{"title":"Forensic and legal medicine","authors":"J. Payne-James, P. Marks, R. Bouhaidar, S. Karch","doi":"10.1007/978-1-4020-8265-8_100424","DOIUrl":"https://doi.org/10.1007/978-1-4020-8265-8_100424","url":null,"abstract":"","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128433843","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":"Reactive arthritis","authors":"C. Stober, H. Gaston","doi":"10.1093/med/9780198746690.003.0449","DOIUrl":"https://doi.org/10.1093/med/9780198746690.003.0449","url":null,"abstract":"The term ‘reactive arthritis’ is sometimes used rather loosely to cover any form of arthritis that follows infection, and then includes post-viral arthritides, rheumatic fever, Lyme disease, and other forms of arthritis that do not generally share clinical features. Reactive arthritis a subset of post-infectious arthritis, and causative organisms are usually localized to the gastrointestinal or genitourinary tracts. Following infection, organisms or their components find their way to joints, where they provoke inflammatory immune responses. Whether the responses cross-react with self antigens is unclear; arthritis may be maintained by persistent infection. The disease commonly has specific extra-articular features not seen in other forms of post-infectious arthritis, and is genetically and pathologically a form of spondyloarthritis.","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128655166","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":"Neisseria gonorrhoeae","authors":"J. Sherrard, M. Unemo","doi":"10.1093/med/9780198746690.003.0110","DOIUrl":"https://doi.org/10.1093/med/9780198746690.003.0110","url":null,"abstract":"\u0000 Neisseria gonorrhoeae is a Gram-negative, intracellular diplococcus that is transmitted by direct inoculation of infected secretion from one mucosa to another. It primarily colonizes the columnar epithelium of lower genital tract, only occasionally spreading to the upper genital tract or causing systemic disease. Oropharyngeal and rectal infections are common in men who have sex with men but also occur in women. N. gonorrhoeae is almost exclusively transmitted by sexual activity. Oropharyngeal and rectal infections usually produce no symptoms; disseminated gonococcal infection is a comparatively benign bacteraemia affecting joints (particularly shoulder and knee) and skin; traditionally more common in women than men. The gonococcus has adapted rapidly to prevalent antimicrobial usage, leading to resistance to all antibiotics used for treatment, notably penicillins, fluoroquinolones, macrolides, tetracycline, and cephalosporins. This development has resulted in major concerns internationally and the introduction of international and national action/response plans as well as dual antimicrobial therapy.","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128921485","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":"Adaptive immunity","authors":"P. Klenerman","doi":"10.1093/med/9780198746690.003.0040","DOIUrl":"https://doi.org/10.1093/med/9780198746690.003.0040","url":null,"abstract":"The adaptive immune response is distinguished from the innate immune response by two main features: its capacity to respond flexibly to new, previously unencountered antigens (antigenic specificity), and its enhanced capacity to respond to previously encountered antigens (immunological memory). These two features have provided the focus for much research attention, from the time of Jenner, through Pasteur onwards. Historically, innate and adaptive immune responses have often been treated as separate, with the latter being considered more ‘advanced’ because of its flexibility. It is now clear this not the case, and in recent years the molecular basis for these phenomena has become much better understood.","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"19 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121233610","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":"Legionellosis and legionnaires’ disease","authors":"D. Viasus, J. Carratalá","doi":"10.1093/med/9780198746690.003.0143","DOIUrl":"https://doi.org/10.1093/med/9780198746690.003.0143","url":null,"abstract":"Legionellaceae are Gram-negative bacilli, of which Legionella pneumophila is the principal cause of human infections. Their natural habitats are freshwater streams, lakes, thermal springs, moist soil, and mud, but the principal source for large outbreaks of legionellosis is cooling systems used for air conditioning and other cooling equipment. Legionella spp. are principally transmitted to humans through contaminated water aerosols. Middle-aged men, smokers, regular alcohol drinkers, and those with comorbidity are most at risk. Aside from supportive care, the first-choice antibiotics are macrolides (mainly azithromycin) and/or fluoroquinolones (especially levofloxacin). Case fatality is 5–15% in previously well adults, but much higher in those who are immunocompromised or develop respiratory failure. Prognosis is improved by early administration of effective anti-legionella antibiotic therapy. Prevention is by the correct design, maintenance, and monitoring of water systems.","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126949575","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":"Therapeutic anticoagulation","authors":"D. Keeling","doi":"10.1093/med/9780198746690.003.0376","DOIUrl":"https://doi.org/10.1093/med/9780198746690.003.0376","url":null,"abstract":"The main indications for therapeutic anticoagulation are venous thromboembolism, deep vein thrombosis, and pulmonary embolism, and the prevention of stroke in patients with atrial fibrillation or mechanical heart valves. Low-molecular-weight heparins have largely replaced unfractionated heparin in its treatment. Their much more predictable anticoagulant response combined with high bioavailability after subcutaneous injection means that the dose can be calculated by body weight and given subcutaneously without any monitoring or dose adjustment. Their widespread use resulted in most patients with deep vein thrombosis being managed as outpatients, and this is also increasingly the case for uncomplicated pulmonary embolism. Oral direct inhibitors of anticoagulation that specifically target thrombin or factor Xa are increasingly used to treat acute venous thromboembolism and for stroke prevention in atrial fibrillation.","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125952796","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}
F. McGill, J. Farrar, B. Wills, M. D. de Jong, D. Warrell, T. Solomon
{"title":"Viral infections","authors":"F. McGill, J. Farrar, B. Wills, M. D. de Jong, D. Warrell, T. Solomon","doi":"10.1093/med/9780198746690.003.0596","DOIUrl":"https://doi.org/10.1093/med/9780198746690.003.0596","url":null,"abstract":"This chapter looks at how enteroviruses are responsible for most cases of viral meningitis where a pathogen is identified; many other viruses can also cause meningitis with considerable geographical and seasonal variation. Their typical presentation is with sudden onset of fever, headache, neck stiffness, and photophobia. There is no change in conscious level. Prognosis is generally good, though recent data suggest not always. Viruses invade and damage the central nervous system in two ways: directly, by infecting the leptomeninges, brain, and spinal cord; and, indirectly, by inducing an immunological reaction resulting in para and postinfectious diseases. In both cases, the terms ‘meningitis’, ‘encephalitis’, and ‘myelitis’ are used alone or in combination.","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124193584","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":"Coxiella burnetii infections (Q fever)","authors":"T. Marrie","doi":"10.1093/med/9780198746690.003.0146","DOIUrl":"https://doi.org/10.1093/med/9780198746690.003.0146","url":null,"abstract":"Q fever is a zoonosis caused by Coxiella burnetii, an intracellular Gram-negative spore-forming bacterium, the common animal reservoirs of which are cattle, sheep, and goats. Rats and mice have been implicated as reservoirs in some areas. In French Guiana the three-toed sloth is the reservoir. C. burnetti is trophic for the endometrium and mammary glands of female animals, and during pregnancy the organism reaches very high concentrations in the placenta such that at the time of parturition organisms are aerosolized and contamination of the environment occurs. Inhalation of even one microorganism can result in infection. Diagnosis is confirmed by serological testing: in acute disease antibodies to phase II antigen are higher than those to phase I, whereas the reverse is true in chronic disease.","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127756874","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":"Normal and abnormal sexual differentiation","authors":"S. Ahmed, A. Lucas-Herald","doi":"10.1093/med/9780198746690.003.0257","DOIUrl":"https://doi.org/10.1093/med/9780198746690.003.0257","url":null,"abstract":"Human sex development follows an orderly sequence of embryological events coordinated by a cascade of gene expression and hormone production in a time- and concentration-dependent manner. Underpinning the entire process of fetal sex development is the simple mantra: sex chromosomes (XX or XY) dictate the gonadotype (ovary or testis), which then dictates the somatotype (female or male phenotype). The constitutive sex in fetal development is female. Disorders of sex development (DSD) can be classified into three broad categories based on the knowledge of the karyotype: sex chromosome abnormality (e.g. X/XY, mixed gonadal dysgenesis); XX DSD (e.g. congenital adrenal hyperplasia); XY DSD (e.g. partial androgen insensitivity syndrome).","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132624421","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":"Symptoms other than pain","authors":"R. McQuillan","doi":"10.1093/med/9780198746690.003.0065","DOIUrl":"https://doi.org/10.1093/med/9780198746690.003.0065","url":null,"abstract":"Common symptoms in life-limiting illness include pain, fatigue, anorexia, nausea, constipation, and dyspnoea. These may be due to disease or disease progression, treatment side effects, an intercurrent acute problem, or comorbidity. Patients with life-limiting illnesses often have multiple comorbidities and might be on many medications. Effective treatment always depends on making as precise a diagnosis as possible (e.g. pharmacological management of nausea and vomiting is guided by the presumed mechanism). Symptoms can also herald an emergency (e.g. sepsis, delirium, spinal cord compression), when the patient’s frailty, likely prognosis, and own values and wishes need to be taken into account in planning management. Individualized assessment and decision-making are vital.","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130792998","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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