Diseases of Calcium Metabolism and Metabolic Bone Disease
- Diseases of Calcium Metabolism and Metabolic Bone Disease
Latest Updates
Medical Management of Premature Ejaculation
- The International Society for Sexual Medicine agreed on a definition of premature ejaculation in 2014.
- Premature ejaculation (PE) classification has been expanded to include natural variable (variable PE) and premature-like ejaculatory dysfunction (subjective PE).
- There is now well-established pharmacotherapy mainly with SSRIs with differing levels of efficacy as well as potential adjunctive therapy with topical or local anesthetics.
Diseases of the Pericardium, Cardiac Tumors, and Cardiac Trauma
- Lightning strikes may also cause myocardial injury,
- which may be evident through ECG changes, biomarker elevations, and echocardiographic ventricular wall motion abnormalities.
- Pericarditis and pericardial effusion may also occur. These abnormalities tend to resolve within several weeks.
Diseases of the Pericardium, Cardiac Tumors, and Cardiac Trauma
- Lightning strikes may also cause myocardial injury,
- which may be evident through ECG changes, biomarker elevations, and echocardiographic ventricular wall motion abnormalities.
- Pericarditis and pericardial effusion may also occur. These abnormalities tend to resolve within several weeks.
Intrahepatic Cholangiocarcinoma
- The majority of patients with iCCA present with locally advanced or metastatic disease.
- Surgery for patients iCCA involves margin-negative resection with porta hepatis lymphadenectomy including at least six lymph nodes.
- Formal volumetry should be considered for patients requiring extended hepatectomy to ensure adequatefuture liver remnant size
- Adjuvant chemotherapy should be considered after resection, particularly for high-risk features such as lymph node involvement or positive margins.
Intrahepatic Cholangiocarcinoma
- The majority of patients with iCCA present with locally advanced or metastatic disease.
- Surgery for patients iCCA involves margin-negative resection with porta hepatis lymphadenectomy including at least six lymph nodes.
- Formal volumetry should be considered for patients requiring extended hepatectomy to ensure adequatefuture liver remnant size
- Adjuvant chemotherapy should be considered after resection, particularly for high-risk features such as lymph node involvement or positive margins.
Opioids for Anesthesia and Postoperative Pain Control
- Clinical gestalt can also accurately assess the pretest probability of PE.
- For patients with a low pretest probability of PE, the Pulmonary Embolism Rule-out Criteria can be used to rule out PE without further testing including no need to order a D-dimer.
- The YEARS protocol may be used to exclude a subset of patients from having a workup to rule out PE when their D-dimer is less than 1000 as opposed to 500.
- Intravenous alteplase, catheter-directed thrombolysis, surgical embolectomy, and catheter-directed embolectomy are treatment modalities for patients with PE who are hemodynamically unstable.
- For patients in imminent or actual PE-related cardiac arrest, current guidelines recommend a bolus regimen consisting of 50 mg IV t-PA given over two minutes and repeated after 15 minutes in the absence of return of spontaneous circulation.
- A subset of patients with PE can be treated as outpatients if their Simplified Pulmonary Severity Index is 0.
- Emphasis on landmark clinical trials in metastatic prostate cancer (especially since 2010)
- Critical analysis and summary of PSA-based prostate cancer screening
- Advances and integration of genomic sciences in early and advanced stages of prostate cancer
.png)
