Latest Updates

Lower Gastrointestinal Bleeding

Chasen A Croft, MD, FACS, Frederick Moore, MD, FACS, MCCM
    • Multidetector CT
    • Microcatheter superselective embolization
    • Video capsule endoscopy
    • Push enteroscopy
    • CT enterography

Approach to Acid-Base Disorders

Horacio J Adrogué, MD, Nicolaos E Madias, MD

    Epidemiology of Acute Kidney Injury

    Renato Antunes Caires, MD, Emmanuel A. Burdmann, MD, PhD, Elerson Carlos Costalonga, MD, Verônica Torres Costa e Silva, MD, PhD
      • Recent surveys demonstrated that the worldwide incidence of acute kidney injury (AKI) is increasing, occurring in 21% of hospital admissions.
      • Several risk factors for AKI development have been highlighted recently, such as fluid overload, chloride-rich intravenous fluid therapy, anemia, hyperuricemia, and use of warfarin.
      • New biomarkers of kidney injury, such as urinary neutrophil gelatinase-associated lipocalin, cystatin C, and interleukin-18, have been able to identify patients with AKI who present the worse prognosis, particularly critically ill patients.
      • Hospital-associated AKI is associated with long-term mortality, and the most important risk factors for this late lethality are older age, preexisting comorbid disease (chronic kidney disease [CKD], cardiovascular disease, or malignancy), and incomplete organ recovery with persistent kidney damage.
      • AKI is associated with de novo end-stage renal disease (ESRD) (CKD development, progression of preexisting CKD) and the occurrence of ESRD in the long term, and high-risk patients recovering from an AKI episode such as those with baseline CKD, diabetes mellitus, or heart failure and those dialyzed for AKI should likely be followed by a nephrologist.

    Rapidly Progressive Glomerulonephritis

    Stephen P McAdoo, MRCP PhD, Charles D. Pusey , FRCP DSc

      Basics of Imaging Techniques in Evaluation of Soft Tissue Tumors

      Emily Alanna Aherne, MB BCh, BAO, BMed Sci, MRCPI, FFR, RCSI,, Sinchun Hwang, MD
        • Magnetic resonance imaging (MRI) is the imaging modality of choice for detection and characterization of soft tissue lesions with technical advances in functional imaging beyond morphologic information.
        • MRI requires good understanding of basic principles of MRI sequences and common artifacts for better interpretation.
        • Computed tomography (CT) has substantially improved in its multiplanar and volume-rendering ability with thinner slice image reconstruction after the introduction of a helical CT scanner. 
        • CT is highly sensitive in detecting calcification and gas and the imaging modality of choice in evaluation of pulmonary metastases.
        • Ultrasonography is a readily available imaging modality with the ability to differentiate solid from cystic lesions and allow real-time evaluation without ionizing radiation.
        • Positron emission tomography has become an excellent imaging modality for both staging and screening of metabolically active tumor by providing the anatomic details and metabolic activity of both benign and malignant tumors.

      Basics of Imaging Techniques in Evaluation of Soft Tissue Tumors

      Emily Alanna Aherne, MB BCh, BAO, BMed Sci, MRCPI, FFR, RCSI,, Sinchun Hwang, MD
        • Magnetic resonance imaging (MRI) is the imaging modality of choice for detection and characterization of soft tissue lesions with technical advances in functional imaging beyond morphologic information.
        • MRI requires good understanding of basic principles of MRI sequences and common artifacts for better interpretation.
        • Computed tomography (CT) has substantially improved in its multiplanar and volume-rendering ability with thinner slice image reconstruction after the introduction of a helical CT scanner. 
        • CT is highly sensitive in detecting calcification and gas and the imaging modality of choice in evaluation of pulmonary metastases.
        • Ultrasonography is a readily available imaging modality with the ability to differentiate solid from cystic lesions and allow real-time evaluation without ionizing radiation.
        • Positron emission tomography has become an excellent imaging modality for both staging and screening of metabolically active tumor by providing the anatomic details and metabolic activity of both benign and malignant tumors.

      Upper Extremity Revascularization Procedures

      David L. Cull, MD, FACS, Sagar S Gandhi, MD
        • Presentation and etiology of upper extremity limb ischemia
        • Detailed description of the treatment of chronic arm ischemia
        • Endovascular advances in the treatment of acute and chronic arm ischemia

      Myxofibrosarcoma and Undifferentiated Pleomorphic Sarcoma

      Ann Y Lee, MD
        • Myxofibrosarcoma has characteristic infiltrative borders that can be seen as T2 hyperintense “tails” on MRI and require a 2 cm clinical resection margin to minimize the incidence of positive margins.
        • The entity formerly known as malignant fibrous histiocytoma is now known as undifferentiated pleomorphic sarcoma and is considered a diagnosis of exclusion.
        • Improved knowledge of risk factors for local and distant recurrence helps guide the use of radiation therapy and chemotherapy, as well as follow-up strategies.
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