Latest Updates

Human Trafficking

Celeste S Royce, MD, Nisha Verma, MD
    • Victims of the human sex trafficking industry interface with healthcare providers at high rates.
    • Warning signs for human sex trafficking have gained greater recognition, and multiple intervention programs have been established to help providers respond to victims of sex trafficking.

Infertility

Alan H. DeCherney, MD, Katherine A Green, MD, Eric D. Levens, MD
    • Updates regarding the assessment and treatment of ovulatory disorders
    • Ovulation induction with letrozole in anovulatory patients
    • Advances in in vitro fertilization, including genetic screening
    • Fertility preservation options, including in vitro oocyte maturation, ovarian tissue cryopreservation, and mature oocyte cryopreservation

The Use of Adjuvant or Neoadjuvant Chemotherapy in Extremity and Truncal Sarcoma

Robert J Canter, MD, MAS
    • Soft tissue sarcomas are heterogeneous tumors with diverse behavior and response to therapy.
    • Increasing data favor a histology-driven approach to soft tissue sarcoma multidisciplinary treatment.
    • Chemotherapy in the management of primary resectable soft tissue sarcoma is controversial and evolving.
    • Recent evidence supports a more routine use of neoadjuvant chemotherapy in high-risk soft tissue sarcoma.
    • Recent suggest that narrow, but negative margins with radiotherapy lead to favorable local control rates.

Squamous Cell Carcinoma of the Esophagus

Wayne L Hofstetter, MD, Kyle G Mitchell, MD, David B Nelson, MD
    • Endoscopic therapy has become a definitive therapeutic modality for intramucosal disease.
    • Definitive chemoradiation has become an alternative strategy in patients demonstrating a complete clinical response
    • Trimodality therapy has emerged as a preferred approach in most operable patients with resectable tumors.

Antepartum and Postpartum Hemorrhage

Lauriane Guichard, MD, Carlo Pancaro, MD
    • Delineation of obstetric hemorrhage class based on blood loss in addition to vital sign changes
    • Use of Maternal Early Warning Criteria for early detection of acute hemorrhage
    • Use of obstetric hemorrhage emergency flowcharts to help guide resuscitation
    • Use of rotational thromboelastometry to guide obstetric hemorrhage blood product administration
    • Early use of tranexamic acid to reduce obstetric hemorrhage mortality

The Use of Adjuvant or Neoadjuvant Chemotherapy in Extremity and Truncal Sarcoma

Robert J Canter, MD, MAS
    • Soft tissue sarcomas are heterogeneous tumors with diverse behavior and response to therapy.
    • Increasing data favor a histology-driven approach to soft tissue sarcoma multidisciplinary treatment.
    • Chemotherapy in the management of primary resectable soft tissue sarcoma is controversial and evolving.
    • Recent evidence supports a more routine use of neoadjuvant chemotherapy in high-risk soft tissue sarcoma.
    • Recent suggest that narrow, but negative margins with radiotherapy lead to favorable local control rates.

Squamous Cell Carcinoma of the Esophagus

    • Endoscopic therapy has become a definitive therapeutic modality for intramucosal disease.
    • Definitive chemoradiation has become an alternative strategy in patients demonstrating a complete clinical response
    • Trimodality therapy has emerged as a preferred approach in most operable patients with resectable tumors.

Neurosurgical Critical Care

Shouri Lahiri, MD, Jose Manuel Sarmiento, MD, MPH
    • An important goal in neurologic critical care is to detect and treat secondary brain injury before permanent damage occurs. Advances in invasive multimodal monitoring of the brain improve real-time continuous assessment of brain physiology, quantify the effect of interventions, and prognosticate clinical outcomes in high-risk patients with traumatic brain injury who are in coma or sedated.
    • Identifying diagnostic biomarkers for early detection of spinal cord injury is currently being investigated. Candidate biomarkers for traumatic spinal cord injury include glial fibrillary acidic protein, neurofilaments, cleaved tau, myelin basic protein, neuron-specific enolase, S100B, and soluble CD95 ligand.
    • Sepsis-associated encephalopathy is a global brain dysfunction secondary to sepsis that can develop early in polytrauma patients, often before other organs are affected. Clinical symptoms of altered mental status and focal neurologic signs may be masked by sedation and intubation. Therefore, early diagnosis is being investigated with neuromonitoring such as electroencephalography, magnetic resonance imaging, transcranial Doppler ultrasonography, and serum biomarkers.
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