What's New | Decker

2024 KDIGO Practice Guidelines
Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada
Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder: Synopsis of the Kidney Disease: Improving Global Outcomes 2017 Clinical Practice Guideline Update.

2024 KDIGO Practice Guidelines
Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada
Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder: Synopsis of the Kidney Disease: Improving Global Outcomes 2017 Clinical Practice Guideline Update.

2024 KDIGO Practice Guidelines
Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada
Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder: Synopsis of the Kidney Disease: Improving Global Outcomes 2017 Clinical Practice Guideline Update.

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.

The recent Food and Drug Administration–approved drug Rytary is a novel designed capsule and delivery system containing both standard- and extended-release levodopa/carbidopa components that were designed to reduce the number of dosages taken per day. A recent randomized, double-blind, placebo-controlled study of Rytary in levodopa-naïve Parkinson disease (PD) patients showed significant improvements in the Unified Parkinson Disease Rating Scale and in quality of life measurements at 30 weeks compared with placebo. Rytary will need time in clinical practice to better define its role in therapy.

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

Bactericidal antibiotics are used parenterally in high doses. With the exception of PVE caused by staphylococci, antimicrobial therapy for PVE caused by a specific organism uses the same drugs recommended for native valve endocarditis.
Endocarditis caused by relatively penicillin-resistant (MIC = 0.2 to 0.5 µg/mL) viridans or other nonenterococcal streptococci is treated with a higher dose of penicillin G combined with gentamicin. If the strain is even more resistant to penicillin (MIC > 0.5 µg/mL), the infection is treated with one of the standard regimens for enterococcal endocarditis.
Operative intervention to débride infected perivalvular tissue or to replace or reconstruct a dysfunctioning valve is important in the management of complicated infective endocarditis that involves either a native or a prosthetic valve. Overall, surgery is indicated in 25 to 40% of patients with infective endocarditis, and up to 45% of patients undergo surgery during the active phase of their disease.

The cholinesterase inhibitors donepezil, galantamine, and rivastigmine have been approved by the Food and Drug Administration (FDA) for the treatment of AD dementia.
Patients with mild to moderate AD dementia are the appropriate candidates for cholinesterase inhibitor therapy. These patients need a designated caregiver to supervise the use of the medication.
Support for and empowerment of the caregivers of dementia patients must be an integral part of management. The emotional and physical health of caregivers is critical to long-term outcomes.

Nephrology