Sleep medicine

Sleep medicine

Sleep medicine is a medical specialty or subspecialty devoted to the diagnosis and therapy of sleep disturbances and disorders. From the middle of the 20th century, research has provided increasing knowledge and answered many questions about sleep-wake functioning.[1] The rapidly evolving field[2] has become a recognized medical subspecialty in some countries. Dental sleep medicine also qualifies for board certification in some countries. Properly organized, minimum 12-month, postgraduate training programs are still being defined in the United States.[3][4] In some countries, the sleep researchers and the doctors who treat patients may be the same people.
The first sleep clinics in the United States were established in the 1970s by interested doctors and technicians; the study, diagnosis and treatment of obstructive sleep apnea were their first tasks. As late as 1999, virtually any American doctor, with no specific training in sleep medicine, could open a sleep laboratory.[5]
Disorders and disturbances of sleep are widespread and can have significant consequences for affected individuals as well as economic and other consequences for society.[6][7][8][9] The U.S. National Transportation Safety Board has, according to Dr. Charles Czeisler, discovered that the leading cause of fatal-to-the-driver heavy truck crashes is fatigue-related (fatigue 31%, alcohol and other drug use 29%),[10] and sleep deprivation has been a significant factor in dramatic accidents, such as the Exxon Valdez oil spill, the nuclear incidents at Chernobyl and Three Mile Island and the explosion of the space shuttle Challenger.[11]

Rheumatology

Rheumatology

Rheumatology is a sub-specialty in internal medicine and paediatrics, devoted to the diagnosis and therapy of rheumatic diseases. Clinicians who specialize in rheumatology are called Rheumatologists. Rheumatologists deal mainly with clinical problems involving joints, soft tissues and the allied conditions of connective tissues. The term rheumatology originates from the Greek word rheuma, meaning "that which flows as a river or stream," and the suffix -ology, meaning "the study of."
Rheumatology is a rapidly evolving medical specialty, with advancements owing largely to new scientific discoveries about the immunology of these disorders. Because the characteristics of rheumatological disorders are best explained by immunology, the pathogenesis of every major rheumatological disorder is now described in terms of the autoimmune system, viz., as an autoimmune disease. Correspondingly, most new treatment modalities are also based on clinical research in immunology and the resulting improved understanding of the genetic bases of rheumatological disorders. Future treatment may include gene therapy, as well. Evidence-based medical treatment of rheumatological disorders has helped patients with rheumatism lead a near normal life.

Pulmonology

Pulmonology

In medicine, pulmonology (aka pneumology) is the specialty that deals with diseases of the lungs and the respiratory tract. It is called chest medicine and respiratory medicine in some countries and areas. Pulmonology is generally considered a branch of internal medicine, although it is closely related to intensive care medicine (aka critical care medicine) when dealing with patients requiring mechanical ventilation. Chest medicine is not a specialty in itself but is an inclusive term which pertains to the treatment of diseases of the chest and contains the fields of pulmonology, thoracic surgery, and intensive care medicine. Pulmonology is concerned with the diagnosis and treatment of lung diseases, as well as secondary prevention (tuberculosis). Physicians specializing in this area are called pulmonologists. In the United Kingdom, Ireland, South Africa and Australia the term "respiratory physician" is used rather than pulmonologist. In Canada, respirology and respirologist are used. Surgery of the respiratory tract is generally performed by specialists in cardiothoracic surgery (or thoracic surgery), though minor procedures may be performed by pulmonologists. As mentioned above, pulmonology is closely related to critical care medicine when dealing with patients that require mechanical ventilation. As a result, many pulmonologists are certified to practice critical care medicine in addition to pulmonary medicine. There are fellowship programs that allow physicians to become board certified in pulmonary and critical care medicine simultaneously. Interventional pulmonology is a relatively new field within pulmonary medicine that deals with the use of procedures such as bronchoscopy to treat several pulmonary diseases. Interventional pulmonology is not its own specialty.

Oncology

Oncology

Oncology (from the Ancient Greek onkos (ὄγκος), meaning bulk, mass, or tumor, and the suffix -logy (-λογία), meaning "study of") is a branch of medicine that deals with tumors (cancer). A medical professional who practices oncology is an oncologist.
Oncology is concerned with:
The diagnosis of any cancer in a person
Therapy (e.g., surgery, chemotherapy, radiotherapy and other modalities)
Follow-up of cancer patients after successful treatment
Palliative care of patients with terminal malignancies
Ethical questions surrounding cancer care
Screening efforts:
of populations, or
of the relatives of patients (in types of cancer that are thought to have a hereditary basis, such as breast cancer)

Neurology

Neurology

Neurology (from Greek νεῦρον, neuron, "nerve"; and -λογία, -logia) is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue, such as muscle.[1] The corresponding surgical specialty is neurosurgery. A neurologist is a physician who specializes in neurology, and is trained to investigate, or diagnose and treat neurological disorders. Pediatric neurologists treat neurological disease in children. Neurologists may also be involved in clinical research, clinical trials, as well as basic research and translational research.

Nephrology

Nephrology

Nephrology (from Greek νεφρός - nephros, "kidney", combined with the suffix -logy, "the study of") is a branch of internal medicine and pediatrics dealing with the study of the function and diseases of the kidney.[1]


Scope of the specialty

Nephrology concerns the diagnosis and treatment of kidney diseases, including electrolyte disturbances and hypertension, and the care of those requiring renal replacement therapy, including dialysis and renal transplant patients. Many diseases affecting the kidney are systemic disorders not limited to the organ itself, and may require special treatment. Examples include acquired conditions such as systemic vasculitides (eg. ANCA vasculitis) and autoimmune diseases (eg lupus), as well as congenital or genetic conditions such as polycystic kidney disease.

Hepatology

Hepatology

Hepatology is the branch of medicine that incorporates study of liver, gallbladder, biliary tree and pancreas as well as management of their disorders. Etymologically the word Hepatology is formed of ancient Greek hepar(ηπαρ) or hepato-(ηπατο-) meaning ' liver' and suffix -logia(-λογια) meaning 'word' or 'speech'. Although traditionally considered a sub-specialty of gastroenterology, rapid expansion has led in some countries to doctors specialising solely on this area, who are called hepatologists.
Diseases and complications related to viral hepatitis and alcohol are the main reason for seeking specialist advice. One third of world population has been infected with Hepatitis B virus at some point in their life. Although most of them would clear the virus from the body, approximately 350 million have become persistent carriers. Up to 80% of liver cancers can be attributed to either hepatitis B or Hepatitis C virus. In terms of number of mortality, the former is second only to smoking among known agents causing cancer. With more widespread implementation of vaccination and strict screening before blood transfusion, lower infection rates are expected in the future. In many countries, though, overall alcohol intake is on the rise, and consequently the number of people with cirrhosis and other related complications is increasing.

Hematology

Hematology

Hematology, also spelled haematology (from the Greek αἷμα haima "blood" and -λoγία), is the branch of internal medicine, physiology, pathology, clinical laboratory work, and pediatrics that is concerned with the study of blood, the blood-forming organs, and blood diseases. Hematology includes the study of etiology, diagnosis, treatment, prognosis, and prevention of blood diseases. The laboratology work that goes into the study of blood is frequently performed by a medical technologist. Hematologists physicians also very frequently do further study in oncology - the medical treatment of cancer.
Blood diseases affect the production of blood and its components, such as blood cells, hemoglobin, blood proteins, the mechanism of coagulation, etc.
Physicians specialized in hematology are known as hematologists. Their routine work mainly includes the care and treatment of patients with hematological diseases, although some may also work at the hematology laboratory viewing blood films and bone marrow slides under the microscope, interpreting various hematological test results. In some institutions, hematologists also manage the hematology laboratory. Physicians who work in hematology laboratories, and most commonly manage them, are pathologists specialized in the diagnosis of hematological diseases, referred to as hematopathologists. Hematologists and hematopathologists generally work in conjunction to formulate a diagnosis and deliver the most appropriate therapy if needed. Hematology is a distinct subspecialty of internal medicine, separate from but overlapping with the subspecialty of medical oncology. Hematologists may specialize further or have special interests, for example in:

Geriatrics

Geriatrics

Geriatrics is a subspecialty of medicine that focuses on health care of the elderly. It aims to promote health and to prevent and treat diseases and disabilities in older adults.
Geriatrics was separated from internal medicine as a distinct entity in the same way that neonatology is separated from pediatrics.[1]

Elderly female in residential care home
There is no set age at which patients may be under the care of a geriatrician. Rather, this is determined by a profile of the typical problems that geriatrics focuses on.
The term geriatrics differs from gerontology which is the study of the aging process itself. The term comes from the Greek geron meaning "old man" and iatros meaning "healer". However "Geriatrics" is considered by some as "Medical Gerontology".

Gastroenterology

Gastroenterology

Gastroenterology (MeSH heading)[1] is the branch of medicine whereby the digestive system and its disorders are studied. Etymologically, the name is a combination of three Ancient Greek words gaster (gen.: gastros) (stomach), enteron (intestine), and logos (reason).
Diseases affecting the gastrointestinal tract, which includes the organs from mouth to anus, along the alimentary canal, are the focus of this specialty. Physicians practicing in this field of medicine are called gastroenterologists. They have usually completed the eight years of pre-medical and medical education, the yearlong internship (if this is not a part of the residency), three years of an internal medicine residency, and two to three years in the gastroenterology fellowship. Specialists in GI radiology, hepatobiliary or gastric medicine, or in GI oncology will then complete a two- or three- year fellowship. Gastroenterology is not the same as gastroenterological surgery or of colon and rectal (proctology) surgery, which are specialty branches of general surgery. Important advances have been made in the last fifty years, contributing to rapid expansion of its scope.

Endocrinology

Endocrinology

Endocrinology (from Greek ἔνδον, endo, "within"; κρῑνω, krīnō, "to separate"; and -λογία, -logia) is a branch of medicine dealing with disorder of the endocrine system and its specific secretions called hormones, the integration of developmental events such as proliferation, growth, and differentiation (including histogenesis and organogenesis) and the coordination of metabolism, respiration, excretion, movement, reproduction, and sensory perception depend on chemical cues, substances synthesised and secreted by specialized cells.
Endocrinology is concerned with the study of the biosynthesis, storage, chemistry, and physiological function of hormones and with the cells of the endocrine glands and tissues that secrete them.
The endocrine system consists of several glands, in different parts of the body, that secrete hormones directly into the blood rather than into a duct system. Hormones have many different functions and modes of action; one hormone may have several effects on different target organs, and, conversely, one target organ may be affected by more than one hormone.
In the original 1902 definition by Bayliss and Starling (see below), they specified that, to be classified as a hormone, a chemical must be produced by an organ, be released (in small amounts) into the blood, and be transported by the blood to a distant organ to exert its specific function. This definition holds for most "classical" hormones, but there are also paracrine mechanisms (chemical communication between cells within a tissue or organ), autocrine signals (a chemical that acts on the same cell), and intracrine signals (a chemical that acts within the same cell).[1] A neuroendocrine signal is a "classical" hormone that is released into the blood by a neurosecretory neuron (see article on Neuroendocrinology).

Emergency medicine

Emergency medicine

Emergency medicine is a medical specialty in which a physician receives practical training to care for patients with acute illnesses or injuries which require immediate medical attention. While not usually providing long-term or continuing care, emergency medicine physicians diagnose a variety of illnesses and undertake acute interventions to stabilize the patient. Emergency medicine physicians practice in hospital emergency departments, in pre-hospital settings via emergency medical services, other locations where initial medical treatment of illness takes place, and recently the intensive-care unit. Just as clinicians operate by immediacy rules under large emergency systems, emergency practitioners aim to diagnose emergent conditions and stabilize the patient for definitive care.
Urgent care centers are staffed by physicians, physician assistants, and nurses including nurse practitioners. Such practitioners may or may not be formally trained in emergency medicine. The centers offer primary care treatment to patients who desire or require immediate care, but who do not reach the acuity that requires care in an emergency department or admission to a hospital.
Physicians specializing in emergency medicine can enter fellowships to receive credentials in subspecialties. These are palliative medicine, medical toxicology, pediatric emergency medicine, sports medicine, and undersea and hyperbaric medicine.

Dermatology

Dermatology

Dermatology is the branch of medicine dealing with the skin and its diseases[1], a unique specialty with both medical and surgical aspects.[2][3][4] The name of this specialty originated in the form of the (semantically wrong) words dermologie (in French, 1764) and, a little later, dermatologia (in Latin, 1777).[5] A dermatologist takes care of diseases, in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails.[3]

Cardiology

Cardiology

Cardiology (from Greek καρδίᾱ, kardiā, "heart"; and -λογία, -logia) is a medical specialty dealing with disorders of the heart. The field includes diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology. Physicians specializing in this field of medicine are called cardiologists. Cardiologists should not be confused with cardiac surgeons, cardiothoracic and cardiovascular, who are surgeons who perform cardiac surgery via sternotomy - open operative procedures on the heart and great vessels.
The term cardiology is derived from the Greek word καρδιά (transliterated as kardia and meaning heart or inner self).