• Diagnostic technology is evolving for yeast infections, advancing to include nucleic acid testing and nanotechnology, although this may not be available at all centers.
• There are three general classes of antifungal agents, and the specific class used for an individual infection differs depending on the need to treat is superficial or invasive infection.
• The epidemiology of species responsible for an individual infection may depend on previous exposure and treatment to various antifungal agents.

• CT diagnosis of cholecystitis is not first line.
• Percutaneous cholecystostomy may be definitive treatment for acalculous cholecystitis.
• Point of care US is not suitable in ICU 
• Low-pressure pneumoperitoneum is safe for high-risk patients

• Updated illustrations reflect perianal anatomy in greater detail
• Detailed illustrations accompany descriptions of mucosal advancement flap, ligation of fistula tract, and episioproctotomy techniques
• Additional discussion focuses on management of anovaginal fistulas

Acute appendicitis remains a therapeutic challenge during active pregnancy. Both laparascopic and open approaches can be considered; the techniques remain largely the same, with a few caveats. Fetal monitoring may be performed using a transvaginal or left lateral abdominal wall approach. For open appendectomy, ultrasonography and magnetic resonance imaging may provide direction for the incision. Laparascopic appendectomies should be approached with a open trocar placement in the midline, with direct visualization. Late-term pregnancies may require alternative approaches in the subcostal region, and the patient may be rolled with their left side down to facilitate exposure of the appendix and relieve pressure on the inferior vena cava.

• In the United States, norovirus is by far the most common cause of acute gastroenteritis.  Susceptibility of individuals is determined in part by genetic makeup.
• Norovirus is a cause of prolonged and disabling diarrhea among immunocompromised individuals.
• Worldwide, Shigella species are the most common cause of diarrhea.
• Shiga toxin may be produced by isolates of S. sonnei, as well as by isolates of E coli and S dysenteriae.
• The rates of antibiotic resistance to several bacterial gastrointestinal pathogens continue to increase.

• Enhanced understanding of lung-protective ventilation strategies
• Elevated PaCO2 vs. reduced PaO2 in respiratory acidosis
• Enhanced understanding of the ventilatory load
• Understanding of the renal response to hypercapnia

• Enhanced understanding of lung-protective ventilation strategies
• Elevated PaCO2 vs. reduced PaO2 in respiratory acidosis
• Enhanced understanding of the ventilatory load
• Understanding of the renal response to hypercapnia

• Evidence that the 9-valent HPV vaccine covers approximately 20% more high-risk infections
• Enhanced understanding of the benefits of cervical cancer screening
• Interim evidence suggests primary HPV testing is an option for women starting at age 25 years