Latest Updates

Hypothyroidism and Thyrotoxicosis

Paul W. Ladenson, MD
    • 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum
    • 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis.

Neurovascular Critical Care

Shouri Lahiri, MD, Jose Manuel Sarmiento, MD, MPH
    • Vascular neurosurgery and neurology have dramatically evolved from the 1980s to currently allow for treatment of complex intracranial revascularization, aneurysm, and vascular malformations using intraoperative angiography.
    • Endovascular advances with microcatheter, coils, balloon systems, liquid embolic materials, and stent technology will improve revascularization and successful aneurysm exclusion rates while reducing rebleeding and long-term recurrences.
    • Current clinical trials are attempting to achieve maximal intracerebral hemorrhage evacuation with nondisruptive surgical access modalities. For instance, the ENRICH trial seeks to compare outcomes between standard medical management to early ( < 24 hours) surgical hematoma evacuation using minimally invasive parafascicular surgery. The estimated study completion date is July 2020.

Benign and Malignant Thyroid Diseases

Lindsay EY Kuo, MD, MBA, Matthew A. Nehs, MD, FACS
    • The Bethesda classification system is widely used to report the cytologic appearance of thyroid nodule aspirate.
    • Molecular marker and gene tests have been developed to assist in predicting the malignancy of thyroid nodules.
    • A completely encapsulated follicular variant of papillary thyroid cancer has recently been reclassified as NIFTP.

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.

Thyroidectomy: Technique, Tips, and Troubleshooting

Lindsay EY Kuo, MD, MBA, Matthew A. Nehs, MD, FACS
    • Intraoperative nerve monitoring is frequently used to aid in the identification of the recurrent laryngeal nerve and confirmation of an intact nerve at the end of the operation.
    • Minimally invasive and remote access thyroidectomy are innovative approaches to thyroidectomy to eliminate the need for a neck incision but are technically more challenging and do not have improved outcomes compared to traditional technique.
    • Outpatient thyroidectomy is increasingly common and should be used for appropriate patients after thyroid lobectomy.

Principles of Neurologic Ethics

Jay M. Baruch, MD, Matthew S. Siket, MD
    • Informed refusal as opposed to informed consent for time-sensitive interventions in Emergency Medicine, such as thrombolysis and endovascular clot retrieval in ischemic stroke
    • Moral distress as a new concept affecting emergency nurses and providers. It describes the sense of being unable to provide the care needed for a patient due to a mix of time, environment and resource stressors. It influences decision-making, wellness, and burnout.
    • Artificial intelligence in medical decision-making

Principles of Neurologic Ethics

Jay M. Baruch, MD, Matthew S. Siket, MD
    • Informed refusal as opposed to informed consent for time-sensitive interventions in Emergency Medicine, such as thrombolysis and endovascular clot retrieval in ischemic stroke
    • Moral distress as a new concept affecting emergency nurses and providers. It describes the sense of being unable to provide the care needed for a patient due to a mix of time, environment and resource stressors. It influences decision-making, wellness, and burnout.
    • Artificial intelligence in medical decision-making

Principles of Neurologic Ethics

Jay M. Baruch, MD, Matthew S. Siket, MD
    • Informed refusal as opposed to informed consent for time-sensitive interventions in Emergency Medicine, such as thrombolysis and endovascular clot retrieval in ischemic stroke
    • Moral distress as a new concept affecting emergency nurses and providers. It describes the sense of being unable to provide the care needed for a patient due to a mix of time, environment and resource stressors. It influences decision-making, wellness, and burnout.
    • Artificial intelligence in medical decision-making
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