What's New | Decker

Michael R Foley, MD, Trevor E Quiner, MD, MSc, Resident Physician

Amniotic fluid debris found in maternal lungs are not criteria to diagnose amniotic fluid embolism.
Cardiovascular support during amniotic fluid embolism includes basic life support and advanced cardiac life support.
Coagulopathy related to amniotic fluid embolism should be treated aggressively with massive transfusion protocols.
Cases of amniotic fluid embolism and biologic samples should be reported to national registries.

Robin S Chirackal, MBBS, John C Lieske, MD

Enteric hyperoxaluria is common after bariatric surgery and is associated with an increased risk of kidney stones and chronic kidney disease.
Genetic testing is the preferred method to screen hyperoxaluric or hyperoxalemic patients for primary hyperoxaluria.
Kidney liver transplantation remains the preferred treatment for primary hyperoxaluria type 1 patients that develop end-stage kidney disease; however, techniques to suppress hepatic enzymes in oxalate pathways have shown promise in experimental models.

Alex C Kim, MD, PhD, Hari Nathan, MD, PhD

The Liver Imaging Reporting and Data System for hepatocellular carcinoma (HCC) provides a standardized reporting mechanism for imaging findings and correlation with suspicion for HCC.
Portal vein embolization is being increasingly used for functional future liver remnant volume, with less than 40% in patients undergoing major hepatic resection.
Advances in locoregional liver therapy provide additional treatment options for unresectable liver malignancies.
Lutetium-177(¹⁷⁷Lu)-dotatate is the first peptide receptor radionuclide therapy FDA-approved for neuroendocrine tumors.
Molecular profiling is being increasingly used to guide treatment of hepatic adenomas.

Daniel Mortlock, PhD

Replication crisis: There is increasing evidence that the standard p value threshold of .05 = 5%, commonly used to reject a null hypothesis, is systematically too high for typical problems, such that a number of significant results, in medicine and psychology among others, cannot be replicated. A prominently suggested remedy is to decrease the threshold for rejection to .01 or even .001.
P values: The use of p values to perform hypothesis tests has been a standard statistical technique for decades but has increasingly been called into question. There are a number of reasons for this, including the fact that, for common distributions, the p value is lower than the appropriate Bayesian posterior probability for the null hypothesis.

Moshim Kukar, MD, FACS, Sumana Narayanan, MD

Alexander Lazar, MD, PhD, Ian E McCutcheon, Keila E Torres, MD, PhD, Wei-Lien Wang, MD

Oncogenic signatures responsible for the transformation MPNST include activation of the STAT3/HIF, catenin/Wnt and RHO/ROCK pathways.
MPNSTs often harbor recurrent inactivation of polycomb repressive complex 2 from somatic mutation of EED and/or SUZ12.
Genetic analysis revealed germline mutations in SMARCB1 in approximately 50% of individuals affected by familial schwannomatosis.
Germline mutations in LZTR1 were identified in about 80% of schwannomatosis cases lacking mutations in SMARCB1.

Alexander Lazar, MD, PhD, Ian E McCutcheon, Keila E Torres, MD, PhD, Wei-Lien Wang, MD

Oncogenic signatures responsible for the transformation MPNST include activation of the STAT3/HIF, catenin/Wnt and RHO/ROCK pathways.
MPNSTs often harbor recurrent inactivation of polycomb repressive complex 2 from somatic mutation of EED and/or SUZ12.
Genetic analysis revealed germline mutations in SMARCB1 in approximately 50% of individuals affected by familial schwannomatosis.
Germline mutations in LZTR1 were identified in about 80% of schwannomatosis cases lacking mutations in SMARCB1.

2018 AAFP Key Recommendations for Heel Pain
2017 AAFP Practice Guidelines – Low Back Pain: Noninvasive Management
2015 AAFP Key Recommendations for Corticosteroid Injections – Common Musculoskeletal Conditions

Obstetric Emergencies