What's New

Triple-Negative Breast Cancer

    • Recognition that TNBC is heterogeneous, improving understanding of TNBC biology, potentially enabling more precise therapies.
    • Adding platinum salts and PARP inhibitors to neoadjuvant chemotherapy (NAC) significantly improves pathologic complete response.
    • Axillary pathologic complete response (nodal downstaging) following NAC can result in more conservative axillary surgery.
    • For residual disease post NAC, additional adjuvant therapy with capecitabine improves overall and disease-free survival.

The Anesthesia Machine: Managing Exhaled and Waste Gases

    • CO2 absorbent material composition changes, including lithium-based absorbent, with lower risk of carbon monoxide and compound A production
    • New guidelines from the Malignant Hyperthermia Association of the United States on anesthesia machine preparation for MH-susceptible patients
    • Development of the Vapor-Clean filter, a charcoal-based filter that can remove traces of volatile anesthetic gases and prepare a machine for an MH-susceptible patient in less than two minutes

Imaging and Staging for Stomach Malignancy

    • Endoscopic ultrasonography (EUS) is a currently the mainstay in diagnosis and staging of gastric tumors.
    • EUS FNA offers precise diagnosis for primary tumors, local invasion, and lymph node sampling.
    • PET can evaluate response to chemotherapy with early identification of non-responders and treatment modification.

Imaging and Staging for Stomach Malignancy

    • Endoscopic ultrasonography (EUS) is a currently the mainstay in diagnosis and staging of gastric tumors.
    • EUS FNA offers precise diagnosis for primary tumors, local invasion, and lymph node sampling.
    • PET can evaluate response to chemotherapy with early identification of non-responders and treatment modification.

Medical Expulsive Therapy

    • Medical expulsion therapy may aid in the passage of distal ureteral stones and can be a useful adjunct in their management prior to more definitive surgical intervention.
    • Medical expulsion therapy may increase the rate of ureteral stone passage and decrease time for expulsion.
    • The data available at this time are strongest for the use of -antagonists in this role and may work best for distal ureteral stones from 5 to10 mm in size.

Electrical and Fire Safety in the OR

    • Use of line isolation monitors to monitor the isolated power system ensuring that it is fully isolated from the ground
    • Use of ground fault circuit interrupter to help prevent individuals from receiving an electrical shock in a grounded power system by monitoring both sides of the circuit for the equality of the current flow
    • Discovery that sevoflurane and desiccated CO2 absorbent can undergo exothermic chemical reactions causing fires prompting preventive measures

Cutaneous Scarring

    • Over the past 10 years, our understanding of the pathogenesis of keloids and hypertrophic scars has improved markedly. As a result, these previously intractable scars are now regarded as being treatable.
    • Keloids and hypertrophic scars are inflammatory disorders of the reticular dermis.
    • Mechanical forces play an important role in the pathophysiology of keloids and hypertrophic scars.
    • Hypertension is associated with the development of severe keloids and hypertrophic scars.

The Respiratory System: Physiologic Assessment and Real-world Application

    • Reflectance Pulse Oximetry: The use of backscattered light rather than transmitted light can be helpful in low-signal settings.
    • Improved Signal Processing for Pulse Oximetry: Proprietary algorithms and advances in signal processing have improved the precision of pulse oximetry.
    • Calorimetric Detection: Colorimetric CO2 detection can be used to ensure nasoenteric placement rather than respiratory placement.
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