Latest Updates

Cervical Radiculopathy

Robert B Bolash, MD, Pavan Tankha, DO
    • Physical exam maneuvers have demonstrated high specificity and low sensitivity for cervical radiculopathy
    • CT myelography may offer better sensitivity for foraminal and bony abnormalities as compared to MRI
    • Cervical epidural steroid injections may result in the resolution of symptoms in 40-75% of patients
    • Failure to respond to conservative and interventional approaches in three months warrants a surgical consult

Physicians' Role in Curbing the Worst Drug Crisis in America: Prescription Opioid Abuse

Sairam Atluri, MD, FIPP, Gururau Sudarshan, MD, FRCA
    • Use of screening tools to stratify patients into different risk categories of opioid misuse to accomplish appropriate opioid prescribing
    • Emphasis on monitoring techniques to assess compliance of patients on opioids
    • Importance of opioid dose limitations in curbing opioid abuse

Role of Cannabis in Anxiety Disorders

    • Cannabis as a whole, and its spectrum of biochemicals, elicit variable response in both anxiogenesis and anxiolysis, dependent on the proportions of phytocannabinoids
    • CBD provides anxiolysis in most situations, while THC is generally accepted to produce anxiety mechanisms of cannabinoid action on anxiety pathways are complex and involve overlapping interplay of neurochemical pathways
    •  Additional studies are required to elucidate the effects of specific agents versus whole plant extract as well as administration routes in controlled environments

Viral Hepatitis A

Brittany L Kmush, PhD, Kenrad E Nelson, MD
    • Several safe and effective vaccines exist to prevent hepatitis A infections.
    • Significant morbidity continues to occur in the United States among international travelers, injection drug users, and persons with underlying liver disease.
    • In developing countries, the epidemiologic transition has increased the prevalence of clinically severe hepatitis A infections.

Benign Breast Disease

Stephen R Grobmyer, MD, FACS, Stephanie A Valente, DO, FACS
    • Recent research has explored approaches to distinguishing benign and malignant breast lesions with higher accuracy. Artificial intelligence with combined data from mammogram image biomarkers and clinical parameters can more robustly predict breast malignancy.
    • A new modality of treatment under investigation is ultrasound-guided high-intensity focused ultrasound ablation. This may be an effective, safe, and well tolerated treatment for breast fibroadenomas.
    • Although the exact etiology of cyclic mastalgia is unknown, due to its association with the menstrual cycle, it is thought to be related to certain breast histologic changes, hormonal fluctuations, or fluid-electrolyte or nutritional imbalance.

Benign Breast Disease

Stephen R Grobmyer, MD, FACS, Stephanie A Valente, DO, FACS
    • Recent research has explored approaches to distinguishing benign and malignant breast lesions with higher accuracy. Artificial intelligence with combined data from mammogram image biomarkers and clinical parameters can more robustly predict breast malignancy.
    • A new modality of treatment under investigation is ultrasound-guided high-intensity focused ultrasound ablation. This may be an effective, safe, and well tolerated treatment for breast fibroadenomas.
    • Although the exact etiology of cyclic mastalgia is unknown, due to its association with the menstrual cycle, it is thought to be related to certain breast histologic changes, hormonal fluctuations, or fluid-electrolyte or nutritional imbalance.

Mechanical Ventilation: Advanced Ventilation and Adjuncts

Lewis J Kaplan, MD, FACS, FCCM, FCCP, Adrian A. Maung, MD, FACS, FCCM
    • The use of prone positioning to improve the outcome in patients with acute respiratory distress syndrome
    • The use of neuromuscular blockade in patients with severe acute respiratory distress syndrome
    • High-flow nasal cannula therapy as a possible alternative to noninvasive positive-pressure ventilation

Diagnosis of Diabetic Foot

Anil Hingorani, MD, FACS
    • Development of guidelines for diagnosis and treatment of diabetic foot to help codify worldwide data across various specialties involved with diabetic foot 
    • Magnetic resonance angiography (MRA) and spiral CT angiography (CTA) have been proposed as alternatives to invasive angiography in the evaluation of vascular occlusive disease
    • Currently, it is clear that resistant organisms, particularly methicillin-resistant Staphylococcus aureus (MRSA), are playing a growing role in the development of skin and soft tissue infections. Traditionally arising in patients who had previously been hospitalized and those who had previously received antibiotic therapy, MRSA-associated infections are now frequently encountered in outpatient settings
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