Latest Updates

Minimally Invasive Approaches to Forehead Rejuvenation

Paul S Cederna, MD, Dhivya R Srinivasa, MD
    • Evolution in fixation techniques
    • Endoscopic dissection
    • Temporal changes in the Aesthetic Brow

Biochemical Recurrence after Radical Prostatectomy

Brian Chapin, MD, Scott Delacroix, MD, Dunia Khaled, MD
    • Historical versus novel predictors of biochemical recurrence (BCR), metastasis, and cancer-specific mortality
    • Historical versus novel imaging modalities in staging of BCR
    • Emerging salvage therapies for BCR

Introduction to Ureteroceles: Presentation, Diagnosis, and Initial Management

David A Diamond, MD, Joseph W McQuaid, MD, MPH
    • Goals of ureterocele management include: prevention of renal damage, prevention of infection, and preservation of continence.
    • Prenatal diagnosis of ureteroceles results in decreased morbidity both before and after surgical intervention.
    • Patients presenting with obstruction and sepsis benefit from prompt, transurethral decompression.
    • Any endoscopic technique chosen should aim to relieve obstruction while minimizing surgical morbidity and de novo reflux.

Cardiac Arrest And Resuscitation

Shamai A. Grossman, MD, MS, Patrick Hughes, MD, Oren Mechanic, MD, MPH
    • Despite continued research, the principal evidence-based interventions are high-quality chest compressions and early defibrillation when indicated.
    • Advanced airway management is not shown to improve neurologically intact survival.
    • Minimizing interruptions in chest compressions improves survival.
    • Vasopressin has been removed from ACLS guidelines.
    • Amiodarone is only recommended in ventricular fibrillation or ventricular tachycardia that is refractory to chest compressions, vasopressors, and defibrillation.
    • Capnography provides useful information with regard to the effectiveness of chest compressions, confirmation of endotracheal tube placement, and prognostic information.

Viral Zoonoses

Duane J. Gubler, ScD, Lyle R Petersen, MD, MPH

    Systemic Mastocytosis

    Matthew J. Hamilton, MD
      • The most prominent symptoms of SM are those caused by mast cell activation and include flushing, abdominal pain, and cramping.
      • SM is diagnosed by defined criteria including appearance and number of the clonal mast cells on bone marrow or intestinal biopsy.
      • Treatment for the most common form of SM is directed at mast cell activation and symptom control.

    Postoperative Pain Management

    Abhishek Parmar, MD, MS
      • Update to pharmacologic options in multimodal analgesia
      • Increasing use of epidural anesthesia
      • Expansion of literature supporting regional nerve blocks and details on techniques
      • Rise of opiate addiction crisis and information on best prescriber practices to minimize abuse

    Ventilator Weaning

    Brian Brajcich, MD, Ann Hwalek, DO, Joseph Posluszny, MD
      • Spontaneous breathing trials remain the mainstay of assessing ventilator weaning and preparing for extubation.
      • The use of high-flow nasal cannula following extubation may be more useful and successful than noninvasive ventilation in preventing reintubation.
      • The use of a T-piece trial is no longer recommended.
      • Timing of tracheostomy remains controversial.
      • Dexmedetomidine is a newer sedative that may be useful in extubating patients with high sedation requirements but good pulmonary mechanics.
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