Latest Updates

Evaluation of Infertility

    • Zika virus:  Delayconception if potential exposure:  8 weeks: females or 3 months: males
    • Subclinical hypothyroid: Treatment is associated with improved pregnancy outcomes when TSH levels are above 4 mIU/L.
    • Tubal patency: Hysterosalpingo-contrast sonography was recently introduced as an additional screening method to assess tubal patency.

Initial Management of Life-Threatening Trauma

    • 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.

Bipolar Disorders and Their Clinical Management, Part I: Epidemiology, Etiology, Genetics, and Neurobiology

    • Review of emerging genetics and etiologic theories of bipolar disorders
    • Correlation between recent neurobiologic findings and clinical manifestations of bipolar disorders
    • Discussion of the role of endocrine and immune alterations in metabolic derangements associated with bipolar disorders

Bipolar Disorders and Their Clinical Management, Part I: Epidemiology, Etiology, Genetics, and Neurobiology

    • Review of emerging genetics and etiologic theories of bipolar disorders
    • Correlation between recent neurobiologic findings and clinical manifestations of bipolar disorders
    • Discussion of the role of endocrine and immune alterations in metabolic derangements associated with bipolar disorders

Initial Management of Life-Threatening Trauma

    • 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.

CSF leak and encephalocele

    • The proportion of spontaneous CSF leaks is increasing and appears to be related to increasing prevalence of obesity and obstructive sleep apnea
    • Resolution of obesity and obstructive sleep apnea may prevent CSF leak recurrence, development of a leak at another site, or even allow a CSF leak to heal without surgery
    • Intracranial hypertension is now being recognized as a cause for other otologic and non-otologic symptoms such as headaches and pulsatile tinnitus

Initial Management of Life-Threatening Trauma

    • 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.

Pathophysiology of Alzheimer Disease

    • Amyloid positron emission tomography (PET) has greatly expanded our knowledge of Alzheimer disease (AD), from its preclinical to its clinical manifestations.
    • Tau PET has become available as a research tool and is providing new insights into the evolution of AD.
    • A conceptual scheme that classifies the imaging and cerebrospinal fluid biomarkers of AD into amyloid, tau, and neurodegeneration has been adopted.
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