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Physical Medicine and Rehabilitation: Modalities and Exercise

Steven Calvino, MD, David Fealey, MD, Jacob LaSalle, MD

Kinesio taping in treatment of musculoskeletal injury
Cryotherapy and delayed-onset muscle soreness following rigorous exercise activities
Most recent recommendations from the American College of Sports Medicine for physical activity

Vascular Anomalies

Javier A Couto, MD, Arin K Greene, MD, MMSc

Sirolimus is an effective systemic medication for lymphatic malformations
Infantile hemangiomas do not improve significantly after 3 years of age; thus, intervention for a residual deformity should not be prolonged after this time
The somatic mutation for most vascular anomalies has recently been discovered, providing the potential for the development of pharmacotherapy for these lesions

Infrainguinal Arterial Procedures

Amy B. Reed, MD, FACS

varying imaging modalities for planning
variety of options for lower extremity bypass
incorporation of endovascular techniques with bypass

Infrainguinal Arterial Procedures

Amy B. Reed, MD, FACS

varying imaging modalities for planning
variety of options for lower extremity bypass
incorporation of endovascular techniques with bypass

Nondiabetic Endocrine Emergencies 2: Hypoparathyroidism, Hyperparathyroidism, Myxedema Coma, And Thyroid Storm

Jason J Lewis, MD, Richard E Wolfe, MD

Surgical management via parathyroidectomy is the only definitive therapy for hyperparathyroidism and more cost-effective than long-term observation or medical management.
Treatment with IV T4 is the mainstay therapy for myxedema coma, and addition of T3 may be beneficial.
Treatment of thyroid storm involves controlling hyperpyrexia. Ice packs, or cooling blankets, should be used with high fever. Aspirin and other NSAIDs should be avoided because they displace T4 from thyroid-binding globulin, resulting in increased free T4. Acetaminophen does not affect free thyroid hormone.

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

Musculoskeletal Problems In The Female Athlete

Irfan M Asif, MD, Kimberly Harmon, MD, Mallory Shasteen, MD

Operative treatment is not as successful for atraumatic shoulder instability as it is for traumatic instability. Treatment should start with a supervised exercise regimen.
Prevention programs, including neuromuscular and proprioceptive interventions, reduce ACL injuries by 50.7%.
There is a lack of evidence to show that knee orthoses reduce knee pain or improve function in individuals undergoing exercise programs for patellofemoral pain.

Thoracic Injuries and Management Options

Michal Radomski, MD, Babak Sarani, MD, FACS, FCCM

Treatment of rib fractures is centered on pain control. Multimodality treatment utilizing non-narcotic medications is optimal.
Operative fixation of flail chest is associated with decreased respiratory failure, pneumonia, pain.
Patients with type III or IV blunt aortic injury require repair, preferably using an endovascular approach.
Most esophageal injuries require open repair. Time to repair is directly associated with mortality. Stenting has little role in repair.

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