What's New | Decker

Contemporary understanding of ventricular mechanics with identification of the structure and function of the ventricular myocardial band
Detailed description of the anatomic proximity of cardiac structures and how knowledge of this proximity helps prevent intraoperative complications and damage to critical cardiac structures
Comprehensive description of aortic root anatomy and mechanics and application of how this anatomy dictates performance of transcatheter aortic valve replacement

Megan Fix, MD, Steven Glerum, MD

Abdominal radiographs to diagnose functional constipation in pediatric patients not indicated.
In unreliable pediatric patients, plain abdominal radiography may be useful.
PEG is recommended as first-line maintenance treatment for functional constipation.

Nonmydriatic fundus cameras with digital transmission enable efficient, remote retinopathy screening supervised by ophthalmologists.
Two-step approach: significant lesions in digital retinal photographs prompt full ophthalmologist examinations.
Cost-saving strategy for retinopathy screening, particularly beneficial in remote areas.
Newer drugs (SGTLT 2 inhibitors, GLP-1 agonists, MR antagonists) offer added cardiovascular and renal benefits in diabetes.
Chronic complications in diabetes require specialized management and consultation with appropriate specialists.

Nonmydriatic fundus cameras with digital transmission enable efficient, remote retinopathy screening supervised by ophthalmologists.
Two-step approach: significant lesions in digital retinal photographs prompt full ophthalmologist examinations.
Cost-saving strategy for retinopathy screening, particularly beneficial in remote areas.
Newer drugs (SGTLT 2 inhibitors, GLP-1 agonists, MR antagonists) offer added cardiovascular and renal benefits in diabetes.
Chronic complications in diabetes require specialized management and consultation with appropriate specialists.

Imaging modalities in the assessment of NAFLD
Controlled attenuation parameter as a point of care measure for hepatic steatosis
Proton density fat fraction as MRI based measure for hepatic steatosis
Liver stiffness measurement on elastography as a correlate of hepatic fibrosis or cirrhosis
Active clinical trials in phase 2b and 3, yet no FDA approved therapy
Intense lifestyle changes with 5-10% weight loss can improve fibrosis and steatosis

Lip Taping and nasoalveolar molding pre-operatively can greatly improve surgical outcomes.
3-Dimensional printing used to make nasoalveolar molding appliances

Early recognition of shock is difficult but essential for preservation of cellular and organ function and survival. The earliest clinical signs are nonspecific, with the initial inflammatory response including tachycardia, fevers, or cool or clammy skin.
The approach to shock ultimately requires understanding and correcting its etiology (eg, antibiotics and source control for sepsis, thrombectomy after massive pulmonary embolus, hemorrhage control after trauma, and so forth). However, until these are diagnosed and addressed directly, clinicians ultimately have three approaches in their armamentarium: volume expansion, vasopressors, and cardioactive agents.
The PAC was introduced in 1970. Its use increased over the next 3 decades and eventually was considered the standard of care for most critically ill patients. However, the use of PACs declined rapidly after the results of the randomized, controlled trial published in the New England Journal of Medicine revealing no benefit in high-risk surgical patients.

Indocyanine green based fluorescent imaging to assess vascular perfusion
Allograft dermal skin regeneration: Acellular dermal regeneration templates
Microvascular techniques for larger, deeper defects with skin and color matching

Organ Systems: Anatomy & Physiology