Latest Updates

Microsurgical Reconstruction of the Upper Extremity

Nikolas H Kazmers, MD, MSE, L. Scott Levin, MD, FACS, Zvi Steinberger, MD, Stephanie Thibaudeau, MD
    • Recent literature highlighting considerations for surgical timing of microsurgical reconstruction is reviewed and summarized.
    • Recent literature highlighting risk factors for failure of free flaps is reviewed and summarized.
    • Newer concepts, including perforator freestyle flaps, have been introduced.

Erectile Dysfunction: Evaluation, Including Diagnostic Studies

Sevann Helo, MD, Kevin T McVary, MD, Nicholas Tadros, MD MCR
    • Risk assessment in patients with cardiovascular disease
    • Penile Doppler ultrasonography
    • Cavernosometry and cavernosography

Diagnosis, Etiology, and Treatment of Premenstrual Dysphoric Disorder

Marlene P. Freeman, MD, Edwin Raffi, MD, MPH
    • Diagnosing PMDD only formally achieved after ruling out other underlying mood or anxiety disorder, and if the symptoms persist for two consecutive months, in a cyclic fashion.
    • Differential Diagnosis for PMDD include any mood or anxiety disorder, or PTSD. Providers should rule out PME of one of these disorders first.
    • The etiology of PMDD is likely multifactorial and includes the interplay between genetics, neurosteroids, neurotransmitters, brains structure and function, and the pathophysiology that connects these factors.
    • Of the pharmacologic approaches, serotonergic reuptake inhibitors and oral contraceptives should initially be considered for treatment of PMDD.

Immunosuppression

Steven Gabardi, PharmD, BCPS, FAST, FCCP, Miae Kim, MS, PharmD, BCPS
    • Full review of all available literature on transplant immunosuppression use in renal transplantation
    • Recommendations for strategies to manage common adverse reactions from transplant immunosuppressants
    • Evaluation of specific medications that are used for the management of antibody-mediated rejection

Head and Neck Melanoma: An Overview

Samuel Kim, MD, Deepak Narayan, MD
    • A recently discovered gain-of-function mutation in the RAC1 gene in melanomas may provide a potential target for pharmacologic treatment.
    • Adoptive cell therapy has been refined and advanced to become an effective form of personalized cancer therapy, but the search continues to generalize its use.
    • Expanding our knowledge of and targeting the tumor microenvironment, which provides several means of tumor protection, may unlock the full potential of immunotherapy.

Chemotherapy for Gynecologic Malignancies

Lauren E Dockery, MD, MS, Laura L Holman, MD, MS
    • Targeted therapies such as antiangiogenesis agents improve outcomes in ovarian and metastatic cervical cancer. 
    • Poly(ADP)ribose polymerase (PARP) inhibitors improve outcomes as treatment and maintenance therapies in recurrent epithelial ovarian cancer. 
    • Intraperitoneal administration of chemotherapy can be considered for a select group of patients with ovarian cancer in the front-line setting. 

Conservative Management of Acute Kidney Injury

Rolando Claure-Del Granado, MD, FASN, Etienne Macedo, MD, PhD, Ravindra L. Mehta, MD, FASN
    • Approaches to breast augmentation in the male-to-female transgender patient require special attention outside of conventional breast augmentations.
    • Understanding the differences in the nipple-areola complex (NAC) between females and males when undertaking gender-confirming breast augmentations
    • Special consideration is needed for the clitoral and urethral anatomy in gender-confirming vaginoplasty.
    • Postoperative care and complications in gender-confirming vaginoplasty require close follow-up and consideration. 

Surgical Management of the Breast

Anees B Chagpar, MD, MSc, MPH, MA, MBA
    • Diagnosis of breast cancer: from open biopsy of palpable lesions to minimally invasive image-guided core-needle biopsy
    • Extirpation of primary breast cancer: from mastectomy to breast conservation and oncoplastics
    • Lymph node evaluation: from axillary dissection to sentinel node biopsy
    • Integration with multidisciplinary management of breast cancer
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