What's New | Decker

BTAI is now the gold standard n treating patients with these problems
The grade of injury with these lesions has been defined and there is controversy on which lesion should be treated and how emergently
Recently in the US a device changed its IFU because of complications after TEVAR for BTAI. It was being used outside its IFU.
Recent advancement on sizing and device differences between BTAI and other pathologies treated with TEVAR

Use of HVPG to accurately diagnose portal hypertension
Child-Pugh score and MELD score in risk stratification and decision-making
Fibroelastography, multidetecter row CT scan, and capsule endoscopy as emerging modalities in detection of varices.

Spirometry has few absolute contraindications, although several conditions should merit caution and others may affect the quality of results. Pain, nausea, or other subjective discomforts, as well as altered mental status, will likely lead to poor results and therefore are relative contraindications.
The role of the carbon monoxide (CO) diffusing capacity (DL_CO) test is to provide information on the transfer of gas from alveolar air to the bloodstream. DL_CO reflects the overall efficiency of gas movement at each step from the mouth to the hemoglobin in the pulmonary capillary blood.
Certain substances and behavior should be avoided prior to testing as they can lead to either false positives or false negatives. Recent upper respiratory tract infection and cigarette smoking can elevate bronchial hyperresponsiveness.

Improvements in transdermal drug delivery with use of fractional lasers/radiofrequency ablation combined with ultrasound therapy. Advances in nanotechnology will further improve the ability to deliver targeted therapies
Improved understanding of signaling pathways in wound healing states will allow for future target-specific therapeutics. Some candidate drugs are being tested in animal models
Tissue engineering and use of polysaccharide and protein scaffolds may eventually improve wound healing via delivery of growth factors, favorable cytokines, and improvement in tissue oxygenation

Initial volume resuscitation should commence with 1 L isotonic crystalloid solution followed by blood products at 1:1:1 ratio (1 unit packed red blood cells to 1 unit fresh frozen plasma to 1 unit platelets) if the patient is not responsive to the initial fluid bolus.
In patients with massive hemorrhage or evidence of fibrinolysis, tranexamic acid has demonstrated improved survival if administered within 3 hours of injury.
Use of resuscitative endovascular balloon occlusion of the aorta may be an important adjunct in the control of life-threatening abdominal or pelvic hemorrhage.
In cases of external hemorrhage of an extremity, a tourniquet should be used to control bleeding.

Large randomized trials of Pap and HPV cotesting found that after extended follow-up, the incidence of invasive cervical cancer was significantly lower in women initially screened with HPV-based testing compared with cytology alone.
Screening that includes assessment of HPV status provides 60 to 70% greater protection against invasive cervical carcinomas compared with cytology alone.
Vaccination rates for the HPV vaccine, approved in the United States since 2006, are well below national goals, and provider recommendation has been found to be the most important factor influencing a patient’s or parent’s decision as to whether or not to accept the HPV vaccine.

Spirometry has few absolute contraindications, although several conditions should merit caution and others may affect the quality of results. Pain, nausea, or other subjective discomforts, as well as altered mental status, will likely lead to poor results and therefore are relative contraindications.
The role of the carbon monoxide (CO) diffusing capacity (DL_CO) test is to provide information on the transfer of gas from alveolar air to the bloodstream. DL_CO reflects the overall efficiency of gas movement at each step from the mouth to the hemoglobin in the pulmonary capillary blood.
Certain substances and behavior should be avoided prior to testing as they can lead to either false positives or false negatives. Recent upper respiratory tract infection and cigarette smoking can elevate bronchial hyperresponsiveness.

Spirometry has few absolute contraindications, although several conditions should merit caution and others may affect the quality of results. Pain, nausea, or other subjective discomforts, as well as altered mental status, will likely lead to poor results and therefore are relative contraindications.
The role of the carbon monoxide (CO) diffusing capacity (DL_CO) test is to provide information on the transfer of gas from alveolar air to the bloodstream. DL_CO reflects the overall efficiency of gas movement at each step from the mouth to the hemoglobin in the pulmonary capillary blood.
Certain substances and behavior should be avoided prior to testing as they can lead to either false positives or false negatives. Recent upper respiratory tract infection and cigarette smoking can elevate bronchial hyperresponsiveness.

IM Cardiovascular Medicine