What's New | Decker

Pulmonary hypertension can be treated with single or combination therapy employing calcium channel blockers, phosphodiesterase inhibitors, guanylate cyclase stimulators, endothelin receptor antagonists, and prostanoids.
Levosimendan is a calcium sensitizer used to treat cardiogenic shock and right heart failure.
Clevidipine is an ultra-rapid acting calcium channel blocker used for perioperative hypertension management in cardiovascular and vascular diseases, neurosurgery, and surgery for pheochromocytoma.

Radiofrequency ablation as a treatment modality has revolutionized therapy for many SVTs; acts as a first-line alternative to drug therapy in some circumstances, with a high acute success rate and relatively low complication rate.
Cryoablation therapy emerging as an alternative in ablative therapies. Investigation of this modality for SVTs is ongoing.
Detailed drug regimens optimized for acute and chronic management of specific SVTs; detailed in the 2015 ACC/AHA/HRS practice guidelines.

The REVERT trial concluded that a modified valsalva maneuver has a higher rate of cardioversion than historical vagal maneuvers.
In a patient with stable SVT where vagal maneuvers have failed, IV adenosine remains the first-line pharmacologic agent.
Combining adenosine and saline in a single syringe, rather than administration of adenosine followed by a saline flush, has been proven to be an effective form of administration.

Sepsis syndromes have been redefined (Sepsis-3 definitions) by international experts, based on sepsis mortality data extracted large administrative databases.
National focus has turned to early identification of sepsis as a key determinant of outcomes. International critical care experts have recommended using the qSOFA criteria in the Emergency Department setting to identify sepsis risk in patients prior to obtaining diagnostics.
The Center for Medicare and Medicaid Services (CMS) has added a sepsis quality measure (SEP-1) as a reporting requirement for all US hospital tied to Medicare & Medicaid reimbursement. This measure has increased awareness of sepsis performance and focused quality efforts on improvement.
2018 update to bundles to simplify to 1-hour bundle.

Latest available ACC/AHA guidelines and ongoing controversy around optimal heart rate targets
Updated classification for patients with valvular and nonvalvular AF algorithm for maintenance of sinus rhythm
2019 AHA/ACC/HRS and 2020 ESC/EACTS practice guidelines delineated new and modified anticoagulation recommendations pertaining to NOACs.

BTAI is now the gold standard n treating patients with these problems
The grade of injury with these lesions has been defined and there is controversy on which lesion should be treated and how emergently
Recently in the US a device changed its IFU because of complications after TEVAR for BTAI. It was being used outside its IFU.
Recent advancement on sizing and device differences between BTAI and other pathologies treated with TEVAR

BTAI is now the gold standard n treating patients with these problems
The grade of injury with these lesions has been defined and there is controversy on which lesion should be treated and how emergently
Recently in the US a device changed its IFU because of complications after TEVAR for BTAI. It was being used outside its IFU.
Recent advancement on sizing and device differences between BTAI and other pathologies treated with TEVAR

Diagnosing borderline personality disorder (BPD) is focused on identifying patterns of symptoms that are consistent over time across several domains.
Development of BPD depends on an interactive combination of temperamental factors and environment stresses.
Distinguishing BPD from other psychiatric disorders, such as bipolar disorder, is essential in providing effective treatment.
Patients with BPD are highly stigmatized in the mental health system and receive poorer quality of care than patients with some other disorders.
BPD has a positive prognosis, with improvements typically seen within several years.

Pharmacology