Latest Updates

Endoscopic Management of Polyps and Early Malignancy

    • Endoscopic full-thickness resection has been successfully performed for the treatment of gastric tumors invading deep into the gastric wall.
    • Endoscopic submucosal dissection is emerging as a consideration for colorectal polyps greater than 2 cm in size owing to higher en blocresection rates and fewer local recurrences than endoscopic mucosal resection.
    • Advanced endoscopic resection techniques, including endoscopic submucosal dissection, are becoming more widespread as global expertise develops.
    • A combination of endoscopic resection and radiofrequency ablation is effective for nodular high-grade esophageal dysplasia.

Approach to Acid-Base Disorders

    Rapidly Progressive Glomerulonephritis

      Lower Gastrointestinal Bleeding

        • Multidetector CT
        • Microcatheter superselective embolization
        • Video capsule endoscopy
        • Push enteroscopy
        • CT enterography

      Epidemiology of Acute Kidney Injury

        • Recent surveys demonstrated that the worldwide incidence of acute kidney injury (AKI) is increasing, occurring in 21% of hospital admissions.
        • Several risk factors for AKI development have been highlighted recently, such as fluid overload, chloride-rich intravenous fluid therapy, anemia, hyperuricemia, and use of warfarin.
        • New biomarkers of kidney injury, such as urinary neutrophil gelatinase-associated lipocalin, cystatin C, and interleukin-18, have been able to identify patients with AKI who present the worse prognosis, particularly critically ill patients.
        • Hospital-associated AKI is associated with long-term mortality, and the most important risk factors for this late lethality are older age, preexisting comorbid disease (chronic kidney disease [CKD], cardiovascular disease, or malignancy), and incomplete organ recovery with persistent kidney damage.
        • AKI is associated with de novo end-stage renal disease (ESRD) (CKD development, progression of preexisting CKD) and the occurrence of ESRD in the long term, and high-risk patients recovering from an AKI episode such as those with baseline CKD, diabetes mellitus, or heart failure and those dialyzed for AKI should likely be followed by a nephrologist.

      Basics of Imaging Techniques in Evaluation of Soft Tissue Tumors

        • Magnetic resonance imaging (MRI) is the imaging modality of choice for detection and characterization of soft tissue lesions with technical advances in functional imaging beyond morphologic information.
        • MRI requires good understanding of basic principles of MRI sequences and common artifacts for better interpretation.
        • Computed tomography (CT) has substantially improved in its multiplanar and volume-rendering ability with thinner slice image reconstruction after the introduction of a helical CT scanner. 
        • CT is highly sensitive in detecting calcification and gas and the imaging modality of choice in evaluation of pulmonary metastases.
        • Ultrasonography is a readily available imaging modality with the ability to differentiate solid from cystic lesions and allow real-time evaluation without ionizing radiation.
        • Positron emission tomography has become an excellent imaging modality for both staging and screening of metabolically active tumor by providing the anatomic details and metabolic activity of both benign and malignant tumors.

      Basics of Imaging Techniques in Evaluation of Soft Tissue Tumors

        • Magnetic resonance imaging (MRI) is the imaging modality of choice for detection and characterization of soft tissue lesions with technical advances in functional imaging beyond morphologic information.
        • MRI requires good understanding of basic principles of MRI sequences and common artifacts for better interpretation.
        • Computed tomography (CT) has substantially improved in its multiplanar and volume-rendering ability with thinner slice image reconstruction after the introduction of a helical CT scanner. 
        • CT is highly sensitive in detecting calcification and gas and the imaging modality of choice in evaluation of pulmonary metastases.
        • Ultrasonography is a readily available imaging modality with the ability to differentiate solid from cystic lesions and allow real-time evaluation without ionizing radiation.
        • Positron emission tomography has become an excellent imaging modality for both staging and screening of metabolically active tumor by providing the anatomic details and metabolic activity of both benign and malignant tumors.

      The Immunocompromised Surgical Patient

        Studies have shown that among HIV-infected patients, involvement of infectious disease specialists reduces hospital costs and complications and results in better control of viral loads…. The current recommended treatment regimen for HIV-infected individuals includes a three-drug regimen of which two are nucleoside reverse transcriptase inhibitors and the other is either an integrase strand transfer inhibitor, a nonnucleoside reverse transcriptase inhibitor, or a boosted protease inhibitor…. Blood transfusion has been associated with immunosuppression (transfusion-related immunomodulation), with the potential to further depress an already compromised immune system in a transplant recipient and resulting in infection or cancer recurrence.

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