What's New | Decker

The International Society for Sexual Medicine agreed on a definition of premature ejaculation in 2014.
Premature ejaculation (PE) classification has been expanded to include natural variable (variable PE) and premature-like ejaculatory dysfunction (subjective PE).
There is now well-established pharmacotherapy mainly with SSRIs with differing levels of efficacy as well as potential adjunctive therapy with topical or local anesthetics.

Lightning strikes may also cause myocardial injury,
which may be evident through ECG changes, biomarker elevations, and echocardiographic ventricular wall motion abnormalities.
Pericarditis and pericardial effusion may also occur. These abnormalities tend to resolve within several weeks.

Lightning strikes may also cause myocardial injury,
which may be evident through ECG changes, biomarker elevations, and echocardiographic ventricular wall motion abnormalities.
Pericarditis and pericardial effusion may also occur. These abnormalities tend to resolve within several weeks.

The majority of patients with iCCA present with locally advanced or metastatic disease.
Surgery for patients iCCA involves margin-negative resection with porta hepatis lymphadenectomy including at least six lymph nodes.
Formal volumetry should be considered for patients requiring extended hepatectomy to ensure adequatefuture liver remnant size
Adjuvant chemotherapy should be considered after resection, particularly for high-risk features such as lymph node involvement or positive margins.

The majority of patients with iCCA present with locally advanced or metastatic disease.
Surgery for patients iCCA involves margin-negative resection with porta hepatis lymphadenectomy including at least six lymph nodes.
Formal volumetry should be considered for patients requiring extended hepatectomy to ensure adequatefuture liver remnant size
Adjuvant chemotherapy should be considered after resection, particularly for high-risk features such as lymph node involvement or positive margins.

Clinical gestalt can also accurately assess the pretest probability of PE.
For patients with a low pretest probability of PE, the Pulmonary Embolism Rule-out Criteria can be used to rule out PE without further testing including no need to order a D-dimer.
The YEARS protocol may be used to exclude a subset of patients from having a workup to rule out PE when their D-dimer is less than 1000 as opposed to 500.
Intravenous alteplase, catheter-directed thrombolysis, surgical embolectomy, and catheter-directed embolectomy are treatment modalities for patients with PE who are hemodynamically unstable.
For patients in imminent or actual PE-related cardiac arrest, current guidelines recommend a bolus regimen consisting of 50 mg IV t-PA given over two minutes and repeated after 15 minutes in the absence of return of spontaneous circulation.
A subset of patients with PE can be treated as outpatients if their Simplified Pulmonary Severity Index is 0.

Karthik Giridhar, MD, Manish Kohli, MD

Emphasis on landmark clinical trials in metastatic prostate cancer (especially since 2010)
Critical analysis and summary of PSA-based prostate cancer screening
Advances and integration of genomic sciences in early and advanced stages of prostate cancer

Karthik Giridhar, MD, Manish Kohli, MD

Emphasis on landmark clinical trials in metastatic prostate cancer (especially since 2010)
Critical analysis and summary of PSA-based prostate cancer screening
Advances and integration of genomic sciences in early and advanced stages of prostate cancer

Andrology