Latest Updates

Upper Extremity Revascularization Procedures

David L. Cull, MD, FACS, Sagar S Gandhi, MD
    • Presentation and etiology of upper extremity limb ischemia
    • Detailed description of the treatment of chronic arm ischemia
    • Endovascular advances in the treatment of acute and chronic arm ischemia

Myxofibrosarcoma and Undifferentiated Pleomorphic Sarcoma

Ann Y Lee, MD
    • Myxofibrosarcoma has characteristic infiltrative borders that can be seen as T2 hyperintense “tails” on MRI and require a 2 cm clinical resection margin to minimize the incidence of positive margins.
    • The entity formerly known as malignant fibrous histiocytoma is now known as undifferentiated pleomorphic sarcoma and is considered a diagnosis of exclusion.
    • Improved knowledge of risk factors for local and distant recurrence helps guide the use of radiation therapy and chemotherapy, as well as follow-up strategies.

Tumor Immunology

Haidong Dong, MD, PhD, Svetomir N Markovic, MD, PhD, Rachel L Maus, PhD
    • Development of effective immunotherapies hinges on addressing the immunosuppressive tumor microenvironment to overcome immune tolerance.
    • Immunotherapies aimed at reengaging the antitumor immune response have yielded encouraging preclinical and clinical results.
    • Alternatively, neutralizing immunotherapies target inhibitory immune mechanisms within the cancer setting, resulting in impressive clinical responses.
    • Novel combinatorial immunotherapy approaches hold great promise for establishing durable clinical responses.

Surgical Management of Extremity and Truncal Sarcoma

Janice N Cormier, MD, MPH, Christina L Roland, MD
    • Multimodality treatment including surgery, radiation, and chemotherapy results in improved local recurrence and survival outcomes.
    • Wide resection with 1 to 2 cm margin standard over amputation
    • Multidisciplinary planning necessary for complex resections and reconstruction

Plasmapheresis

François Madore, MD, MSc
    • Plasmapheresis techniques are reviewed, including centrifugation and membrane filtration methods.
    • Selective apheresis procedures are discussed.
    • Technical considerations are discussed for optimal plasmapheresis prescription.
    • The present review discusses renal conditions for which plasmapheresis may be attempted with recommendations based on evidence from the literature.

Brain Death and Resuscitation of the Organ Donor 

Kasra Khatibi, MD, Chitra Venkatasubramanian, MBBS, MD, MSc,
    • Checklist for brain death determination to minimize variability in the performance of brain death exam.
    • Details on ancillary testing for brain death determination.
    • Section on apnea testing while on ECMO.
    • Communication tools for physicians discussing brain death with families.
    • Practical tips on organ preservation for donation after brain death.

Surgical Management of Extremity and Truncal Sarcoma

Janice N Cormier, MD, MPH, Christina L Roland, MD
    • Multimodality treatment including surgery, radiation, and chemotherapy results in improved local recurrence and survival outcomes.
    • Wide resection with 1 to 2 cm margin standard over amputation
    • Multidisciplinary planning necessary for complex resections and reconstruction

Disorders of Water Balance

Jonathan W. Bress, MD, John K. Hix, MD, Stephen M. Silver, MD, Richard H Sterns, MD, FACP
    • Bone disease in hyponatremia
    • Therapeutic strategies to prevent overcorrection of hyponatremia
    • Therapeutic relowering of the serum sodium for inadvertent overcorrection of hyponatremia
    • Vasopressin antagonists in the treatment of hyponatremia
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