Latest Updates

Basic Concepts of Anesthesia

Pooja Pandya, MD, George P. Yang, MD, PhD
    • Increasing adoption of risk calculators to assess operative risks
    • Use of regional anesthesia approaches to decrease narcotic usage
    • Impact of ERAS pathways on approaches to perioperative management

Basic Concepts of Anesthesia

Pooja Pandya, MD, George P. Yang, MD, PhD
    • Increasing adoption of risk calculators to assess operative risks
    • Use of regional anesthesia approaches to decrease narcotic usage
    • Impact of ERAS pathways on approaches to perioperative management

Antiepileptic and Antidepressant Drugs Used in the Treatment of Pain

Lucia Daiana Voiculescu, MD
    • Gabapentinoids
    • Antiepileptic and antidepressant drugs used in pain therapy: approved indications and off-label use
    • Antiepileptic drugs used as adjuvant analgesics in the perioperative period

Nutritional Management of Celiac Disease

Ciarán P Kelly, MD, Satya Kurada, MD, Mariana Urquiaga, MD
    • Glutenases: Clinical trials using glutenases versus placebo have demonstrated worsening of histologic findings in the placebo group compared with glutenases on consumption of up to 2 g of gluten.
    • Tight junction regulators: Larazotide acetate demonstrated a reduction in gluten-induced immune reactivity and symptoms when celiac subjects were exposed to a 2.7 g gluten challenge when compared with placebo in a randomized, double-blind, placebo-controlled trial.
    • IgY antibodies: Animal studies using mice fed with gastric-stabilized antigliadin IgY antibodies derived from the egg yolks of gluten-immunized chickens in addition to gluten showed a reduction in gluten absorption from the diet.

Parenteral Nutrition–Associated Liver Toxicity: Prevention, Diagnosis, and Management

Lorenzo Anez-Bustillos, MD, Meredith A. Baker, MD, Duy T. Dao, MD, Gillian L. Fell, MD, Kathleen M. Gura, PharmD, Mark Puder, MD, PhD
    • Fish oil–based lipid emulsions may be efficacious in the treatment of parenteral nutrition–associated liver disease (PNALD).
    • Lipid reduction (e.g., to 1 g/kg/day) does not decrease the incidence of PNALD but does slow its progression.
    • Patients whose cholestasis reverses with fish oil therapy or achievement of enteral autonomy may have stable rather than progressive cirrhosis and should not be transplanted based on biopsy alone.

Extent of Gastrectomy and Lymphadenectomy for Gastric Adenocarcinoma

Kevin K. Chang, MD, Sam S. Yoon, MD
    • The eighth edition of the AJCC Cancer Staging Manual now includes prognostic information for clinical TNM staging and post–neoadjuvant therapy staging.
    • A D2 lymphadenectomy is frequently recommended as the nodal dissection of choice for locally advanced gastric adenocarcinoma.
    • Laparoscopy-assisted operations are associated with improved overall morbidity and comparable lymph node yield.

Child Abuse and Nonaccidental Trauma

S Terez Malka, MD
    • Abusive injuries account for over 1% of pediatric emergency department visits.
    • Skeletal survey should now be obtained in any child under age 3 with concern for abusive injury.
    • Cardiopulmonary resuscitation does not lead to significant rib fractures or retinal hemorrhages, and these conditions should be considered highly concerning for abusive injury.

Pathologic Evaluation of Soft Tissue Sarcoma

Narasimhan P. Agaram, MBBS
    • Concepts of pathologic examination and grading
    • Important diagnostic criteria for each soft tissue sarcoma
    • Latest molecular diagnostic methods used in the diagnosis of sarcomas
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