What's New | Decker

Hydrochlorothiazide is not beneficial in treating ICU-acquired hypernatremia
Hypernatremia after hypertonic saline irrigation is rare, but might cause severe complications
Hypercalcemia induces targeted autophagic degradation of aquaporin-2 at the onset of nephrogenic diabetes insipidus
Hypernatremia identified as new predictor of worse clinical outcomes after percutaneous endoscopic gastrostomy placement

Hydrochlorothiazide is not beneficial in treating ICU-acquired hypernatremia
Hypernatremia after hypertonic saline irrigation is rare, but might cause severe complications
Hypercalcemia induces targeted autophagic degradation of aquaporin-2 at the onset of nephrogenic diabetes insipidus
Hypernatremia identified as new predictor of worse clinical outcomes after percutaneous endoscopic gastrostomy placement

Patients with borderline resectable pancreatic adenocarcinoma who are able to undergo successful resection may have survival comparable to patients with resectable disease.
For patients with locally advanced pancreatic adenocarcinoma, neoadjuvant FOLFIRINOX may allow up to 61% of patients to undergo successful resection.
For patients with resectable pancreatic adenocarcinoma and a positive intraoperative frozen section, additional resection to achieve a negative neck margin after a positive frozen section may not be associated with improved overall survival.

Identification of major anxiety disorders observed in adults according to the DSM-5
Description of physiologic, cognitive, and behavioral components of anxiety and their relevance to diagnosis and treatment
Review of cognitive-behavioral treatments and their efficacy for anxiety disorders in adults
Review of pharmacologic treatments and their efficacy for anxiety disorders in adults

Hydrochlorothiazide is not beneficial in treating ICU-acquired hypernatremia
Hypernatremia after hypertonic saline irrigation is rare, but might cause severe complications
Hypercalcemia induces targeted autophagic degradation of aquaporin-2 at the onset of nephrogenic diabetes insipidus
Hypernatremia identified as new predictor of worse clinical outcomes after percutaneous endoscopic gastrostomy placement

The 2003 Rotterdam criteria are more broadly inclusive than the NIH criteria, allowing improved sensitivity for PCOS diagnosis. Diagnosis by the Rotterdam criteria requires the presence of two of the following three conditions: (1) hyperandrogenism, (2) oligo-ovulation, and (3) a classic PCOM described as evidence of any one or both of the following in either ovary: (1) presence of 12 or more follicles measuring 2 to 9 mm in diameter [see Figure 1] and/or (2) an increased ovarian volume (> 10 mL) in the absence of a dominant follicle or corpus luteum in either ovary.
The goals of evaluation are to (1) determine the source of hyperandrogenism (i.e., adrenal or ovarian), (2) assess the severity of androgen excess, (3) rule out an adrenal or ovarian tumor, and (4) screen for metabolic accompaniments of PCOS, including insulin resistance and the MetS.
Spironolactone, an aldosterone antagonist, has demonstrated efficacy against acne and hirsutism associated with PCOS. The antiandrogenic effects of spironolactone are attributed to (1) reduced adrenal androgen production, (2) competitive blockade on androgen receptors in target tissue, and (3) some degree of suppression of 5a-reductase, the enzyme responsible for conversion of testosterone to a more potent androgen dihydrotestosterone.

The 2003 Rotterdam criteria are more broadly inclusive than the NIH criteria, allowing improved sensitivity for PCOS diagnosis. Diagnosis by the Rotterdam criteria requires the presence of two of the following three conditions: (1) hyperandrogenism, (2) oligo-ovulation, and (3) a classic PCOM described as evidence of any one or both of the following in either ovary: (1) presence of 12 or more follicles measuring 2 to 9 mm in diameter [see Figure 1] and/or (2) an increased ovarian volume (> 10 mL) in the absence of a dominant follicle or corpus luteum in either ovary.
The goals of evaluation are to (1) determine the source of hyperandrogenism (i.e., adrenal or ovarian), (2) assess the severity of androgen excess, (3) rule out an adrenal or ovarian tumor, and (4) screen for metabolic accompaniments of PCOS, including insulin resistance and the MetS.
Spironolactone, an aldosterone antagonist, has demonstrated efficacy against acne and hirsutism associated with PCOS. The antiandrogenic effects of spironolactone are attributed to (1) reduced adrenal androgen production, (2) competitive blockade on androgen receptors in target tissue, and (3) some degree of suppression of 5a-reductase, the enzyme responsible for conversion of testosterone to a more potent androgen dihydrotestosterone.

The contribution of genetics to Parkinson disease (PD) is suggested by the increased risk of disease associated with a family history, and community-based studies that found a 1.5- to threefold increased risk of PD in persons with an affected first-degree relative. However, the most convincing evidence to date has come with the discovery of monogenic forms of PD. Highly penetrant mendelian forms of PD have now been associated with mutations in different genes but, in most populations, causative mutations in these genes have been found in fewer than 5% of patients. Nevertheless, different variants with incomplete penetrance in the LRRK2 and the GBA gene are strong risk factors for PD, and are especially prevalent in some populations. Mutations of the GBA gene are indeed the most important risk factor yet discovered for PD; the presence of a GBA mutation in homozygous or heterozygous form is associated with an approximately 20-fold increase in the risk for PD.

Surgical Physiology