Latest Updates

Disorders of Water and Sodium Balance: Hypernatremia

    • Hydrochlorothiazide is not beneficial in treating ICU-acquired hypernatremia
    • Hypernatremia after hypertonic saline irrigation is rare, but might cause severe complications
    • Hypercalcemia induces targeted autophagic degradation of aquaporin-2 at the onset of nephrogenic diabetes insipidus
    • Hypernatremia identified as new predictor of worse clinical outcomes after percutaneous endoscopic gastrostomy placement

Disorders of Water and Sodium Balance: Hypernatremia

    • Hydrochlorothiazide is not beneficial in treating ICU-acquired hypernatremia
    • Hypernatremia after hypertonic saline irrigation is rare, but might cause severe complications
    • Hypercalcemia induces targeted autophagic degradation of aquaporin-2 at the onset of nephrogenic diabetes insipidus
    • Hypernatremia identified as new predictor of worse clinical outcomes after percutaneous endoscopic gastrostomy placement

Epidemiology and Molecular Biology of Colorectal Cancer

    • Current data on the epidemiology of colorectal cancer in United States and globally
    • Classification and detailed description of the three major molecular pathways for colorectal cancer carcinogenesis
    • Modern classification of familial syndromes based on polyp type and description of newly discovered familial colorectal cancer syndromes

Epidemiology and Molecular Biology of Colorectal Cancer

    • Current data on the epidemiology of colorectal cancer in United States and globally
    • Classification and detailed description of the three major molecular pathways for colorectal cancer carcinogenesis
    • Modern classification of familial syndromes based on polyp type and description of newly discovered familial colorectal cancer syndromes

Catatonia

    • Catatonia was considered a subtype of schizophrenia in DSM-I through DSM-III-R.
    • Catatonia is listed as a specifier in DSM-5 and ICD-10.
    • Most persons with catatonia have a mood disorder, most commonly bipolar disorder.
    • There is no known cause, but the condition is probably mediated by GABAergic neurotransmission.
    • Catatonia is effectively treated with benzodiazepines and/or electroconvulsive therapy.

Nonalcoholic Fatty Liver Disease

    • Imaging modalities in the assessment of NAFLD
    • Controlled attenuation parameter as a point of care measure for hepatic steatosis
    • Proton density fat fraction as MRI based measure for hepatic steatosis
    • Liver stiffness measurement on elastography as a correlate of hepatic fibrosis or cirrhosis
    • Active clinical trials in phase 2b and 3, yet no FDA approved therapy
    • Intense lifestyle changes with 5-10% weight loss can improve fibrosis and steatosis

Surgical Management of Melanoma and Other Skin Cancers

    • An interesting advance in the treatment of advanced basal cell carcinoma is the use of inhibitors of the sonic hedgehog pathway. The vast majority of basal cell carcinomas harbor genetic mutations in the hedgehog signaling pathway, which results in constitutive activation and basal cell proliferation.
    • SLNB is generally not recommended unless the lesion is between 0.75 and 1.0 mm, high risk based on histologic features (e.g., ulcerated or with > 1 mitoses/mm2), or inadequately staged (e.g., positive deep margin).
    • An important variable in the prognosis of melanoma is the thickness of the primary tumor as assessed using the Breslow system. Tumor thickness in the Breslow system is measured from the epidermal surface to the deepest point of the tumor with a calibrated ocular micrometer.

Principles of Initial Trauma Evaluation and Management

    • There is a shift to change the definition of massive transfusion to focus on units per time as opposed to total units administered.
    • While laparotomy is still considered the gold standard treatment for gunshot wounds to the abdomen, selective NOM of penetrating abdominal wounds is possible. NOM can only be performed in centers that have the staffing and resources to perform serial examinations and the ability to take the patient to the OR at any time should they decompensate. 
    • Resuscitation of the trauma patient, like much of critical care, is a sophisticated art of balancing the needs of competing organ systems in a patient with multiple injuries. Resuscitation of the trauma patient focuses on prevention of the lethal triad of trauma and secondary injury. The term refers to a triad of acidosis, coagulopathy, and hypothermia resulting from injury and blood loss.
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