Latest Updates

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

Mechanical Ventilation: Approaches and Special Considerations

Lewis J Kaplan, MD, FACS, FCCM, FCCP, Adrian A. Maung, MD, FACS, FCCM
    • Consideration for specific ventilator modes for those at risk of acute respiratory distress syndrome (ARDS)
    • The use of respiratory therapist–guided spontaneous breathing trials
    • Changes in the pattern of tracheostomy use for acute respiratory failure
    • Expanded penetrance of palliative care in those with prolonged mechanical ventilation
    • The expanded use of extracorporeal techniques for severe ARDS

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

Chronic Kidney Failure and Dialysis

Raghu V Durvasula, MD, Jonathan Himmelfarb, MD
    • Studies in populations of European ancestry have identified a role for variants of the uromodulin (UMOD) gene in modulating the risk of developing CKD. Encoding Tamm-Horsfall protein, which is synthesized by tubular epithelial cells of the thick ascending limb, certain allelic variants of UMOD appear to confer a protective effect of developing CKD, with a reduced odds ratio of 0.76.
    • An alternative approach is to measure the urine protein-to-creatinine spot ratio, which detects all forms of protein present in the urine and eliminates potential imprecisions attributable to urinary concentration. A spot ratio greater than 0.2 is suggestive of underlying kidney injury.
    • The gold standard for hemodialysis access remains the AV fistula, which is surgically created by connecting an artery directly to a vein, typically in the arm. AV fistulas remain superior to other forms of dialysis access and are associated with higher achieved clearance, longer patency rates, fewer infectious complications, and overall greater patient sense of well-being.
« Previous | Next »
Updates per yearSpecialty updatesNumber of sections