Latest Updates

Management of Acute Iliofemoral Deep Vein Thrombosis

Albeir Y Mousa, MD, FACS, RPVI, MPH, MBA
    • Mechanical removal of acute venous thrombus with increased safety
    • Selection of catheter-directed thrombolysis in patients with thrombotic iliofemoral DVT
    • Protocols of pharmacomechanical thrombolysis
    • Using intravascular ultrasonography to guide intraoperative therapy

HER-2-Amplified Breast Cancer

Zahraa Al-Hilli, MD, Judy C Boughey, MD
    • The monoclonal antibody trastuzumab has revolutionized the treatment of HER-2-positive breast cancer, resulting in improved patient outcomes.
    • Dual anti-HER-2 therapy has been shown to result in increased pathologic complete response (pCR) rates in patients treated in the neoadjuvant setting.
    • pCR has been shown to be associated with a good prognosis and outcome in patients receiving neoadjuvant chemotherapy.
    • Novel anti-HER-2 agents are currently being investigated in ongoing trials.

Hand Infections

Scott D Lifchez, MD, FACS, Colton McNichols, MD
    • A recently published large database study of outpatient hand surgery procedures states that postoperative infection risk is less than 1%.
    • Prophylactic antibiotics for elective procedures lasting less than 2 hours are not necessary.
    • Trimethoprim/sulfamethoxazole and doxycycline are commonly used PO empiric antibiotics for hand infections due to the increased prevalence of methicillin-resistant Staphylococcus aureus.

Pediatric Abdominal Emergencies

Jeffrey Bullard-Berent, MD, FAAP, FACEP, Aaron Kornblith, MD
    • Pediatric surgical emergencies occur at characteristic ages, and emergency physicians need to be aware of this on presentation.
    • Diagnosis of incarcerated inguinal hernia is a clinical diagnosis.
    • Ultrasonography is the initial imaging modality of choice for midgut volvulus, pyloric stenosis, intussusception, and appendicitis.
    • Hydrostatic and pneumatic enema is the therapeutic method of choice for reduction of ileocolic intussusception.
    • In children with suspected appendicitis, the application of a staged algorithm, including a scoring system and ultrasonography, can improve test characteristics.

Pediatric Upper Airway Obstruction

Michael W. Chan, MD, Suzanne M. Schmidt, MD
    • Evidence that imaging (radiographs, computed tomography, magnetic resonance imaging) should be reserved for selected patients
    • Evidence that procedural intervention may not always be required in cases of peritonsillar and retropharyngeal abscesses
    • Enhanced understanding of epiglottitis pathophysiology, diagnosis, and treatment

Pediatric Upper Airway Obstruction

Michael W. Chan, MD, Suzanne M. Schmidt, MD
    • Evidence that imaging (radiographs, computed tomography, magnetic resonance imaging) should be reserved for selected patients
    • Evidence that procedural intervention may not always be required in cases of peritonsillar and retropharyngeal abscesses
    • Enhanced understanding of epiglottitis pathophysiology, diagnosis, and treatment

Nonsurgical Management Options for Pelvic Organ Prolapse: Review of the Current Evidence

Nathan Kow, MD
    • Despite any recent advances in pessaries, they remain the first-line therapy for pelvic organ prolapse.
    • Most available studies regarding pessaries demonstrate ease of fitting, with favorable short-term and long-term outcomes.
    • Recent randomized controlled trials have shown conflicting results regarding efficacy of pelvic floor muscle therapy

Fiber and Nutritional Health

Joanne L Slavin, PhD, RD
    • Dietary fiber intake is a nutrient of concern, with intakes less than half of recommended amounts.
    • Oats, barley, and psyllium have approved health claims in the United States for their ability to lower blood lipids.
    • Recommended dietary fiber intakes are based on prospective studies and the relationship of fiber intakes to reduced incidence of cardiovascular disease.
    • Foods high in dietary fiber, grains, vegetables, fruits, and legumes should be increased in the diet to improve fiber intakes.
    • Fiber supplements should be recommended on a case-by-case basis as there is wide variation in a patient’s response to additional fiber.
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