BOOK
Fracture Management for Primary Care and Emergency Medicine E-Book
M. Patrice Eiff | Robert L. Hatch
(2018)
Additional Information
Book Details
Abstract
Fracture Management for Primary Care and Emergency Medicine E-Book
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| IBC | ES1 | ||
| Neonatology Questions and Controversies | i | ||
| Series Page | ii | ||
| Neonatology Questions and Controversies | iii | ||
| Copyright | iv | ||
| Contributors | v | ||
| Preface | ix | ||
| Series Foreword | xi | ||
| Contents | xiii | ||
| 1 - Cerebral Circulation and Hypotension in the Premature Infant: Diagnosis and Treatment | 1 | ||
| Definition of Hypotension | 2 | ||
| Pathogenesis and Diagnosis of Pathologic Cerebral Blood Flow | 7 | ||
| Monitoring of Blood Pressure, Systemic and Organ Blood Flow, and Cerebral Function | 11 | ||
| Doppler Ultrasound | 11 | ||
| Impedance Electrical Cardiometry | 12 | ||
| Near-Infrared Spectroscopy | 12 | ||
| Amplitude-Integrated EEG (Cerebral Function Monitoring) | 13 | ||
| Summary of the Monitoring Methods Discussed | 14 | ||
| Treatment Strategies | 14 | ||
| Systemic Hypotension | 15 | ||
| Treatment of Hypotension Associated With PDA | 16 | ||
| Treatment of Hypotension Associated With Other Causes Such as Sepsis, Adrenal Insufficiency, and Hypovolemia | 17 | ||
| The Impact of Provision of Intensive Care on Systemic and Cerebral Hemodynamics | 18 | ||
| Summary and Recommendations | 19 | ||
| Diagnosis of Hypotension | 19 | ||
| Treatment of Hypotension | 20 | ||
| REFERENCES | 22 | ||
| 2 - Intraventricular Hemorrhage and White Matter Injury in the Preterm Infant | 27 | ||
| Background | 28 | ||
| Neuropathology: Relevance to Clinical Findings | 28 | ||
| Pathogenesis | 28 | ||
| Periventricular White Matter Injury Associated With IVH | 29 | ||
| Clinical Features | 30 | ||
| Complications | 30 | ||
| Prevention | 30 | ||
| Perinatal Strategies | 30 | ||
| Antenatal Steroids | 30 | ||
| Pregnancy-Induced Hypertension | 31 | ||
| Magnesium Sulfate | 31 | ||
| Route of Delivery | 31 | ||
| Delayed Cord Clamping | 32 | ||
| Postnatal Strategies | 32 | ||
| Postnatal Factors Associated With an Increased Risk | 32 | ||
| Postnatal Administration of Medications to Reduce Severe IVH | 33 | ||
| White Matter Injury in the Absence of Hemorrhage | 33 | ||
| Periventricular Leukomalacia | 35 | ||
| Pathogenesis | 35 | ||
| Vascular Factors | 35 | ||
| Intrinsic Vulnerability of the Differentiating Oligodendrocyte | 36 | ||
| Free Radical Injury | 36 | ||
| Excitotoxic Injury (Glutamate) | 36 | ||
| Cytokines | 37 | ||
| Maternal Fetal Infection and/or Inflammation and White Matter Injury | 37 | ||
| Clinical Factors Associated With PVL | 38 | ||
| Prevention | 38 | ||
| Outcome | 39 | ||
| Intraventricular Hemorrhage | 39 | ||
| White Matter Injury | 39 | ||
| Gaps in Knowledge | 40 | ||
| Conclusions | 40 | ||
| REFERENCES | 40 | ||
| 3 - Posthemorrhagic Hydrocephalus Management Strategies | 47 | ||
| Question 1: What Measurements of Ventricular Size Are Used in Diagnosis of PHVD? | 49 | ||
| Question 2: How Can Ventricular Dilation Driven By Cerebrospinal Fluid Under Pressure Be Distinguished From Ventricular Dilation Caused By Loss of Periventricular White Matter? | 51 | ||
| Question 3: How Is Excessive Head Enlargement Defined? | 51 | ||
| Question 4: How Is Raised Intracranial Pressure Recognized? | 51 | ||
| Question 5: What Is Infant A’s Prognosis? | 52 | ||
| Question 6: What Is the Mechanism of PHVD? | 53 | ||
| Question 7: How Can PHVD Injure White Matter? | 53 | ||
| Raised Intracranial Pressure, Parenchymal Compression, and Ischemia | 53 | ||
| Free Radical‒Mediated Injury | 54 | ||
| Proinflammatory Cytokines | 55 | ||
| Loss of White Matter and Gray Matter | 55 | ||
| Question 8: What Interventions Have Been Used in PHVD, and Is There Any Evidence That They Improve Outcome? | 55 | ||
| Ventriculoperitoneal Shunt Surgery | 55 | ||
| Objectives in Treating PHVD | 55 | ||
| Repeated Lumbar Punctures or Ventricular Taps | 56 | ||
| Drug Treatment to Reduce CSF Production | 56 | ||
| Intraventricular Fibrinolytic Therapy | 56 | ||
| External Ventricular Drain | 56 | ||
| Tapping Via an Ommaya Reservoir | 57 | ||
| Ventriculosubgaleal Shunt | 57 | ||
| Third Ventriculostomy | 58 | ||
| Choroid Plexus Coagulation | 58 | ||
| Drainage, Irrigation, and Fibrinolytic Therapy | 58 | ||
| Stem Cell Therapy | 60 | ||
| Conclusions | 60 | ||
| Gaps in Knowledge | 60 | ||
| REFERENCES | 60 | ||
| 4 - Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: Different Cooling Regimens and Infants Not Included in Prior Trials | 63 | ||
| Rationale for Further Investigations of Therapeutic Hypothermia | 64 | ||
| What Is the Optimal Temperature and Duration for Therapeutic Hypothermia? | 64 | ||
| How Late Can Hypothermia be Initiated? | 66 | ||
| Should Infants With Mild HIE Receive Hypothermia Therapy? | 68 | ||
| Should Hypothermia Be Used in Preterm Infants With HIE? | 70 | ||
| How Should Cooling on Transport Be Conducted? | 71 | ||
| Is Therapeutic Hypothermia Neuroprotective When Used in Low- and Middle-Income Countries? | 72 | ||
| Conclusions | 73 | ||
| REFERENCES | 74 | ||
| 5 - General Supportive Management of the Term Infant With Neonatal Encephalopathy Following Intrapartum Hypoxia-Ischemia | 77 | ||
| Introduction | 79 | ||
| Delivery Room Management | 79 | ||
| Early Identification of Infants at Highest Risk for Development of Hypoxic-Ischemic Brain Injury | 80 | ||
| Supportive Care | 81 | ||
| Ventilation | 81 | ||
| Maintenance of Adequate Perfusion | 82 | ||
| Fluid Status | 82 | ||
| Control of Blood Glucose Concentration | 82 | ||
| Temperature | 83 | ||
| Seizures | 84 | ||
| Prophylactic Barbiturates | 84 | ||
| Potential Neuroprotective Strategies Aimed at Ameliorating Secondary Brain Injury | 85 | ||
| Oxygen Free Radical Inhibitors and Scavengers | 85 | ||
| Excitatory Amino Acid Antagonists | 86 | ||
| Magnesium | 86 | ||
| Xenon | 87 | ||
| Erythropoietin | 87 | ||
| Gaps in Knowledge | 88 | ||
| REFERENCES | 88 | ||
| 6 - Focal Cerebral Infarction | 93 | ||
| Perinatal Arterial Ischemic Stroke | 94 | ||
| Epidemiology | 94 | ||
| Risk Factors | 94 | ||
| Maternal Risk Factors | 94 | ||
| Antepartum and Intrapartum Risk Factors | 95 | ||
| Placental Risk Factors | 95 | ||
| Infant Factors | 95 | ||
| Clinical Manifestations | 96 | ||
| Fetal Ischemic Stroke | 96 | ||
| Neonatal Arterial Stroke | 96 | ||
| Ischemic Stroke in the Preterm Infant | 96 | ||
| Presumed Perinatal Ischemic Stroke | 97 | ||
| Imaging Arterial Ischemic Stroke | 97 | ||
| Management of Perinatal Arterial Ischemic Stroke | 98 | ||
| Cerebral Sinovenous Thrombosis | 99 | ||
| Epidemiology | 99 | ||
| Risk Factors for CSVT | 99 | ||
| Clinical Manifestations | 100 | ||
| Imaging CSVT | 100 | ||
| Management of CSVT | 100 | ||
| Hemorrhagic Stroke | 101 | ||
| Clinical Features | 101 | ||
| Hemorrhagic Stroke in Preterm Infants | 102 | ||
| Imaging Hemorrhagic Stroke | 102 | ||
| Management of Perinatal Hemorrhagic Stroke | 102 | ||
| Evaluation of Newborns With Suspected Stroke | 102 | ||
| History and Physical Examination | 102 | ||
| Differential Diagnosis | 103 | ||
| Approach to Investigations (Table 6.2) | 103 | ||
| Neuroimaging | 103 | ||
| Laboratory Investigations | 103 | ||
| Electroencephalography | 104 | ||
| Placental Pathology | 105 | ||
| Neurologic Outcome | 105 | ||
| Neuromotor Outcome | 105 | ||
| Neonatal Seizures and Epilepsy | 105 | ||
| Neurobehavioral Outcome | 105 | ||
| Visual Function | 106 | ||
| Stroke Recurrence | 106 | ||
| Controversies in Neonatal Stroke | 106 | ||
| Hematologic Investigations | 106 | ||
| Therapeutic Hypothermia for Neonatal Stroke | 106 | ||
| Anticoagulation for CSVT | 107 | ||
| REFERENCES | 107 | ||
| 7 - Diagnosis and Management of Acute Seizures in Neonates | 111 | ||
| Diagnosis | 111 | ||
| Classifications | 111 | ||
| Focal Clonic Seizures | 111 | ||
| Focal Tonic Seizures | 114 | ||
| Myoclonic Jerks | 114 | ||
| Autonomic Signs | 114 | ||
| Spasms | 114 | ||
| Subclinical Seizures | 114 | ||
| Definition of Seizures | 114 | ||
| Definition of Neonatal Status Epilepticus | 115 | ||
| Controversies in Definition and Classification of Seizures | 115 | ||
| Differential Diagnosis | 115 | ||
| Diagnostic Tools and Monitoring | 116 | ||
| EEG Characteristics of Neonatal Seizures | 117 | ||
| Standard EEG Versus Long-Term or Continuous Monitoring | 117 | ||
| Controversies in Monitoring | 117 | ||
| Management | 118 | ||
| Therapy | 120 | ||
| Efficacy and Safety of Antiseizure Medications for Seizures | 121 | ||
| Phenobarbital and Phenytoin | 121 | ||
| Midazolam | 122 | ||
| Lidocaine | 122 | ||
| Levetiracetam | 122 | ||
| Topiramate | 122 | ||
| Antiepileptic Drug Treatment Duration and Discontinuation | 122 | ||
| Hypothermia | 123 | ||
| Controversies in Therapy | 123 | ||
| “Newborn-Tailored” Pharmacotherapy | 123 | ||
| Age-Appropriate Antiseizure Therapies | 124 | ||
| Timing of Therapy Administration | 124 | ||
| Predictors of Response to Antiseizure Medications | 124 | ||
| Electrographic-Only Seizures | 124 | ||
| Synergistic Effects of Hypothermia and Anticonvulsant Medications | 124 | ||
| Conclusions | 124 | ||
| REFERENCES | 125 | ||
| 8 - Neonatal-Onset Epilepsies: Early Diagnosis and Targeted Treatment | 131 | ||
| The New Chapter of Neonatal Epilepsies | 132 | ||
| Landscape of the Neonatal Epilepsies | 132 | ||
| KCNQ2/3-Associated Neonatal Epilepsies | 133 | ||
| Epilepsy of Infancy With Migrating Focal Seizures Associated With KCNT1 | 137 | ||
| SCN2A-Associated Neonatal Epilepsies | 138 | ||
| The Promise and the Challenge of Precision Medicine in the Nursery | 138 | ||
| REFERENCES | 139 | ||
| 9 - Glucose and Perinatal Brain Injury—Questions and Controversies | 141 | ||
| Glucose Metabolism in the Fetus and Newborn | 142 | ||
| Preterm Infants | 142 | ||
| Intrauterine Growth Restriction | 142 | ||
| Cerebral Metabolism of Glucose | 143 | ||
| Alternate Substrates to Glucose | 143 | ||
| Glucose Transporters | 144 | ||
| Definitions | 144 | ||
| Controversy and Question | 145 | ||
| Symptomatic Versus Asymptomatic Hypoglycemia | 145 | ||
| Duration of Hypoglycemia | 146 | ||
| Causes of Hypoglycemia | 148 | ||
| Incidence | 148 | ||
| Pathophysiology of Hypoglycemia | 149 | ||
| Cerebral Blood Flow, Glucose Utilization, and Cerebral Energy Metabolism | 149 | ||
| Cerebral Biochemical Alterations During Hypoglycemia | 149 | ||
| Hypoglycemia and Brain Damage | 150 | ||
| Neuroimaging Abnormalities | 151 | ||
| Controversy and Question | 153 | ||
| Hypoglycemia and Hypoxia-Ischemia, Seizures | 153 | ||
| Case History | 154 | ||
| Outcome | 155 | ||
| Treatment | 156 | ||
| Conclusions | 157 | ||
| REFERENCES | 157 | ||
| 10 - Hyperbilirubinemia and the Risk for Brain Injury | 163 | ||
| Definition and Epidemiology | 164 | ||
| History of KSD Prevalence | 165 | ||
| Pathogenesis of Bilirubin Neurotoxicity | 165 | ||
| Active Transport of Bilirubin | 166 | ||
| Mechanisms of Bilirubin Damage | 166 | ||
| Bilirubin and Calcium Homeostasis | 166 | ||
| Mechanisms of Auditory Dysfunction | 167 | ||
| Neuroprotective Action of Bilirubin | 167 | ||
| Molecular Response to Hyperbilirubinemia | 167 | ||
| Developmental Susceptibility | 168 | ||
| Diagnosis: Acute Bilirubin Encephalopathy and Kernicterus Spectrum Disorders | 168 | ||
| Suggested Improvements to the AAP Guidelines for the Treatment of Hyperbilirubinemia | 168 | ||
| Acute Bilirubin Encephalopathy | 169 | ||
| ABE and Auditory Nervous System | 169 | ||
| ABE and Neuroimaging | 171 | ||
| New Strategies in the Diagnosis of ABE | 172 | ||
| Kernicterus Spectrum Disorders | 172 | ||
| Diagnosis of Kernicterus Spectrum Disorders | 172 | ||
| Recommendations for Prevention and Treatment | 174 | ||
| Recommendation for the Prevention and Treatment of ABE | 174 | ||
| Recommendation for the Diagnosis of KSD and Treatment of Its Clinical Manifestations | 178 | ||
| Expanding the Idea of Kernicterus as a Spectrum of Disorders | 179 | ||
| Bilirubin Neurotoxicity in the Very Premature Infant | 179 | ||
| Difficulties in Assessing Kernicterus in Preterm Infants | 180 | ||
| Genetics of KSDs and Susceptibility to Bilirubin Neurotoxicity | 181 | ||
| Gaps in Knowledge | 182 | ||
| Conclusion | 182 | ||
| REFERENCES | 183 | ||
| 11 - Neonatal Meningitis: Current Treatment Options | 187 | ||
| Question 1: What Risk Factors Predispose This Infant to Have Early-Onset Bacterial Meningitis? | 188 | ||
| Question 2: Do Infants With Meningitis Have Positive Blood Cultures? | 189 | ||
| Question 3: What Is the Optimal Evaluation for Possible Late-Onset Sepsis in Preterm Infants in the NICU? | 191 | ||
| Question 4: What Is the Empirical Antimicrobial Choice for Possible Late-Onset Sepsis in the NICU? | 192 | ||
| Question 5: What Is the Treatment of Meningitis in Neonates, Particularly That Caused by Gram-Negative Bacilli? | 193 | ||
| Question 6: Should Other Therapies Be Considered? | 195 | ||
| Question 7: What Is the Duration of Treatment for Meningitis in Neonates? | 197 | ||
| Question 8: When Should Neuroimaging Be Considered, and What Type of Examination Is Recommended? | 197 | ||
| Question 9: Should Other Adjunctive Therapies Be Provided to an Infant With Meningitis? | 199 | ||
| Question 10: What If the Infant’s CSF Is Abnormal but Routine Bacterial Cultures of CSF and Blood Are Sterile? | 199 | ||
| Question 11: What Is the Outcome of Meningitis in Neonates? | 200 | ||
| Conclusion | 200 | ||
| REFERENCES | 200 | ||
| 12 - Neonatal Herpes Simplex Virus, Congenital Cytomegalovirus, and Congenital Zika Virus Infections | 207 | ||
| Question 1: When Does Infection Occur? | 207 | ||
| Neonatal HSV Disease | 207 | ||
| Congenital CMV Infection | 208 | ||
| Congenital Zika Infection | 208 | ||
| Question 2: What Are the Risk Factors for Neonatal Infection? | 208 | ||
| Neonatal HSV Disease | 208 | ||
| Congenital CMV Infection | 209 | ||
| Congenital Zika Infection | 209 | ||
| Question 3: What Are the Clinical Manifestations of Neonatal Infection and Disease? | 210 | ||
| Neonatal HSV Disease | 210 | ||
| Congenital CMV Infection | 210 | ||
| Congenital Zika Infection | 211 | ||
| Question 4: What Are the Treatments and Outcomes for HSV, CMV, and Zika Virus Infections in Neonates? | 212 | ||
| Neonatal HSV Disease | 212 | ||
| 13 - Neonatal Hypotonia | 223 | ||
| Clinical History Collection | 223 | ||
| Clinical Evaluation | 224 | ||
| Neurologic Examination of the Hypotonic Infant | 225 | ||
| Diagnostic Investigation | 225 | ||
| Most Common Neuromuscular Disorders Presenting With Congenital Hypotonia | 227 | ||
| Spinal Muscular Atrophies | 227 | ||
| Myopathies | 228 | ||
| Congenital Muscular Dystrophies | 228 | ||
| Congenital Myopathies | 230 | ||
| Pompe Disease | 230 | ||
| Congenital Myotonic Dystrophy | 231 | ||
| Neuromuscular Junction Defects | 231 | ||
| REFERENCES | 232 | ||
| 14 - Amplitude-Integrated EEG and Its Potential Role in Augmenting Management Within the NICU | 235 | ||
| Amplitude-Integrated EEG | 235 | ||
| Assessment of aEEG Background Pattern | 236 | ||
| Comparison With Standard EEG | 237 | ||
| Background Pattern | 237 | ||
| Prognostic Value of aEEG in HIE: Noncooled Situation | 237 | ||
| Prognostic Value of aEEG in HIE: Cooled Situation | 238 | ||
| aEEG and Seizures | 240 | ||
| Seizure Detection | 240 | ||
| Should We Treat Subclinical Seizures? | 242 | ||
| aEEG in Preterm Infants | 243 | ||
| Pitfalls and Artifacts | 246 | ||
| Seizure-Like Artifacts | 247 | ||
| aEEG in Other Clinical Conditions | 247 | ||
| Gaps in Knowledge | 248 | ||
| Conclusion | 252 | ||
| REFERENCES | 252 | ||
| 15 - Congenital Heart Disease: An Important Cause of Brain Injury and Dysmaturation | 257 | ||
| Fetal Brain Injury and Maturation | 258 | ||
| Prenatal Diagnosis | 258 | ||
| Postnatal Diagnosis | 258 | ||
| Malformation Grouping | 260 | ||
| Transposition of Great Vessels | 260 | ||
| Hypoplastic Left Heart Syndrome | 262 | ||
| Brain Injury and Brain Maturation | 262 | ||
| Cranial Ultrasound Versus MRI | 262 | ||
| Cerebral Ischemia and Stroke | 264 | ||
| White Matter Injury | 265 | ||
| Cerebral Sinovenous Thrombosis | 266 | ||
| Subdural Hemorrhage | 266 | ||
| Brain Dysmaturation | 266 | ||
| Neuromonitoring | 267 | ||
| Intraoperative Monitoring | 267 | ||
| Near-Infrared Spectroscopy | 267 | ||
| Amplitude-Integrated Electroencephalography | 268 | ||
| Continuous Electroencephalography | 268 | ||
| Advanced Magnetic Resonance Imaging Techniques in Congenital Heart Disease | 269 | ||
| MR Diffusion Tensor Imaging | 269 | ||
| Magnetic Resonance Spectroscopy | 269 | ||
| Functional MRI | 269 | ||
| Other Techniques | 270 | ||
| Neurodevelopment of the Infant With CHD | 270 | ||
| Predictors of Outcomes | 270 | ||
| Preoperative Factors | 272 | ||
| Intraoperative Factors | 272 | ||
| Postoperative Factors | 272 | ||
| New Interventions and Neuroprotection | 273 | ||
| Gaps in Knowledge | 273 | ||
| REFERENCES | 273 | ||
| 16 - Long-Term Follow-Up of the Very Preterm Graduate | 281 | ||
| The Major Sequelae of Very Preterm Birth | 282 | ||
| Cerebral Palsy | 282 | ||
| Cognitive Impairment in Infancy | 283 | ||
| Sensory Outcomes | 283 | ||
| Behavior | 283 | ||
| Classification of Impairment | 284 | ||
| Learning Points | 284 | ||
| Transition to School | 285 | ||
| Starting School | 285 | ||
| Emerging Impairments at Early School Age | 285 | ||
| Cognitive Function | 285 | ||
| School Attainment | 286 | ||
| Behavior | 286 | ||
| Motor Problems | 286 | ||
| Changes Over Time for Individual Children | 287 | ||
| Learning Points | 287 | ||
| Transition to Young Adult Life | 288 | ||
| Learning Points | 289 | ||
| Components of a Follow-Up Program | 289 | ||
| Gaps in Knowledge | 290 | ||
| Conclusions | 290 | ||
| REFERENCES | 290 | ||
| Index | 293 | ||
| A | 293 | ||
| B | 294 | ||
| C | 294 | ||
| D | 295 | ||
| E | 296 | ||
| F | 296 | ||
| G | 296 | ||
| H | 297 | ||
| I | 298 | ||
| K | 299 | ||
| L | 299 | ||
| M | 299 | ||
| N | 300 | ||
| O | 301 | ||
| P | 301 | ||
| Q | 302 | ||
| R | 302 | ||
| S | 302 | ||
| T | 303 | ||
| U | 304 | ||
| V | 304 | ||
| W | 304 | ||
| X | 304 | ||
| Y | 304 | ||
| Z | 304 | ||
| IFC | ES2 |