{"title":"Lyme Disease and Other Spirochetal Zoonoses","authors":"D. Tompkins, B. Luft","doi":"10.2310/NEURO.1133","DOIUrl":"https://doi.org/10.2310/NEURO.1133","url":null,"abstract":"<jats:p />","PeriodicalId":11220,"journal":{"name":"DeckerMed Medicine","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87240587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although common, delayed puberty can be distressing to patients and families. Careful assessment is necessary to ensure appropriate physical and social development in patients that require intervention to reach pubertal milestones and achieve optimal growth. Most pubertal delay is from lack of activation of the hypothalamic-pituitary-gonadal axis which then results in a functional or physiologic GnRH deficiency. The delay may be temporary or permanent. Constitutional delay (CDGP), also referred to as self-limited delayed puberty (DP), describes children on the extreme end of normal pubertal timing and is the most common cause of delayed puberty, representing about one third of cases. Hypergonadotropic hypogonadism (primary hypogonadism) results from a failure of the gonad itself, and hypogonadotropic hypogonadism (secondary hypogonadism) results from a failure of the hypothalamic-pituitary axis, which is usually caused by another process, often systemic. Diagnosis is based on history and examination. Treatment is based on the underlying cause of pubertal delay and may include hormone replacement. Involving a pediatric endocrinologist should be considered. Appropriate counseling and ongoing support are important for all patients and families, regardless of underlying disease process. This review contains 4 figures, 4 tables, and 32 references. Keywords: puberty, delayed puberty, hypogonadism, hypogonadotropic hypogonadism, hypergonadotropic hypogonadism, menarche, thelarche, constitutional delay and growth in puberty, Turner syndrome
{"title":"Delayed Puberty","authors":"A. French","doi":"10.2310/im.19116","DOIUrl":"https://doi.org/10.2310/im.19116","url":null,"abstract":"Although common, delayed puberty can be distressing to patients and families. Careful assessment is necessary to ensure appropriate physical and social development in patients that require intervention to reach pubertal milestones and achieve optimal growth. Most pubertal delay is from lack of activation of the hypothalamic-pituitary-gonadal axis which then results in a functional or physiologic GnRH deficiency. The delay may be temporary or permanent. Constitutional delay (CDGP), also referred to as self-limited delayed puberty (DP), describes children on the extreme end of normal pubertal timing and is the most common cause of delayed puberty, representing about one third of cases. Hypergonadotropic hypogonadism (primary hypogonadism) results from a failure of the gonad itself, and hypogonadotropic hypogonadism (secondary hypogonadism) results from a failure of the hypothalamic-pituitary axis, which is usually caused by another process, often systemic. Diagnosis is based on history and examination. Treatment is based on the underlying cause of pubertal delay and may include hormone replacement. Involving a pediatric endocrinologist should be considered. Appropriate counseling and ongoing support are important for all patients and families, regardless of underlying disease process. \u0000This review contains 4 figures, 4 tables, and 32 references.\u0000Keywords: puberty, delayed puberty, hypogonadism, hypogonadotropic hypogonadism, hypergonadotropic hypogonadism, menarche, thelarche, constitutional delay and growth in puberty, Turner syndrome","PeriodicalId":11220,"journal":{"name":"DeckerMed Medicine","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84715861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
As part 3 of the three chapters on sleep-disordered breathing, this chapter reviews central sleep apnea (CSA). CSA is defined as recurrent apneic events during sleep in the absence of respiratory muscle effort and loss of neuronal output to respiratory muscles. The most common cause of CSA is compromised cardiac function. In patients with CSA whose ejection fraction is less than or equal to 45%, adaptive servo-ventilation (ASV) has been shown to increase mortality. With the abuse of opioids reaching epidemic proportions, it has been estimated that 30 to 75% of patients on chronic opioid therapy have a significant increased incidence of CSA. Opioid-induced sleep-disordered breathing can be treated with ASV. This review contains 1 figure, and 37 references. Key Words: adaptive servo-ventilation, central sleep apnea, Cheyne-Stokes respiration, congenital central hypoventilation syndrome, impaired central ventilatory drive, opioid abuse, PHOX2B gene, supplemental oxygen
{"title":"Central Sleep Apnea","authors":"D. Lim, Richard Schwab","doi":"10.32388/99my0h","DOIUrl":"https://doi.org/10.32388/99my0h","url":null,"abstract":"As part 3 of the three chapters on sleep-disordered breathing, this chapter reviews central sleep apnea (CSA). CSA is defined as recurrent apneic events during sleep in the absence of respiratory muscle effort and loss of neuronal output to respiratory muscles. The most common cause of CSA is compromised cardiac function. In patients with CSA whose ejection fraction is less than or equal to 45%, adaptive servo-ventilation (ASV) has been shown to increase mortality. With the abuse of opioids reaching epidemic proportions, it has been estimated that 30 to 75% of patients on chronic opioid therapy have a significant increased incidence of CSA. Opioid-induced sleep-disordered breathing can be treated with ASV.\u0000This review contains 1 figure, and 37 references.\u0000Key Words: adaptive servo-ventilation, central sleep apnea, Cheyne-Stokes respiration, congenital central hypoventilation syndrome, impaired central ventilatory drive, opioid abuse, PHOX2B gene, supplemental oxygen","PeriodicalId":11220,"journal":{"name":"DeckerMed Medicine","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74035851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lower gastrointestinal bleeding (LGIB) is a common gastrointestinal emergency. Colonoscopy is the initial diagnostic and therapeutic procedure for most patients with LGIB. The optimal timing of colonoscopy is uncertain, but earlier examinations are associated with higher diagnostic yield. In patients with severe bleeding, colonoscopy should be performed within 24 hours of presentation after an adequate orally administered colon preparation. Additional washing during colonoscopy and careful inspection should be performed to identify high-risk stigmata. Endoscopic therapy should be attempted if high-risk bleeding stigmata are identified. The endoscopic treatment modality depends on the bleeding source, location, operator expertise, and the need for ongoing anticoagulation or antiplatelet therapy. This review 5 tables, 5 figures, and 50 references. Keywords: argon plasma coagulation, clipping, colonoscopy, diverticular bleeding, endoscopic band ligation, endoscopic hemostasis, postpolypectomy bleeding, stigmata of recent hemorrhage, vascular ectasias
{"title":"Endoscopic Management of Lower Gastrointestinal Hemorrhage","authors":"Rebecca L. Kosowicz, L. Strate","doi":"10.2310/im.5661","DOIUrl":"https://doi.org/10.2310/im.5661","url":null,"abstract":"Lower gastrointestinal bleeding (LGIB) is a common gastrointestinal emergency. Colonoscopy is the initial diagnostic and therapeutic procedure for most patients with LGIB. The optimal timing of colonoscopy is uncertain, but earlier examinations are associated with higher diagnostic yield. In patients with severe bleeding, colonoscopy should be performed within 24 hours of presentation after an adequate orally administered colon preparation. Additional washing during colonoscopy and careful inspection should be performed to identify high-risk stigmata. Endoscopic therapy should be attempted if high-risk bleeding stigmata are identified. The endoscopic treatment modality depends on the bleeding source, location, operator expertise, and the need for ongoing anticoagulation or antiplatelet therapy.\u0000This review 5 tables, 5 figures, and 50 references.\u0000Keywords: argon plasma coagulation, clipping, colonoscopy, diverticular bleeding, endoscopic band ligation, endoscopic hemostasis, postpolypectomy bleeding, stigmata of recent hemorrhage, vascular ectasias","PeriodicalId":11220,"journal":{"name":"DeckerMed Medicine","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88735309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lung Transplantation 2: Care of the Lung Transplant Recipient","authors":"H. Goldberg","doi":"10.2310/im.1347","DOIUrl":"https://doi.org/10.2310/im.1347","url":null,"abstract":"<jats:p />","PeriodicalId":11220,"journal":{"name":"DeckerMed Medicine","volume":"437 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79614081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：