for anxiety and depression in adolescents. Through social media adolescents may be exposed to advertisements with high-calorie, low-nutrient foods and beverages that could lead to dietary changes promoting weight gain. Prevention efforts for adolescents include less screen time, more physical activities, healthier diets, mandatory school-based physical education, and increased accessibility to parks and playgrounds.
Pain in Infants and Children
Authors: Harrison Denise , Bueno Mariana , Pope Nicole Marie 
Published: May 2024

Abstract
Sick and preterm newborns and hospitalized infants and children are especially vulnerable to pain. Vulnerabilities relate to repeated painful procedures required during hospitalizations, immature developmental stages, parental separation, lack of known effective pain treatment at different ages, and, where evidence exists, lack of consistent use of the evidence. In addition, this population is at risk of long-term pain consequences, including fear and anxiety related to needles and medical care. Reducing the burden of pain and involving parents in pain care are priorities for reducing vulnerabilities in newborns and young children. When painful procedures are required, breastfeeding, skin-to-skin, and small volumes of sweet solutions are recommended for newborns and young infants. Facilitating the use of effective distraction techniques and applying topical anesthetics are recommended for young children. The social communication model of pain and the model of parent involvement in infant pain management are used to understand pain from a biopsychosocial perspective.
Pain in Women
Authors: Dodman Keisha G. , Berken Allison M. , Barreveld Antje M. 
Published: May 2024

Abstract
Although gender equality has significantly evolved over centuries, sociocultural disparities as well as important biological differences persist between women and men. Recognizing biological differences as well as potential biases toward women is essential to providing optimal health care. This chapter provides an overview of the history of pain in women as well as the genetic, biological, and psychosocial underpinnings of chronic pain in this vulnerable population. The chapter provides a brief review of pain states specific to the female sex and chronic pain diseases more commonly seen in women. The chapter asserts that it is imperative for the health care community to recognize biases, gendered norms, and barriers to pain care in women to guarantee improved access to contemporary, informed, and compassionate diagnosis and treatment.
Pain in Cognitive Impairment
Authors: Geppert Cynthia M. A. , Cardon Karen E. 
Published: May 2024

Abstract
This chapter examines challenges in identifying, accurately assessing, and appropriately managing chronic pain in patients with cognitive impairment. It specifically focuses on three subgroups: dementia (multiple types are reviewed), developmental delay, and traumatic brain injury. The chapter provides a review of the clinical presentation and specific features of pain epidemiology, common comorbidities, and risk factors for pain in these populations, as well as treatment considerations. Much of the chapter focuses on a discussion of models of vulnerability in the three cohorts, along with examining difficulties in accurately assessing pain, and the many challenges to safe and appropriate patient-centered pain care. It concludes with a discussion of pathways to improved care for patients with cognitive impairment, including addressing the broader social context, advocacy, research, education, and accessible and integrated health care.
Pain in Military Personnel
Authors: Wilson Sara M. , Byrne Taylor J. 
Published: May 2024

Abstract
The military has been described as the most engrossing and demanding institution in American society. Unique experiences of the service member include special training requirements, frequent relocations, geographic isolation from support structures, deployments, redeployments, integrating from the military to the civilian workforce, and financial stressors. Despite these unique experiences, the military population is not classically considered a vulnerable population. This chapter highlights several aspects of the military population that promote vulnerability in the context of health care, specifically regarding the development of chronic pain. In addition to vulnerability due to the institutional nature of service, military-specific requirements and exposures increase service members’ vulnerability to developing illness and injury at an increased rate compared to the general population. These unique exposures increase the rate of chronic pain conditions, depression, post-traumatic stress disorder (PTSD), and traumatic brain injury. Approximately half of all veterans enrolled in the Veterans Affairs (VA) health care system experience chronic pain compared to 30% of the U.S. population. Furthermore, compared to nonveterans, veterans with chronic pain suffer from more complex pain syndromes, often associated with comorbid conditions such as depression and PTSD. This chapter explores the vulnerability of the military population, the impact of chronic pain in this unique population, and both risk factors and protective factors for developing chronic pain. It also outlines many of the strategies and programs the U.S. Department of Defense and VA have instituted to improve chronic pain measurement and outcomes.
Pain and Torture
Authors: Asgary Ramin , de C. Williams Amanda C. 
Published: May 2024

Abstract
Addressing physical and psychological pain, common among survivors of maltreatment and torture, requires comprehensive approaches. Refugees and asylum seekers are at a particularly high risk. In host societies, there might be a lack of recognition, experience, and structural support and related policies in both health care and social systems to meet their needs. Access to care is complicated because survivors are often in precarious situations, struggling with legal status, accommodation, finances, and basic necessities. The concept of vulnerability, inadequate social support and isolation, health care and social system barriers, health care professionals’ accountability and ethics, and social responsibility and corresponding level of accountability all pose further challenges and opportunities. Survivors who experience pain, usually persistent, have difficulty accessing appropriate assessment and treatment: Pain from torture is complex and poorly understood, and it may correspond poorly to accounts of injury. Pain may be inappropriately assigned to psychological causes, in the context of a high psychosocial burden among survivors. Expert assessment and treatment are needed but often limited and insufficient. They require the establishment of trust for survivors to disclose their history and develop a shared understanding of pain. Treatment, especially for chronic pain, is difficult to implement and follow, given other competing demands or barriers. It requires a multidisciplinary approach to further connect care to other forms of support beyond direct treatment. Comprehensive and specialized centers have been successful and warrant further exploration and investment.
Pain in Extreme Situations
Authors: Gelfand Harold J. , Tracy Erin A. , Bell Austin G. 
Published: May 2024

Abstract
Management of pain in victims of armed conflict and natural disasters is a particularly challenging aspect of casualty care. These events impose significant traumatic stress on individuals and communities, altering environments such that routine medical systems are disrupted, thus demanding specialized responses to meet the unique challenges in providing care to victims. Injury patterns can vary greatly depending on the nature of the incident, and they can encompass multiple organ systems across a wide range of patient age and comorbidity. Appropriate and timely pain management has a significant impact on outcome and persistent disability in those suffering trauma, requiring systems and resources to be developed in advance of need. Among such programs is the Joint Trauma System (JTS) of the U.S. military. The JTS has developed evidence-based policies and guidelines directing the resources and care to be used in the combat and disaster environment. Included is doctrine on the provision of analgesic care and monitoring for casualties based on degree and nature of injury. It is a moral and clinical imperative that pain be addressed as close to the time of injury as possible; this is reflected in JTS clinical practice guidelines and is driving research and development of new analgesic modalities that can be safely provided to wounded at the point of injury. Chronic pain has a significant socioeconomic impact on both medical need and dependence on social services. Early and appropriate pain intervention can help diminish this burden on victims and society.
Pain in Low-Income Nations
Authors: Workneh Rediet Shimeles , Nyirigira Gaston , Faponle Fola , Sutton Olivia , Amaefuna Steven , Tomobi Oluwakemi , Finley Allen , Sampson John 
Published: May 2024

Abstract
Chronic pain is a major public health issue, particularly in people in low- and middle-income countries (LMICs). Pain management in Africa is a critical health care issue, given the high prevalence of pain and limited access to pain medications in many African countries. In many cases, pain is undertreated, leading to suffering and decreased quality of life. The associated challenges are complex, including cultural beliefs and attitudes toward pain, inadequate training of health care professionals in pain management, limited availability and affordability of pain medications, and regulatory barriers to their use. Addressing these challenges requires a multifaceted approach that involves advocacy, education, policy reform, and increased access to medications. Improved pain management in Africa has the potential to improve the quality of life for millions, enhance the effectiveness of health care systems, and reduce the burden of pain-related disability and mortality. To address these challenges, several strategies can be employed, including improving access to pain medications through policy changes, increasing health care provider training in pain management, implementing multidisciplinary pain management programs, and addressing cultural attitudes toward pain and pain management. These are all necessary steps toward better management of chronic pain in LMICs. This chapter focuses on the African continent as a representation of challenges in many LMICs.
Cancer Pain
Authors: Ma Shuran , Christiansen Sandy 
Published: May 2024

Abstract
Pain is a common symptom of cancer, even in survivors. Despite this, there is a large disparity in pain control among vulnerable patient populations. Pediatric and geriatric patients are more likely to have difficulty expressing their pain and are dependent on caregivers. Different races may be more reluctant to report pain or treat pain, especially in the setting of medical disease such as cancer. Lower income and limited access to health care also prevent patients from receiving the pain treatments they need. When cancer pain is not adequately treated, it leads to not only poorer quality of life for the patient and their caregivers but also economic burden on the health care system from emergency department visits and hospitalizations. Solutions to this disparity include education and support to patients, family members, and health care providers. Telehealth has also been able to bridge the care gap for those who have limited access to health care resources. Finally, the World Health Organization has published guidelines to support primary care physicians in the management of patients’ cancer pain.
Pain in Sickle Cell Disease
Authors: Mulchan Siddika S. , Coco Megan , Boruchov Donna 
Published: May 2024

Abstract
Pain is the hallmark symptom of sickle cell disease. Vaso-occlusive pain crises are multifactorial in origin. Medical and psychological complications affect the perception of pain. A biopsychosocial model of pain uses a holistic approach to conceptualize the factors that contribute to the pain experience. Sickle cell disease predominantly affects people of color, and perceived injustice as well as health-related stigma and racial bias have all contributed to feelings of mistrust and often lead to negative health outcomes for individuals with sickle cell disease. The opioid crisis in the United States has inadvertently had a negative effect on access to pain medications for people with sickle cell disease. Mood disorders and pain catastrophizing also negatively impact pain crises in sickle cell disease. Remediation and treatment of pain in sickle cell disease include the development of coping skills and psychological adjustment skills and the guidance of a multidisciplinary health care team that includes physicians, nurse practitioners, nurses, social workers, and psychologists.
Pain in People Living with HIV
Authors: George Mary Catherine , Douglas Sotonye , Coyle Kaitlyn , Griffiths Shanna-Kay Christa , Robinson-Papp Jessica 
Published: May 2024

Abstract
Treating pain in people living with HIV, despite advances in HIV treatment, continues to be challenging due to pervasive stigma, coupled social and economic challenges, creating complexity in providing sufficient pain care. These challenges include gender, racial, and ethnic minority status, substance use disorders, and trauma. This chapter discusses the vulnerabilities experienced by some people living with HIV and how they might contribute to the experience of chronic pain, reviews the types of chronic pain that are common in people living with HIV and approaches to treatment, and discusses how the lens of vulnerability might be applied to a conceptual model of pain in people living with HIV to identify novel treatment strategies.
Managing Pain in Patients on Long-Term Opioids
Authors: Sandbrink Friedhelm 
Published: May 2024

Abstract
This chapter addresses key clinical issues related to opioid prescribing, including benefits and risks in the treatment of chronic pain, and provides clinical strategies to optimize safety and effectiveness, based on recently published guidelines by the Centers for Disease Control and Prevention and by the U.S. Department of Veterans Affairs and U.S. Department of Defense. Whereas opioids have wide efficacy and utility in the treatment of acute and cancer-related pain, their use for chronic non–cancer-related pain is controversial because risks of long-term opioid therapy generally outweigh the potential benefits. A careful evaluation of the patient may assist in assessing risk prior to initiating opioid therapy. Patients with a history of substance use disorder and other mental health disorders are particularly vulnerable, as are younger patients, the frail or elderly, and people with medical conditions such as sleep apnea. Opioid therapy is initiated with short-acting opioids and prescribed at the lowest effective dosage and duration based on clinical indication. Risk mitigation strategies include prescription drug monitoring programs, urine drug testing, patient education and clear communication of safety expectations (e.g., informed consent), naloxone co-prescribing, and close monitoring and reassessment. Dosage escalations and co-prescribing with benzodiazepines should be avoided. Opioid tapering must be individualized, and sudden discontinuation should be avoided. Opioid therapy with buprenorphine is an emerging strategy associated with lower risk for overdose. Patients with suspected opioid use disorder should not be abandoned but, rather, carefully assessed and supported by providing evidence-based therapy including medication such as buprenorphine.
Movement Disorders
Authors: Selwa Linda M. , Gelb Douglas J. 
Published: May 2024

Abstract
This chapter begins with a general approach to movement disorders, a set of definitions, and a classification system. This is followed by detailed discussion of the clinical manifestations, pathophysiology, and approach to diagnosis and management of major movement disorders: essential tremor; Parkinson disease (PD); other parkinsonian syndromes—including dementia with Lewy bodies (DLB), progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), and multiple system atrophy (MSA); hereditary ataxias—including Friedreich ataxia, ataxia telangiectasia, spinocerebellar ataxias, episodic ataxias, and fragile X-associated tremor/ataxia syndrome (FXTAS); Huntington disease; tardive dyskinesias; dystonias; Wilson disease; and Tourette syndrome. The misfolded proteins associated with these disorders are emphasized.