What's New | Decker

Discussion of the evolution of DSM substance use disorder diagnoses over time
Overview of the biological, environmental, and personal factors implicated in the development of substance use disorders
Critical reviews of the current diagnostic criteria, epidemiology, and clinical presentation of the major substances of misuse

There has been much interest in the development of breast cancer prevention strategies. Pharmacologic approaches are the most developed at this time. The nonsteroidal selective estrogen receptor modulator (SERM) tamoxifen, a mainstay in the management of breast cancer, has also been tested as a chemopreventive agent.
Screening strategies for breast cancer include the triad of breast self-examination (BSE), clinical breast examination by a health care professional, and screening mammography. Although widely touted as an important component of early detection, BSE is of uncertain value.
Increased understanding of growth pathways of breast cancer has led to the identification of crucial nonendocrine pathways that are potential targets for therapy. One such target is the HER-2 protein, a transmembrane protein that is overexpressed in about 20% of breast cancers, generally because of gene amplification.

Discussion of the evolution of DSM substance use disorder diagnoses over time
Overview of the biological, environmental, and personal factors implicated in the development of substance use disorders
Critical reviews of the current diagnostic criteria, epidemiology, and clinical presentation of the major substances of misuse

BTAI is now the gold standard n treating patients with these problems
The grade of injury with these lesions has been defined and there is controversy on which lesion should be treated and how emergently
Recently in the US a device changed its IFU because of complications after TEVAR for BTAI. It was being used outside its IFU.
Recent advancement on sizing and device differences between BTAI and other pathologies treated with TEVAR

Use of HVPG to accurately diagnose portal hypertension
Child-Pugh score and MELD score in risk stratification and decision-making
Fibroelastography, multidetecter row CT scan, and capsule endoscopy as emerging modalities in detection of varices.

Oppositional defiant disorder (ODD) has a high prevalence and substantial morbidity
Diagnosis of ODD is based on a careful history, interview, mental status examination, and collateral information from school.
Disruptive mood dysregulation disorder is a new DSM-5 diagnosis that should be carefully considered in the differential diagnosis of children and adolescents with ODD
Genetic and neuroimaging studies have examined the possible neurobiological basis of ODD, but to date there is no definitive biomarker or biological findings in ODD.
Parent behavioral management training and psychosocial interventions are the cornerstone of treatment planning for ODD.

Extracorporeal membrane oxygenation (ECMO) is a modified method of cardiopulmonary bypass that is used as a last resort modality for support of the pediatric patient in cardiac and/or respiratory failure.
VADs are a newer, alternative method of mechanical circulatory support for children in refractory heart failure or cardiogenic shock who are awaiting transplantation. VAD use in adults is well established, and its use in children has been steadily increasing over the last decade.
Lactate is a by-product of anaerobic metabolism and is often used to diagnose and monitor the progression of shock. Although lactate is less frequently elevated in pediatric patients, an initial elevated lactate level has been found to be associated with increased risk of organ dysfunction in pediatric sepsis and can be followed as a marker of resuscitation.

IM Psychiatry