bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatric EEG
Authors: Wong-Kisiel Lily C. , Wirrell Elaine C. 
Published: October 2022

Abstract
Electroencephalography (EEG) is an important diagnostic tool to evaluate children presenting with a variety of transient central nervous system symptoms, including suspected seizures, as well as those with altered level of consciousness or behavioral changes. The most common referral for EEG is for evaluation of possible seizures as the EEG may confirm the presence of epileptiform abnormalities and provide data on the type of seizure disorder, localization of the seizure focus, and possible etiology. This chapter reviews the various epileptiform and nonepileptiform abnormalities seen in the EEG of infants, children, and adolescents. For each abnormality, a careful electrographic description, as well as the clinical correlates of that finding are provided. Furthermore, the core electrographic features seen in specific pediatric electroclinical syndromes are summarized.
Quantitative Electromyography
Authors: Smith Benn E. 
Published: October 2022

AbstractThe discipline of electromyography (EMG) relies on the skillful application of a wide range of techniques, skills, and intuitions—all of which derive from practiced analysis of electrical signals recorded from muscle. A proper understanding of the available equipment as well as the current strategies to classify motor unit potentials (MUPs) and the muscles from which they are recorded as normal, neurogenic, or myopathic underlies EMG practice. This chapter reviews EMG electrodes, MUP characteristics, and a range of quantitative methods to characterize both MUPs and muscles to determine whether the muscle in question is normal or not in order to help the electromyographer achieve an accurate EMG interpretation.
Electrodiagnostic Assessment of Polyneuropathies
Authors: Mauermann Michelle L. 
Published: October 2022

Abstract
Peripheral neuropathy is one of the most common reasons for referral for electrodiagnostic testing. Nerve conduction studies and needle electromyography aid in diagnosing peripheral neuropathy and defining important features that help to refine the differential diagnosis. Electrodiagnostic testing helps not only to confirm the diagnosis but also to exclude alternative diagnoses. It provides important information regarding type of nerve fibers involved, severity, duration, pathophysiology and prognosis. The electrodiagnostic approach to peripheral neuropathy is based on the typical length-dependent sensory greater than motor pattern; however, modifications are needed when the neuropathy phenotype differs. Autonomic testing is helpful in patients with a small-fiber neuropathy.
Somatosensory Evoked Potentials
Authors: Watson James C. , Rubin Devon I. 
Published: October 2022

Abstract
Somatosensory evoked potentials (SEPs, sometimes called SSEPs) provide a noninvasive, sensitive, and quantitative way of assessing the functional integrity of the peripheral and central proprioceptive, somatosensory conduction pathways. SEP localizing ability is improved when interpreted in the context of other electrophysiologic tests (e.g., sensory nerve conduction studies, which assess peripheral nerve integrity through the dorsal root ganglion) and neuroimaging. Despite the advancements in neuroimaging, SEPs are still useful in the outpatient setting to assess for functional impairment (or preservation) of the proprioceptive pathways in the setting of known central nervous system structural (intrinsic or extrinsic) pathology (spinal stenosis or tumor, e.g.). SEPs are one of the most important diagnostic studies in identifying sensory-predominant polyradiculopathies (e.g., chronic inflammatory sensory polyradiculopathy). SEPs are now routinely used for intraoperative monitoring during spine surgery and in determining prognosis in postanoxic coma.
Quantitative Sudomotor Axon Reflex and Related Tests
Authors: Low Phillip A. , Coon Elizabeth A. 
Published: October 2022

Abstract
Small-fiber nerves may be selectively involved in various disorders. The function of the postganglionic sympathetic sudomotor C fibers can be assessed using the quantitative sudomotor axon reflex test (QSART), noninvasively and reproducibly, to define the severity and distribution of sudomotor failure. The neural pathway evaluated by QSART consists of an axon reflex mediated by the postganglionic sympathetic sudomotor axon. The axon terminal is activated by iontophoresis of acetylcholine, which leads to an impulse that travels antidromically to the branch point, then orthodromically to release acetylcholine from the nerve terminal to stimulate muscarinic receptors on eccrine sweat glands and evoke a sweat response. Normal responses indicate integrity of the postganglionic sympathetic sudomotor axon, while abnormal QSART patterns can indicate sudomotor damage, such as length-dependent reduction responses, indicating distal small-fiber neuropathy. Concomitant use of QSART and a thermoregulatory sweat test may help determine the site of the lesion.
Thermoregulatory Sweat Test
Authors: Fealey Robert D. 
Published: October 2022

AbstractThe thermoregulatory sweat test, when performed correctly, continues to be an excellent test for small-fiber neuropathy, autonomic failure diagnosis, and evaluation of other neurological and dermatological disorders. A dedicated cabinet or room with control of ambient humidity and temperature is important. To achieve a maximal sweat response, elevation and control of skin temperature remain critical components, as does attaining a core temperature of 38.0º C (or raising core temperature by 1.0ºC, whichever is highest) when significant anhidrosis is present. Documentation of the test result includes quantification of anterior body surface anhidrosis and a report displaying a graphical image and interpretation of the result. Parameters for cabinet humidity and temperature, skin temperature control, and the software and hardware currently in use are detailed within.
Cerebral Function Monitoring and Cortical Mapping for Nonepilepsy Surgery
Authors: So Elson L. , Hoffman E. Matthew 
Published: October 2022

Abstract
The purpose of intraoperative neurophysiological monitoring is to optimize postsurgical outcome by guiding the course of surgery. This chapter critically examines the principles and applications of different neurophysiological monitoring techniques in nonepilepsy surgeries. For some time, the use of electroencephalography has been widely established for carotid endarterectomy and cardiac surgery. Other modalities of neurophysiological monitoring have emerged, such as somatosensory evoked potentials (SSEPs), carotid stump pressure measurement, transcranial Doppler, and near-infrared spectrophotometry. More recent studies in the literature compared the yield of some of these techniques. A few studies suggested the usefulness of monitoring surgery with a combination of modalities. This chapter also examines the technical and clinical aspects of neurophysiological monitoring during surgical resection of brain lesions, such as tumors and vascular malformations. When the lesion is near eloquent cortex, electrical stimulation mapping of the cortex and SSEPs are used to guide surgical resection in order to maximize the extent of the resection and minimize the risk of impairing critical cortical functions such as language and motor functions.
Electrical Safety
Authors: Lagerlund Terrence D. , Lundstrom Brian Nils 
Published: October 2022

Abstract
Electrical Safety reviews procedures and standards used to ensure the safety of patients undergoing clinical neurophysiologic studies and of technicians or others performing studies from the standpoint of avoiding electrical shock or injury, as well as safety considerations for electrical stimulation of neural tissue. Electric power distribution in a hospital or clinic and mechanisms of electric shock are discussed, including factors increasing the risk of electric shock in hospitals. Leakage current is defined, and the mechanisms by which leakage current reaches patients and methods to reduce leakage current are discussed. Equipment grounding principles are explained. Tests for equipment grounding and leakage current are described, and rules and procedures to ensure electrical safety are specified. Safety considerations for electrical stimulation near pacemakers and implanted electrical devices are discussed, as well as safety considerations for transcranial electric and magnetic stimulation and for cortical and deep brain stimulation.
Abdominal compartment syndrome
Authors: Navsaria Pradeep , McPherson Deidre , Jonas Eduard 
Published: October 2022

Abstract
The abdominal compartment syndrome (ACS) can be defined as a state of acute organ dysfunction, predominantly affecting the cardiovascular, respiratory, and renal systems from a sustained increase in intra-abdominal pressure (IAP) causing intra-abdominal hypertension (IAH). The early recognition, prompt diagnosis, and immediate intervention of ACS can improve organ dysfunction. Intra-abdominal pressure and the abdominal compartment syndrome are separate, distinct clinical entities. Intra-abdominal pressure is the steady-state pressure concealed within the abdominal cavity. Intra-abdominal hypertension is defined by a sustained or repeated pathological elevation in IAP ≥ 12 mmHg. Abdominal compartment syndrome is defined as a sustained increase of IAP over 20 mmHg that is associated with new or worsening organ function. The effects of IAH are not limited to the intra-abdominal organs but have an impact either directly or indirectly on other organ systems in the body. The definitive diagnosis of IAH/ACS requires a measurement of the IAP. The intra-vesicular technique is a minimally invasive, easy, precise, reliable, and reproducible way of measuring IAP. The development of IAH/ACS during a critical care unit stay is an independent predictor of a patient’s outcome. Medical interventions target three critical contributors to IAH; solid organ and hollow-viscera volume, space-occupying lesions, such as ascites, blood, abdominal packs and tumours, and conditions that limit abdominal wall compliance. Surgical decompression of the abdominal cavity is considered the definitive management of ACS. Temporary abdominal wall closure using negative pressure wound therapy has the highest fascial closure and lowest mortality rates.
Ventral hernia
Authors: Arora Eham , Pauli Eric 
Published: October 2022

AbstractHernia repairs are amongst the most common procedures performed in surgical practice. Over 600,000 repairs are performed annually in the United States alone, of which about 175,000 are for ventral hernias. Despite their sheer numbers, cases exhibit a wide variability in morphology and clinical presentation. There exists a wide gamut of available surgical options with little consensus to help choose between them. The last few years have witnessed a substantial growth of our understanding of the abdominal wall’s surgical anatomy and dynamics. This has led to a surge in available technologies—surgical approaches, myofascial advancement flaps, prosthetic devices—which allow the modern surgeon to repair cases which were hitherto deemed irreparable. More importantly, a clearer understanding of the pathology and prudent employment of repairs has the potential to improve outcomes in all patients in terms of surgical site infections, chronic pain, and recurrence. This chapter will serve as an updated reference for surgical residents and seasoned practitioners helping them evaluate and manage ventral hernias with greater confidence.
Surgical access to the abdomen
Authors: Agrawal Abhishek , Mullick Shweta , Dhar Puneet 
Published: October 2022

Abstract
Anatomy of abdominal wall encountered changes with the site of approach. Clearly understanding the anatomy of the abdominal wall is crucial to the art of making the incision for access to the abdomen and has been briefly outlined. The location and type of incision depends on the urgency of surgery, target organ, habitus, cosmesis, and previous scars. The usage of laparoscopic access has increased dramatically and modes of access have been outlined. It is imperative to have safe peritoneal access and achieve requisite closure. The principle of closure rests mostly on the musculoaponeurotic layer. Common complications include haematoma or seroma, surgical site Infections and wound dehiscence.
Peritoneal malignancy
Authors: Godbole Chintamani , Hallam Sally , Antoun Lina , Youssef Haney 
Published: October 2022

AbstractMalignancy can result from primary or secondary tumours of the peritoneum. Traditionally the discovery of peritoneal cancer at operation was thought to be a terminal event. These patients were offered palliative care with either systemic chemotherapy or best supportive care. However, the last 30 years have seen exciting developments in the surgical and medical treatment of peritoneal malignancy with significant improvements in survival. A few have even achieved cure with this devastating condition. This chapter describes the assessment and management of common primary and secondary peritoneal malignancies. Colorectal peritoneal metastases, pseudomyxoma peritonei, peritoneal mesothelioma, and ovarian cancer are discussed in detail. It also describes the advances in surgical and oncological treatments for these conditions.
Retroperitoneum
Authors: Yadav Amitabh 
Published: October 2022

AbstractThe retroperitoneum is the space in the abdominal cavity, which lies behind the parietal peritoneum. It is of surgical importance because it can be the site for the accumulation of inflammatory or traumatic fluids and, unlike the peritoneal cavity, access to it is difficult. A gastrointestinal surgeon encounters problems affecting this site when he or she has to deal with pancreatitis, trauma, or malignant tumours. A knowledge and understanding of the anatomy, of its various potential spaces and of the communications between them, is essential for the adequate management of diseases in this area. This chapter discusses the embryology, anatomy, fascial structures, compartments, and spaces spread across these inter-fascial planes. It also describes the diseases which are important to a gastro-intestinal surgeon and various approaches to the retroperitoneum, including open and minimally invasive techniques. Finally, it explores the various operative approaches to deal with the pancreatitis with special emphasis on minimally invasive techniques and the common complications of these procedures.
Congenital small bowel abnormalities and their surgical management
Authors: King Sebastian K. , Teague Warwick J. 
Published: October 2022

Abstract
Congenital small bowel abnormalities comprise intestinal atresias, duplication cysts, Meckel’s diverticulum, meconium ileus, and malrotation (with or without volvulus). The presentations and diagnostic pathways for these abnormalities vary, and require an in-depth understanding of each condition. While most may be managed semi-urgently, malrotation with volvulus is a true surgical emergency and requires immediate attention and operative intervention to prevent a potentially catastrophic loss of the midgut. This chapter provides an understanding of each of these abnormalities, with a focus upon their embryological basis, their presentations, and the operative approaches to correct these congenital conditions.
Peptic ulcer disease of the duodenum
Authors: Søreide Kjetil 
Published: October 2022

AbstractUnderstanding and management of peptic ulcer disease have changed dramatically over the past decades. Once a frequent surgical disorder for which several operations were invented and tested, it is now largely a medical condition treatable with appropriate drugs and antibiotics. The discovery of Helicobacter revolutionized the understanding of the disease and led to a shift in management. Complications still occur, largely in the form of bleeding or perforation or, rarely, obstruction. Most bleeding episodes can be managed without surgery in the modern multidisciplinary medical centre, either by endoscopy or interventional radiology. Surgery is still needed for perforations, which may be associated with sepsis and organ failure in the sickest patients. While demography and management has shifted in the high-income country populations, with more elderly and comorbid patients presenting with this disease, many regions in low- and middle-income countries still experience a high disease burden in the young to middle-aged population. This chapter reviews the changes in peptic ulcer management and discusses current management strategies.
Ileus and chronic intestinal pseudo-obstruction
Authors: Vather Ryash , Bissett Ian P. 
Published: October 2022

Abstract
‘Prolonged postoperative ileus’ (PPOI) is an absence of gut function as defined by two or more of nausea/vomiting, inability to tolerate oral diet over 24 hours, absence of flatus over 24 hours, distension, or radiological confirmation of ileus—occurring on or after the fourth postoperative day. The aetiology of ileus is multifactorial with early postoperative gut dysfunction more influenced by opioid administration and autonomic shift, and the sustained dysfunction seen in PPOI more related to inflammation. Clinical risk factors that predispose to postoperative gut dysfunction include male sex, open surgery, increased operative bowel handling, operative duration, blood loss, and increased perioperative crystalloid or red cell transfusion. Preventive measures for PPOI are best addressed by considering the elements which comprise Enhanced Recovery After Surgery protocols viz. fluid restriction, spinal analgesia, early oral feeding, early mobilization, avoidance of opioids, and careful electrolyte monitoring. Management involves exclusion of more sinister pathology by way of cross-sectional imaging followed by correction of electrolyte derangements, nasogastric tube insertion, weaning of opioid analgesia, and use of parenteral nutrition as required. Chronic intestinal pseudo-obstruction (CIPO) is rare, and is underpinned by disease processes that interfere with neurogenic or myogenic small bowel activity. The diagnosis of CIPO is difficult to make and is generally one of exclusion. Management is multidisciplinary and focuses on ensuring nutritional needs are met (either orally or parenterally), treating bacterial overgrowth, and slowing progression of the underlying disease process. There is an evolving role for prokinetics. Surgical options for CIPO include small bowel bypass, resection, diversion, and transplantation.
Biliary and pancreatic sphincter of Oddi disorder
Authors: Ratnayake Chathura B.B. , Bekkali N.L. , Oppong Kofi W. , Pandanaboyana Sanjay 
Published: October 2022

AbstractDysfunction of the sphincter of Oddi is considered to be due to an episodic increased pressure. The ROME III classification, the previously widely accepted framework for defining the condition, has now been replaced by the ROME IV classification. This is largely due to evidence from the EPISOD trial which indicated that sphincter of Oddi manometry did not predict the response to endoscopic sphincterotomy. A systematic and structured approach towards investigating patients who present with post-cholecystectomy biliary- or pancreatic-type pain is imperative in this complex group before their symptoms are attributed to sphincter of Oddi dysfunction. Endoscopic ultrasound can play an important role in identifying occult choledocholithiasis. Endoscopic retrograde cholangiopancreatography on the other hand carries risks in this setting and clear evidence for its benefit is limited to the management of common bile duct stones and papillary stenosis. Biliary and pancreatic sphincter of Oddi dysfunction is likely to be the cause of post-cholecystectomy pain in a small minority of these patients. The majority will have no structural cause identified and will have functional abdominal pain, the aetiology of which is unclear but represents a complex multifactorial disorder of the brain–gut axis.
Malignant tumours of the duodenum, ampulla, and small bowel
Authors: Klaiber Ulla , Hackert Thilo 
Published: October 2022

Abstract
Malignant tumours of the duodenum, ampulla of Vater, and the small bowel are rare tumours of the digestive system, some of them related to genetic disorders such as polyposis syndromes, but also occurring sporadically. While those situated in the duodenum and ampulla are easily accessible by endoscopy with biopsy and histological proof of the lesion, small bowel tumours located distal to the ligament of Treitz can be diagnostically challenging even when advanced endoscopic techniques are used and cross-sectional imaging methods are the more important tools to find and characterize such tumours. Curative surgery is the treatment of choice for all the mentioned malignancies if no distant metastases are found. For duodenal and ampullary malignant tumours, partial pancreatoduodenectomy should be performed; for tumours of the small intestine, surgery comprises segmental bowel resection including the adjacent mesentery with the draining lymph nodes. Adjuvant therapy is not standardized today but may be beneficial in certain subgroups of patients (i.e. nodal positive). Protocols that are applied in ampullary cancers follow the histological differentiation of the tumour targeting either pancreatobiliary (i.e. gemcitabine, FOLFIRINOX) or intestinal (i.e. FOLFOX) cancers. For small bowel cancer, protocols follow standards of colorectal cancer treatment. Neoadjuvant therapy has no defined role in any of the three malignancies. In metastatic tumours, surgery may be indicated for palliative treatment (i.e. obstruction or bleeding) or with a curative approach in selected patients especially in those showing an intestinal differentiation.
Small bowel mesenchymal tumours
Authors: Glyn Tamara , Frizelle Frank 
Published: October 2022

AbstractMesenchymal tumours of the small bowel are tumours originating from mesodermal-derived precursor cells that develop into bone, cartilage, or other connective tissues, such as blood vessels, adipose tissue, smooth muscle, or fibroblasts. Most are found outside the abdomen; however, some can be found in association with the small bowel. These include gastrointestinal stromal tumours, leiomyosarcomas, leiomyomas, lipomas, small bowel desmoids, as well as rare entities such as clear cell sarcoma, inflammatory myofibroblastic tumours, and neurogenic polyps (schwannoma, granular cell tumour, perineurioma, neurofibroma, ganglioneuroma, and gangliocytic paraganglioma). These tumours are rare and their clinical presentation is usually non-specific, usually with bowel obstruction or bleeding. The difficulty accessing the small bowel for investigation and their rarity makes the detection of these tumours a challenge. Treatment and outcome depend on the specific histopathology of the lesions.