Osteoarthritis is a common form of arthritis characterized by degeneration of articular cartilage and pathologic changes in surrounding bone and periarticular tissue. The disease process results in pain and dysfunction of affected joints and is a major cause of disability in the general population. Prognosis is variable; greater muscle strength, mental health, self-efficacy, social support, and aerobic exercise are associated with better outcomes. This review outlines the classification of osteoarthritis (primary and secondary) and its epidemiology and etiologic factors, including risk factors, normal articular cartilage, and pathologic changes. Diagnosis is reviewed in terms of general considerations and specific joint involvement and related complications. The differential diagnosis is discussed. Management of osteoarthritis includes nonpharmacologic measures, pharmacologic therapy, surgery, and disease-modifying or chondroprotective therapy. This review contains 6 figures, 8 tables, and 84 references. Keywords: Knee, hand, hip, osteoarthritis, joint pain, synovial fluid, inflammation, weight-bearing
{"title":"Osteoarthritis","authors":"C. Wise","doi":"10.32388/lnafkb","DOIUrl":"https://doi.org/10.32388/lnafkb","url":null,"abstract":"Osteoarthritis is a common form of arthritis characterized by degeneration of articular cartilage and pathologic changes in surrounding bone and periarticular tissue. The disease process results in pain and dysfunction of affected joints and is a major cause of disability in the general population. Prognosis is variable; greater muscle strength, mental health, self-efficacy, social support, and aerobic exercise are associated with better outcomes. This review outlines the classification of osteoarthritis (primary and secondary) and its epidemiology and etiologic factors, including risk factors, normal articular cartilage, and pathologic changes. Diagnosis is reviewed in terms of general considerations and specific joint involvement and related complications. The differential diagnosis is discussed. Management of osteoarthritis includes nonpharmacologic measures, pharmacologic therapy, surgery, and disease-modifying or chondroprotective therapy. \u0000This review contains 6 figures, 8 tables, and 84 references.\u0000Keywords: Knee, hand, hip, osteoarthritis, joint pain, synovial fluid, inflammation, weight-bearing","PeriodicalId":196621,"journal":{"name":"DeckerMed Transitional Year Weekly Curriculum™","volume":"269 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122538297","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}
The upper respiratory tract includes the sinuses, nasal passages, pharynx, and larynx, and is susceptible to a variety of pathogens including many viruses. Although other pathogens can also cause infections of the upper respiratory tract, we are focusing on viral illnesses for the purposes of this review. Upper respiratory tract infections (URIs) include sinusitis, nasopharyngitis (common cold), pharyngitis, epiglottitis, and tracheitis. URI’s are one of the most frequent causes for visits to see a physician in the United States. Despite the fact that many URIs are caused by viral pathogens, more than half of patients in both the clinic and the emergency department setting with a diagnosis of URI received antibiotics. URIs are generally mild, and self-limited illnesses; however, it is important to recognize clinical entities that may be severe and warrant more extensive diagnostic workup and treatment such as epiglottitis and tracheitis. This review covers the pathophysiology, diagnosis, treatment, disposition and outcome for multiple viral URIs seen commonly in the emergency department setting. This review contains 3 figures, 8 tables, and 87 references. Key words: Common cold, epiglottitis, nasopharyngitis, pharyngitis, sinusitis, tracheitis, upper respiratory tract infection
{"title":"Viral Upper Respiratory Infection","authors":"James C. Simpson, K. Dwyer","doi":"10.2310/TYWC.4237","DOIUrl":"https://doi.org/10.2310/TYWC.4237","url":null,"abstract":"The upper respiratory tract includes the sinuses, nasal passages, pharynx, and larynx, and is susceptible to a variety of pathogens including many viruses. Although other pathogens can also cause infections of the upper respiratory tract, we are focusing on viral illnesses for the purposes of this review. Upper respiratory tract infections (URIs) include sinusitis, nasopharyngitis (common cold), pharyngitis, epiglottitis, and tracheitis. URI’s are one of the most frequent causes for visits to see a physician in the United States. Despite the fact that many URIs are caused by viral pathogens, more than half of patients in both the clinic and the emergency department setting with a diagnosis of URI received antibiotics. URIs are generally mild, and self-limited illnesses; however, it is important to recognize clinical entities that may be severe and warrant more extensive diagnostic workup and treatment such as epiglottitis and tracheitis. This review covers the pathophysiology, diagnosis, treatment, disposition and outcome for multiple viral URIs seen commonly in the emergency department setting.\u0000This review contains 3 figures, 8 tables, and 87 references.\u0000Key words: Common cold, epiglottitis, nasopharyngitis, pharyngitis, sinusitis, tracheitis, upper respiratory tract infection\u0000 ","PeriodicalId":196621,"journal":{"name":"DeckerMed Transitional Year Weekly Curriculum™","volume":"164 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116646318","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}
Of patients who present with major gastrointestinal (GI) bleeding, 20 to 30% will ultimately be diagnosed with bleeding originating from a lower GI source. Lower GI bleeding has traditionally been defined as bleeding originating from a source distal to the ligament of Treitz; however, with the advent of capsule endoscopy and deep enteroscopy allowing for visualization of the entire small bowel, the definition has been updated to GI bleeding originating from a source distal to the ileocecal valve. Lower GI bleeding can range from occult blood loss to massive bleeding with hemodynamic instability and predominantly affects older individuals, with a mean age at presentation of 63 to 77 years. Comorbid illness, which is a risk factor for mortality from GI bleeding, is also more common with increasing age. Most deaths related to GI bleeding are not due to uncontrolled hemorrhage but exacerbation of underlying comorbidities or nosocomial complications. This review covers the following areas: evaluation of lower GI bleeding (including physical examination and diagnostic tests), initial management, and differential diagnosis. Disorders addressed in the differential diagnosis include diverticulosis, arteriovenous malformations (AVMs), ischemic colitis, anorectal disorders, radiation proctitis, postpolypectomy bleeding, and colorectal neoplasms. Figures show an algorithm for management of patients with suspected lower GI bleeding, tagged red blood cell scans, diverticular bleeding, colonic AVM, ischemic colitis, bleeding hemorrhoid, chronic radiation proctitis, and ileocolonic valve polyp. Tables list descriptive terms for rectal bleeding and suggested location of bleeding, imaging modalities and differential diagnosis for lower GI bleeding, endoscopic techniques for hemostasis, and an internal hemorrhoids grading system. This review contains 9 figures, 8 tables, and 103 references.
{"title":"Lower Gastrointestinal Bleeding","authors":"J. Nayor, J. Saltzman","doi":"10.2310/surg.2170","DOIUrl":"https://doi.org/10.2310/surg.2170","url":null,"abstract":"Of patients who present with major gastrointestinal (GI) bleeding, 20 to 30% will ultimately be diagnosed with bleeding originating from a lower GI source. Lower GI bleeding has traditionally been defined as bleeding originating from a source distal to the ligament of Treitz; however, with the advent of capsule endoscopy and deep enteroscopy allowing for visualization of the entire small bowel, the definition has been updated to GI bleeding originating from a source distal to the ileocecal valve. Lower GI bleeding can range from occult blood loss to massive bleeding with hemodynamic instability and predominantly affects older individuals, with a mean age at presentation of 63 to 77 years. Comorbid illness, which is a risk factor for mortality from GI bleeding, is also more common with increasing age. Most deaths related to GI bleeding are not due to uncontrolled hemorrhage but exacerbation of underlying comorbidities or nosocomial complications. This review covers the following areas: evaluation of lower GI bleeding (including physical examination and diagnostic tests), initial management, and differential diagnosis. Disorders addressed in the differential diagnosis include diverticulosis, arteriovenous malformations (AVMs), ischemic colitis, anorectal disorders, radiation proctitis, postpolypectomy bleeding, and colorectal neoplasms. Figures show an algorithm for management of patients with suspected lower GI bleeding, tagged red blood cell scans, diverticular bleeding, colonic AVM, ischemic colitis, bleeding hemorrhoid, chronic radiation proctitis, and ileocolonic valve polyp. Tables list descriptive terms for rectal bleeding and suggested location of bleeding, imaging modalities and differential diagnosis for lower GI bleeding, endoscopic techniques for hemostasis, and an internal hemorrhoids grading system.\u0000This review contains 9 figures, 8 tables, and 103 references.","PeriodicalId":196621,"journal":{"name":"DeckerMed Transitional Year Weekly Curriculum™","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116461104","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}
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
{"title":"Asthma","authors":"Haitham Nsour, A. Dixon","doi":"10.2310/tywc.4205","DOIUrl":"https://doi.org/10.2310/tywc.4205","url":null,"abstract":"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.\u0000\u0000This review contains 3 figures, 16 tables, and 88 references.\u0000Key Words: Asthma, allergic bronchopulmonary aspergillosis, gastroesophageal reflux disease, sinus disease, breathlessness, shortness of breath\u0000 ","PeriodicalId":196621,"journal":{"name":"DeckerMed Transitional Year Weekly Curriculum™","volume":"171 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121715712","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}
During pregnancy many chronic gastrointestinal disorders can undergo exacerbations. In addition, pregnant women are often susceptible to new gastrointestinal symptoms. The goal of care is to control symptoms, minimize exposure to excessive tests and medications and rule out any urgent need for surgery. Efforts should be made to minimize risk to mother and fetus when performing diagnostic endoscopic and radiologic tests. In this chapter, we will review the current management of common gastrointestinal disorders during pregnancy, including gastro-esophageal reflux disease, constipation, appendicitis, inflammatory bowel disease and gall stone disease. The safety of medications used to treat gastrointestinal disease will be reviewed and new treatment guidelines and concepts will be discussed. This review contains 5 tables, 4 figures and 55 references. Key words: appendicitis, cholelithiasis, constipation, Crohn’s disease, gall stones, gastrointestinal disease, gastro-esophageal reflux disease, jaundice, pregnancy, ulcerative colitis
{"title":"Gastrointestinal Diseases in Pregnancy","authors":"Jennifer X. Cai, P. S. D. Silva","doi":"10.2310/TYWC.19053","DOIUrl":"https://doi.org/10.2310/TYWC.19053","url":null,"abstract":"During pregnancy many chronic gastrointestinal disorders can undergo exacerbations. In addition, pregnant women are often susceptible to new gastrointestinal symptoms. The goal of care is to control symptoms, minimize exposure to excessive tests and medications and rule out any urgent need for surgery. Efforts should be made to minimize risk to mother and fetus when performing diagnostic endoscopic and radiologic tests. In this chapter, we will review the current management of common gastrointestinal disorders during pregnancy, including gastro-esophageal reflux disease, constipation, appendicitis, inflammatory bowel disease and gall stone disease. The safety of medications used to treat gastrointestinal disease will be reviewed and new treatment guidelines and concepts will be discussed.\u0000This review contains 5 tables, 4 figures and 55 references.\u0000Key words: appendicitis, cholelithiasis, constipation, Crohn’s disease, gall stones, gastrointestinal disease, gastro-esophageal reflux disease, jaundice, pregnancy, ulcerative colitis","PeriodicalId":196621,"journal":{"name":"DeckerMed Transitional Year Weekly Curriculum™","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133488990","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}
Coronaviruses (CoVs) are a group of viral pathogens that infect mammals and birds. The presentation in humans is typically that of a mild upper respiratory tract infection, similar to the common cold. However, in recent years, dramatic attention has arisen for more lethal members of this viral family (e.g., severe acute respiratory syndrome [SARS-CoV], Middle East respiratory syndrome [MERS-CoV], and coronavirus disease 2019 [COVID-19]). The epidemiology, clinical presentation, diagnosis, and management of these viruses are discussed in this review. Importantly, new guideline tables from the Centers for Disease Control and Prevention, as well as the World Health Organization are provided at the conclusion of the review. This review contains 12 tables, 3 figure and 48 references. Keywords: Coronavirus, severe acute respiratory distress syndrome (SARS), Middle East respiratory syndrome (MERS), COVID-19, respiratory infection, antiviral, real-time polymerase chain reaction
{"title":"Coronaviruses: HCoV, SARS-CoV, MERS-CoV, and COVID-19","authors":"M. Ison","doi":"10.2310/tywc.1422","DOIUrl":"https://doi.org/10.2310/tywc.1422","url":null,"abstract":"Coronaviruses (CoVs) are a group of viral pathogens that infect mammals and birds. The presentation in humans is typically that of a mild upper respiratory tract infection, similar to the common cold. However, in recent years, dramatic attention has arisen for more lethal members of this viral family (e.g., severe acute respiratory syndrome [SARS-CoV], Middle East respiratory syndrome [MERS-CoV], and coronavirus disease 2019 [COVID-19]). The epidemiology, clinical presentation, diagnosis, and management of these viruses are discussed in this review. Importantly, new guideline tables from the Centers for Disease Control and Prevention, as well as the World Health Organization are provided at the conclusion of the review.\u0000This review contains 12 tables, 3 figure and 48 references.\u0000Keywords: Coronavirus, severe acute respiratory distress syndrome (SARS), Middle East respiratory syndrome (MERS), COVID-19, respiratory infection, antiviral, real-time polymerase chain reaction","PeriodicalId":196621,"journal":{"name":"DeckerMed Transitional Year Weekly Curriculum™","volume":"114 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120886083","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}
Psychotic disorders are among the most disabling conditions and constitute a major public health problem. Described throughout recorded time, they affect as many as 5% of the population and cause a disproportionate amount of suffering and loss to society. In the chapter on schizophrenia spectrum and other psychotic disorders, the DSM-5 lists delusional disorder, brief psychotic disorder, schizophreniform disorder, schizophrenia, and schizoaffective disorder, as well as categories for substance- or medically induced psychotic disorders. The term psychosis indicates that the individual has a severe inability to interpret the surrounding environment in a realistic way. Symptoms include hallucinations, delusions, and bizarre behavior. Psychotic disorders are associated with premature death, mostly attributable to suicide. The pathophysiology and etiology of psychotic disorders are only now beginning to be understood, and treatment for these conditions remains suboptimal. Researchers are currently refining the cause of these symptoms and developing more effective treatments. This review contains 3 tables, and 34 references. Key words: Brief psychotic disorder, delusions, hallucinations, psychosis, schizoaffective disorder, schizophrenia, schizophreniform disorder
{"title":"Overview of Schizophrenia and Other Psychotic Disorders","authors":"J. Wilcox, D. Black","doi":"10.2310/PSYCH.13011","DOIUrl":"https://doi.org/10.2310/PSYCH.13011","url":null,"abstract":"Psychotic disorders are among the most disabling conditions and constitute a major public health problem. Described throughout recorded time, they affect as many as 5% of the population and cause a disproportionate amount of suffering and loss to society. In the chapter on schizophrenia spectrum and other psychotic disorders, the DSM-5 lists delusional disorder, brief psychotic disorder, schizophreniform disorder, schizophrenia, and schizoaffective disorder, as well as categories for substance- or medically induced psychotic disorders. The term psychosis indicates that the individual has a severe inability to interpret the surrounding environment in a realistic way. Symptoms include hallucinations, delusions, and bizarre behavior. Psychotic disorders are associated with premature death, mostly attributable to suicide. The pathophysiology and etiology of psychotic disorders are only now beginning to be understood, and treatment for these conditions remains suboptimal. Researchers are currently refining the cause of these symptoms and developing more effective treatments. \u0000This review contains 3 tables, and 34 references.\u0000Key words: Brief psychotic disorder, delusions, hallucinations, psychosis, schizoaffective disorder, schizophrenia, schizophreniform disorder","PeriodicalId":196621,"journal":{"name":"DeckerMed Transitional Year Weekly Curriculum™","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124563704","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}
Pub Date : 2020-08-13DOI: 10.1007/0-387-31804-6_10
Joel A. Gross, M. Gunn, Kathleen R. Fink
{"title":"Trauma Imaging","authors":"Joel A. Gross, M. Gunn, Kathleen R. Fink","doi":"10.1007/0-387-31804-6_10","DOIUrl":"https://doi.org/10.1007/0-387-31804-6_10","url":null,"abstract":"","PeriodicalId":196621,"journal":{"name":"DeckerMed Transitional Year Weekly Curriculum™","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123766355","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}
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