Oxford Medicine Online最新文献

{"title":"The ear, nose, and throat","authors":"James Thomas, T. Monaghan","doi":"10.1093/med/9780199593972.003.0011","DOIUrl":"https://doi.org/10.1093/med/9780199593972.003.0011","url":null,"abstract":"IntroductionHistorySymptoms of ear disordersSymptoms of nasal disordersSymptoms of throat disordersExaminationExamining the earExamining the noseExamining the nasal sinusesExamining the mouth and throatImportant presentations","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78097136","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":"Obstruction","authors":"Jim Cassidy, D. Bissett, Roy A. J. Spence OBE, M. Payne, G. Morris-Stiff","doi":"10.1093/med/9780199689842.003.0035","DOIUrl":"https://doi.org/10.1093/med/9780199689842.003.0035","url":null,"abstract":"This chapter addresses the presentation, diagnosis, and management of cancers manifesting with obstruction of the gastrointestinal system, the urinary tract, and biliary tree.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74100082","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":"Clinical trials","authors":"J. Cassidy, D. Bissett, Roy A. J. Spence OBE, M. Payne, G. Morris-Stiff","doi":"10.1093/med/9780199689842.003.0010","DOIUrl":"https://doi.org/10.1093/med/9780199689842.003.0010","url":null,"abstract":"An overview of this rapidly evolving area of systemic anti-cancer therapy, designed to provide the reader with a starting point from which to keep up-to-date with current recommendations.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73254069","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":"Other investigations","authors":"James Thomas, T. Monaghan","doi":"10.1093/med/9780199593972.003.0020","DOIUrl":"https://doi.org/10.1093/med/9780199593972.003.0020","url":null,"abstract":"Computed tomography (CT)Magnetic resonance imaging (MRI)Barium swallow and mealBarium follow-throughBarium enemaEndoscopic retrograde cholangiopancreatography (ERCP)UltrasoundOesophagogastroduodenoscopy (OGD)ColonoscopyCapsule endoscopyExercise tolerance test (ETT)EchocardiographyCoronary angiography and angioplastyBronchoscopy","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74862031","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":"Biochemical crises","authors":"J. Cassidy, D. Bissett, Roy A. J. Spence OBE, M. Payne, G. Morris-Stiff","doi":"10.1093/med/9780199689842.003.0036","DOIUrl":"https://doi.org/10.1093/med/9780199689842.003.0036","url":null,"abstract":"Malignant hypercalcaemia - Hyponatraemia - Hyperkalaemia - Hyperglycaemia and hypoglycaemia - Acute renal failure - Tumour lysis syndrome","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77752804","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":"The history","authors":"James Thomas, T. Monaghan, P. Thiagarajan","doi":"10.1093/med/9780199593972.003.0002_update_001","DOIUrl":"https://doi.org/10.1093/med/9780199593972.003.0002_update_001","url":null,"abstract":"History takingPresenting complaint (PC)Past medical history (PMH)Drug history (DHx)Allergies and reactionsAlcoholSmokingFamily history (FHx)Social history (SHx)Systematic enquiry (SE)Sexual historyThe elderly patient","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88836388","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":"Colorectal cancer","authors":"J. Cassidy, D. Bissett, Roy A. J. Spence OBE, M. Payne, G. Morris-Stiff, A. Sibtain","doi":"10.1093/med/9780199689842.003.0015_update_001","DOIUrl":"https://doi.org/10.1093/med/9780199689842.003.0015_update_001","url":null,"abstract":"Breast cancer reviews the epidemiology and aetiology of this malignancy, with particular attention to the genetics underlying familial breast cancer, its pathology along with its receptors, oestrogen receptor (ER), the growth factor receptor HER2, and epidermal growth factor receptor (EGFR), and the bearing these have on treatment and prognosis. The benefits of breast cancer screening in the population and families at higher risk are discussed. Presenting symptoms and signs are followed by investigation including examination, bilateral mammography, and core biopsy of suspicious lesions. Management of non-invasive in situ disease is considered. Invasive breast cancer is staged according to TNM guidelines. Early breast cancer is defined, managed frequently by breast conserving surgery and sentinel node biopsy from the axilla. A positive sentinel node biopsy requires clearance of the axilla. Larger lesions may require mastectomy. Breast radiotherapy is indicated after breast conserving surgery. Following surgery, the risk of systemic micrometastatic disease is estimated from the primary size, lymph node spread, and tumour grade. Adjuvant chemotherapy improves treatment outcome in all but very good prognosis premenopausal breast cancer, and intermediate or poor prognosis postmenopausal breast cancer. This is combined with trastuzumab in HER2 positive disease. Adjuvant endocrine therapy is recommended for all ER positive breast cancer, tamoxifen in premenopausal, aromatase inhibitors in postmenopausal women. Neoadjuvant chemotherapy may be used in large operable breast cancers to facilitate breast conserving surgery. Locally advanced breast cancer is defined, its high risk of metastatic disease requiring full staging before treatment. Systemic therapy is often best first treatment, according to receptor profile. Metastatic breast cancer although incurable can be controlled for years using endocrine therapy, chemotherapy, trastuzumab, palliative radiotherapy, and bisphosphonates as appropriate. Male breast cancer is uncommon, but management similar.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83529305","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":"Surgical oncology","authors":"J. Cassidy, D. Bissett, Roy A. J. Spence OBE, M. Payne, G. Morris-Stiff","doi":"10.1093/med/9780199689842.003.0003","DOIUrl":"https://doi.org/10.1093/med/9780199689842.003.0003","url":null,"abstract":"Cancer is a disease of the genes. In the last two decades new technologies have allowed us to interrogate the genome more efficiently and faster. This has led to new therapies and improved understanding of cancers. It is clear the few cancers are caused by just one gene defect and in these rare cases the defective gene or its product is a target for therapeutic intervention. The bigger challenge now is to use this paradigm against multi-genic cancers which are far more common and more complex in their genetic makeup.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74005443","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":"Perioperative Nonopioid Analgesics of Use in Pain Management for Spine Surgery","authors":"K. Fomberstein, M. Rubin, Dipan C. Patel, Ivona Truszkowska, S. G. Farkas","doi":"10.1093/med/9780190626761.003.0003","DOIUrl":"https://doi.org/10.1093/med/9780190626761.003.0003","url":null,"abstract":"This chapter examines the developing role of multimodal analgesia in reducing opioid requirements/dependency in the postoperative period while also facilitating the recovery process without the unwanted adverse side effects associated with opioid use. It reviews a number of medications used in a multimodal regimen including NMDA receptor antagonists, α‎2 agonists, dexamethasone, gabapentinoids, acetaminophen, NSAIDs, COX-2 selective inhibitors, caffeine, and lidocaine. This chapter also discusses the evidence and implications for the use of a specific medication and in which perioperative setting its use has been corroborated. This chapter includes relevant tables and is written for qualified specialist attendings, fellows, residents, and nurses as well as all practitioners involved in the treatment of pain following spine surgery.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73780756","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":"The Neurobiology of Attachment and Mentalizing","authors":"P. Luyten, P. Fonagy","doi":"10.1093/MED/9780199362318.003.0006","DOIUrl":"https://doi.org/10.1093/MED/9780199362318.003.0006","url":null,"abstract":"This chapter addresses the neurobiology of attachment and mentalizing from a developmental psychopathology perspective. It defines attachment, considers its key role in the modulation of the stress response, and describes the general neurobiological process by which this occurs. The chapter then considers the neurobiology of attachment and proceeds to discuss the neurobiological underpinning of mentalizing in relation to attachment and stress regulation. It also focuses on the early development of both capacities in relation to stress regulation and discusses the relationship to the development of psychopathology and personality disorder in particular across the lifespan, with a focus on early childhood and adolescence.","PeriodicalId":19711,"journal":{"name":"Oxford Medicine Online","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74008806","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}