Latest Updates

Initial Management of Life-Threatening Trauma

    • Initial volume resuscitation should commence with 1 L isotonic crystalloid solution followed by blood products at 1:1:1 ratio (1 unit packed red blood cells to 1 unit fresh frozen plasma to 1 unit platelets) if the patient is not responsive to the initial fluid bolus.
    • In patients with massive hemorrhage or evidence of fibrinolysis, tranexamic acid has demonstrated improved survival if administered within 3 hours of injury.
    • Use of resuscitative endovascular balloon occlusion of the aorta may be an important adjunct in the control of life-threatening abdominal or pelvic hemorrhage.
    • In cases of external hemorrhage of an extremity, a tourniquet should be used to control bleeding.

Oppositional Defiant Disorder and Its Clinical Management

    • Oppositional defiant disorder (ODD) has a high prevalence and substantial morbidity
    • Diagnosis of ODD is based on a careful history, interview, mental status examination, and collateral information from school.
    • Disruptive mood dysregulation disorder is a new DSM-5 diagnosis that should be carefully considered in the differential diagnosis of children and adolescents with ODD
    • Genetic and neuroimaging studies have examined the possible neurobiological basis of ODD, but to date there is no definitive biomarker or biological findings in ODD.
    • Parent behavioral management training and psychosocial interventions are the cornerstone of treatment planning for ODD. 

Management of the Geriatric Patient

    • Emphasis on the importance of exercise in interventions to prevent falls

    • Increasing research on interventions to improve frailty with promising work on interventions that include an exercise component as well as nutritional measures

    • Recommendation against vitamin D to prevent falls in patients without osteoporosis or vitamin D deficiency

    • New and emerging therapies for pressure ulcers stress the importance of microclimate control, prophylactic dressings, and attention to reducing shear and friction in addition to pressure.

Management of the Geriatric Patient

    • Emphasis on the importance of exercise in interventions to prevent falls

    • Increasing research on interventions to improve frailty with promising work on interventions that include an exercise component as well as nutritional measures

    • Recommendation against vitamin D to prevent falls in patients without osteoporosis or vitamin D deficiency

    • New and emerging therapies for pressure ulcers stress the importance of microclimate control, prophylactic dressings, and attention to reducing shear and friction in addition to pressure.

Management of the Geriatric Patient

    • Emphasis on the importance of exercise in interventions to prevent falls

    • Increasing research on interventions to improve frailty with promising work on interventions that include an exercise component as well as nutritional measures

    • Recommendation against vitamin D to prevent falls in patients without osteoporosis or vitamin D deficiency

    • New and emerging therapies for pressure ulcers stress the importance of microclimate control, prophylactic dressings, and attention to reducing shear and friction in addition to pressure.

Approach to the Geriatric Patient

    • 2016 EAST practice management guideline on prevention of fall-related injuries in the elderly
    • 2016 CTF on Preventive Health Care recommendations on screening for cognitive impairment in older adults
    • 2016 USPSTF recommendation statement on screening for depression in adults
    • 2015 AGS Beers criteria for potentially inappropriate medication use in older adults
    • 2016 AAO preferred practice guideline on comprehensive adult medical eye evaluation

Early Pregnancy Loss

    • Ultrasonography criteria for the diagnosis of early pregnancy loss have recently been redefined.
    • Medical and surgical management are safe and effective, and should be influenced largely by patient preference.
    • Recommendations regarding interval to next conception have recently shifted away from the traditional 3 months.

Approach to the Geriatric Patient

    • 2016 EAST practice management guideline on prevention of fall-related injuries in the elderly
    • 2016 CTF on Preventive Health Care recommendations on screening for cognitive impairment in older adults
    • 2016 USPSTF recommendation statement on screening for depression in adults
    • 2015 AGS Beers criteria for potentially inappropriate medication use in older adults
    • 2016 AAO preferred practice guideline on comprehensive adult medical eye evaluation
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