What's New | Decker

Total neoadjuvant therapy (neoadjuvant chemotherapy and chemoradiation prior to total mesorectal excision)
Minimally invasive techniques for surgery of rectal cancer (laparoscopy, robotic surgery, and transanal total mesorectal excision)
A novel PD-1 blocker, dostarlimab, has shown very promising results in a phase 2 trial, current demonstrating a 100% clinical remission rate; further study is required to ascertain if this result lasts

Total neoadjuvant therapy (neoadjuvant chemotherapy and chemoradiation prior to total mesorectal excision)
Minimally invasive techniques for surgery of rectal cancer (laparoscopy, robotic surgery, and transanal total mesorectal excision)
A novel PD-1 blocker, dostarlimab, has shown very promising results in a phase 2 trial, current demonstrating a 100% clinical remission rate; further study is required to ascertain if this result lasts

Equity, Inclusion, and Diversity education has increasingly been integrated into medical training

We provide a review of the physiologic changes during pregnancy and how they might affect non-obstetric surgery in parturients.
We discuss pharmacology as is pertinent in parturients undergoing non-obstetric surgery.
Specific considerations for parturients undergoing laparoscopy, trauma or non-obstetric gynecologic surgery are made.

Compartment syndrome of the extremity is a clinical diagnosis in an awake and alert patient.
Measurement of intracompartmental pressures should be performed in the obtunded patient or if clinical assessment is inconclusive.
Once the diagnosis is made, emergent fasciotomy is the treatment of choice as time to fasciotomy is the most important factor determining outcome.
Any patient with risk factors for developing abdominal hypertension should have intra-abdominal pressure assessed, preferably via intermittent or continuous transbladder pressure.
Patients diagnosed with abdominal compartment syndrome require emergent decompressive laparotomy and the creation of a temporary abdominal closure.

Compartment syndrome of the extremity is a clinical diagnosis in an awake and alert patient.
Measurement of intracompartmental pressures should be performed in the obtunded patient or if clinical assessment is inconclusive.
Once the diagnosis is made, emergent fasciotomy is the treatment of choice as time to fasciotomy is the most important factor determining outcome.
Any patient with risk factors for developing abdominal hypertension should have intra-abdominal pressure assessed, preferably via intermittent or continuous transbladder pressure.
Patients diagnosed with abdominal compartment syndrome require emergent decompressive laparotomy and the creation of a temporary abdominal closure.

The MSLT is essential in documenting pathologic sleepiness (e.g., sleep-onset latency of less than 8 minutes) and in diagnosing narcolepsy. The presence of two sleep-onset REMs on four or five nap studies and sleep-onset latency of less than 8 minutes strongly suggests a diagnosis of narcolepsy in the context of an appropriate history.
RLS is a lifelong sensorimotor neurologic disorder with a severe impact on sleep and quality of life that may begin at any age. RLS is most severe in middle-aged or elderly persons, in whom it has a chronic, progressive course. The overall prevalence of RLS for the adult population has been estimated to be about 7.2%, particularly in those of European descent, but the prevalence of the most severe cases (severe symptoms occurring at least two nights a week) is approximately 2.7%
For transient insomnia or insomnia of short duration, treatment with sedative-hypnotics (e.g., zolpidem, zolpidem extended release, zolpidem tartrate sublingual tablets, zaleplon, eszopiclone, or low-dose doxepin) or short- or intermediate-acting benzodiazepines (e.g., temazepam), as well as ramelteon, a melatonin receptor (MT₁ and MT₃) agonist, for a few nights to a few weeks is appropriate.

General Surgery