Latest Updates

The Physics of Ultrasound

    • Three-dimensional ultrasound is has gained significant popularity in clinical use by cardiologists, cardiac anesthetists, and obstetricians.
    • Tissue Doppler and speckle tracking allow more sophisticated analysis of cardiac muscle relaxation and contraction and improved characterization of overall cardiac performance.
    • Miniaturization has allowed development of single-use items, use of intravascular applications, and increased application of ultrasound to the pediatric population.
    • Auto image optimization automatically and continually improves a number of imaging parameters, allowing better time efficiency and interobserver variability during periods of ultrasound image acquisition.

Principles of Wound Management and Soft Tissue Repair II

    • Vascularized composite allotransplantation has emerged as an option for challenging defects.

Liver Tumors

T Peter Kingham, Michael E Lidsky, Kevin C. Soares

    Principles of Wound Management and Soft Tissue Repair I

      • Maintaining a moist environment promotes healing of open wounds
      • Advanced dressings or topical agents have failed to provide any significant improvement over standard saline-soaked gauze

    Principles of Wound Management and Soft Tissue Repair I

      • Maintaining a moist environment promotes healing of open wounds
      • Advanced dressings or topical agents have failed to provide any significant improvement over standard saline-soaked gauze

    Upper Gastrointestinal Endoscopy: Advanced Endoscopic Techniques

    Boxiang Jiang, MD, Jeffrey Marks, MD, FACS, Hahn Soe-Lin, MD
      • Endoluminal lumen apposing metal stents have been utilized to create palliative fistula formation.
      • The submucosal space originally investigated and utilized in POEM has become the new space for further endoluminal therapies.
      • Closure of fistulas are being developed with the use of suturing and over the scope clip technologies.

    Management of Cystic Neoplasms of the Pancreas

    Daniel E Abbott, MD, Adam M Awe, BS, Walker A Julliard, MD, Victoria R Rendell, MD, Sean M Ronnekleiv-Kelly, MD, Sharon M Weber, MD, Emily R Winslow, MD
      • Updated guidelines for pancreatic cyst management have recently been released, including the 2018 European Consensus Guidelines, the 2017 American College of Radiology Guidance, and the 2016 Revisions to the International Consensus Guidelines.
      • Epithelial histologic subtypes of intraductal papillary mucinous neoplasms have been shown to have important implications for prognosis.
      • Pancreatic cyst fluid analysis for DNA biomarkers has shown promise for cyst diagnosis and detection of malignancy in the PANDA clinical trial and other studies although utility in clinical practice has not been demonstrated.
      • A multidisciplinary team at Johns Hopkins Hospital published details of their multidisciplinary pancreatic cyst clinic outcomes, the first of its kind reported in the literature.

    Local Anesthetics for Neuraxial and Regional Techniques

    Krystina Geiger, PharmD, BCPS, BCCCP, Michael J Schontz, PharmD, BCPS, BCCCP
      • Cardiovascular and neurologic adverse effects can amount from local anesthetic systemic toxicity (LAST). The most current recommendations include lipid emulsion therapy as a standard of care for when the patient becomes hemodynamically unstable due to LAST.
      • Liposomal bupivacaine is a delayed release formulation of standard bupivacaine and the most recent local anesthetic with a novel delivery system. This may present a gateway for advancement of new formulations and new approaches to regional techniques.
      • Enhanced recovery after surgery protocols are becoming more common in the surgical world. Local anesthetics will be playing a role in the reduction of opiate consumption and opiate-related side effects. Additionally, mitigation of opiate prescriptions may assist with the reduction of illicit opiate drug use.
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