Latest Updates

Pathologic Evaluation of Soft Tissue Sarcoma

Narasimhan P. Agaram, MBBS
    • Concepts of pathologic examination and grading
    • Important diagnostic criteria for each soft tissue sarcoma
    • Latest molecular diagnostic methods used in the diagnosis of sarcomas

Extent of Gastrectomy and Lymphadenectomy for Gastric Adenocarcinoma

Kevin K. Chang, MD, Sam S. Yoon, MD
    • The eighth edition of the AJCC Cancer Staging Manual now includes prognostic information for clinical TNM staging and post–neoadjuvant therapy staging.
    • A D2 lymphadenectomy is frequently recommended as the nodal dissection of choice for locally advanced gastric adenocarcinoma.
    • Laparoscopy-assisted operations are associated with improved overall morbidity and comparable lymph node yield.

Extent of Gastrectomy and Lymphadenectomy for Gastric Adenocarcinoma

Kevin K. Chang, MD, Sam S. Yoon, MD
    • The eighth edition of the AJCC Cancer Staging Manual now includes prognostic information for clinical TNM staging and post–neoadjuvant therapy staging.
    • A D2 lymphadenectomy is frequently recommended as the nodal dissection of choice for locally advanced gastric adenocarcinoma.
    • Laparoscopy-assisted operations are associated with improved overall morbidity and comparable lymph node yield.

Parenteral Nutrition–Associated Liver Toxicity: Prevention, Diagnosis, and Management

Lorenzo Anez-Bustillos, MD, Meredith A. Baker, MD, Duy T. Dao, MD, Gillian L. Fell, MD, Kathleen M. Gura, PharmD, Mark Puder, MD, PhD
    • Fish oil–based lipid emulsions may be efficacious in the treatment of parenteral nutrition–associated liver disease (PNALD).
    • Lipid reduction (e.g., to 1 g/kg/day) does not decrease the incidence of PNALD but does slow its progression.
    • Patients whose cholestasis reverses with fish oil therapy or achievement of enteral autonomy may have stable rather than progressive cirrhosis and should not be transplanted based on biopsy alone.

Pathologic Evaluation of Soft Tissue Sarcoma

Narasimhan P. Agaram, MBBS
    • Concepts of pathologic examination and grading
    • Important diagnostic criteria for each soft tissue sarcoma
    • Latest molecular diagnostic methods used in the diagnosis of sarcomas

Nephrology: Hypertensive Disorders in Pregnancy

Susan Hou, MD, Kavitha Vellanki, MD
    • New diagnostic criteria for preeclampsia
    • Pathophysiology of preeclampsia
    • Role of serologic biomarkers for diagnosis of preeclampsia
    • Guidelines for target blood pressure in pregnancy

Nephrology: Management of Cardiovascular Disease in Dialysis Patients

John P. Middleton, John K. Roberts
    • Left ventricular hypertrophy is associated with cardiovascular outcomes, including sudden cardiac death. Efforts to mitigate left ventricular hypertrophy (blood pressure control, aggressive fluid management, and frequent hemodialysis) may improve outcomes.
    • Low potassium dialysate (< 2 mEq/L), low calcium dialysate (< 2.5 mEq/L), and high ultrafiltration rates (> 13 mL/kg/hr) have been associated with worse cardiovascular outcomes in hemodialysis patients.
    • End-stage renal disease (ESRD) patients with atrial fibrillation are at increased risk for both stroke and bleeding events. Routine anticoagulation is not recommended for stroke prophylaxis.
    • In two small randomized trials, use of spironolactone reduced cardiovascular events and left ventricular mass index compared with placebo in patients with ESRD.

Nephrology: Drug Dosing in Acute Kidney Injury

Jamil Azzi, MD, Steven Gabardi, PharmD, BCPS, FAST, FCCP, Marjan Sadegh, PharmD, BCPS, Craig A Stevens, PharmD, BCPS
    • Full review of all available literature on the impact of acute kidney injury (AKI) on drug pharmacokinetic parameters
    • Recommendations for drug dosing strategies in patients with AKI, including loading doses, maintenance therapy, and therapeutic drug monitoring
    • Evaluation of specific medications that require special attention in patients with AKI
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