Latest Updates

Basal Cell Carcinoma: Epidemiology, Risk Factors, and Treatment Options

Jeffrey M Farma, MD, FACS
    • Risk factors for patients at risk for developing basal cell skin cancers (BCCs) include exposure to UV solar radiation, long-term immunosuppression, exposure to ionizing radiation, and certain genetic disorders. 
    • Treatment modalities can be divided into surgical and nonsurgical therapies, although surgical therapy is generally the mainstay of treatment. 
    • Superficial therapies, such as topical imiquimod or 5-fluorouracil, photodynamic therapy, or cryotherapy, may be effective for anatomically challenging locations where surgery or radiation is contraindicated, but the cure rates of these approaches are lower compared with surgery. 
    • Recent FDA-approved hedgehog pathway inhibitors include vismodegib and sonidegib for patients who have exhausted surgical and radiation options for treating advanced BCC.

Skin Cancers: Basal Cell Carcinoma: Epidemiology, Risk Factors, and Treatment Options

Jeffrey M Farma, MD, FACS
    • Risk factors for patients at risk for developing basal cell skin cancers (BCCs) include exposure to UV solar radiation, long-term immunosuppression, exposure to ionizing radiation, and certain genetic disorders. 
    • Treatment modalities can be divided into surgical and nonsurgical therapies, although surgical therapy is generally the mainstay of treatment. 
    • Superficial therapies, such as topical imiquimod or 5-fluorouracil, photodynamic therapy, or cryotherapy, may be effective for anatomically challenging locations where surgery or radiation is contraindicated, but the cure rates of these approaches are lower compared with surgery. 
    • Recent FDA-approved hedgehog pathway inhibitors include vismodegib and sonidegib for patients who have exhausted surgical and radiation options for treating advanced BCC.

Nephrology: Acute Graft Dysfunction 

Oluwafisayo Adebiyi, MD, James E. Cooper, MD, Alexander C. Wiseman, MD
    • Differential diagnosis of acute allograft dysfunction
    • Biomarker use in the evaluation of acute graft dysfunction
    • Treatment options for acute allograft rejection

Psychotherapy: Interpersonal Psychotherapy

Ceth Ashen, PhD, Ann Back-Price, MSN, APRN, IAAP, Olga Belik-Tuller, PhD, Anna Brandon, Ph.D,, MSCS, ABPP, Scott Fairhurst, PhD, Aimee Grause, PCNS, Jessica Schultz, PhD, Scott Stuart, MD, Kaela Stuart-Parrigon, M.A.
    • New clinical tools have increased fidelity to IPT and enhanced its clinical application
    • IPT has been shown to be effective with PTSD
    • Dissemination of IPT is greatly increasing
    • Training protocols and guidelines for IPT have been established

Pain Related Disease States: Lumbar Disk Herniation

Sheri L Albers, DO, Mark V Boswell, MD, PhD, Joshua A Hirsch, MD, Laxmaiah Manchikanti, MD
    • The nomenclature of disk herniation has evolved over the years; the current terminology is disk herniation, not disk rupture.
    • The pathophysiology of lumbar disk-related pain or radiculopathy, although not well understood, has expanded and includes inflammation and ischemia of the spinal nerves, apart from compression.
    • Radiographic assessment of disk abnormalities has progressed substantially, with a clear picture of various levels of disk herniation and nerve root abnormalities.
    • Multiple advances have been made in managing lumbar disk herniation with conservative management, including interventional techniques, minimally invasive and endoscopic surgical decompression, and, finally, open decompression.
    • With increasing levels of multiple interventions, various complications have been reported with all modalities, including surgical interventions, leading to post lumbar surgery syndrome and lifelong management in a significant proportion of patients.

Parenchymal Kidney Disease: Paraproteinemia and Deposition Diseases

Nelson Leung, MD, Insara Jaffer Sathick, MBBS, MRCP
    • Enhanced understanding of ALECT2 amyloidosis
    • Best practice for typing of amyloidosis
    • Evidence for distinguising among diseases with organized deposits

Trauma: Management of Extremity Fractures and Complications

Kenji Inaba, MD, MS, FRCSC, FACS, Tim H Lee, MD, MS
    • Antibiotic prophylaxis for all open extremity fractures is recommended.
    • Washout and debridement of all open fractures within 24 hours of admission is recommended.
    • Multidetector computed tomographic angiogram (MDCTA) has high sensitivity and specificity for identifying arterial injury in patients with soft signs of vascular injury due to blunt or penetrating extremity trauma
    • Early tourniquet use can be life-saving when used to control active hemorrhage from severe extremity trauma and is associated with a low rate of complications
    • If not immediately life threatening, the mangled extremity is best managed with a multi-disciplinary team approach.

Pediatrics: Cystic Fibrosis in Childhood and Adolescence

Sabina Sabharwal, MD, MPH
    • As patients with cystic fibrosis (CF) are living longer, gastrointestinal issues are becoming more evident.
    • The CFTR genotype determines the CFTR phenotype.
    • One episode of distal intestinal obstruction syndrome (DIOS) increases the risk of a future episode.
    • In differentiating DIOS from constipation in CF, it is important to use an abdominal x-ray.
    • CFTR potentiator and corrector medications may be helpful for nutritional outcomes in CF patients.
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