- 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
Latest Updates
- 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
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.
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.
Pedicled Flaps in Breast Reconstruction
- We anticipate that the implementation of breast reconstruction-specific QoL evaluations and patient-reported outcomes measures to guide flap choice and design will continue to gain popularity and validity in the coming years.
- Experience with pedicled perforator flaps such as the ICAP, SAAP, SEAP, and will continue to advance, making these flaps more reliable over time.
- Multimodal pain control regimens, including acetaminophen, neuropathic pain agents, and novel local anesthetic blocks, may allow for significantly earlier discharge after pedicled breast reconstruction.
Management and Therapeutic Issues in the Dementias
- The cholinesterase inhibitors donepezil, galantamine, and rivastigmine have been approved by the Food and Drug Administration (FDA) for the treatment of AD dementia.
- Patients with mild to moderate AD dementia are the appropriate candidates for cholinesterase inhibitor therapy. These patients need a designated caregiver to supervise the use of the medication.
- Support for and empowerment of the caregivers of dementia patients must be an integral part of management. The emotional and physical health of caregivers is critical to long-term outcomes.
- Sepsis syndromes have been redefined (Sepsis-3 definitions) by international experts, based on sepsis mortality data extracted large administrative databases.
- National focus has turned to early identification of sepsis as a key determinant of outcomes. International critical care experts have recommended using the qSOFA criteria in the Emergency Department setting to identify sepsis risk in patients prior to obtaining diagnostics.
- The Center for Medicare and Medicaid Services (CMS) has added a sepsis quality measure (SEP-1) as a reporting requirement for all US hospital tied to Medicare & Medicaid reimbursement. This measure has increased awareness of sepsis performance and focused quality efforts on improvement.
- 2018 update to bundles to simplify to 1-hour bundle.
Prevention and Diagnosis of Infection
- Microbiologic studies are critical for characterizing infections. Gram stains and cultures of wound tissue, pus, sputum, urine, and drainage effluent are generally very useful. Identification of not only the particular organism involved but also of its specific antimicrobial susceptibility has become common practice in most hospital clinical laboratories.
- Treatment of CAUTI requires removal or change of the catheter along with systemic antimicrobial therapy. The predominant microorganisms causing CAUTI in the ICU are enteric gram-negative bacilli, Candida species, enterococci, staphylococci, and Pseudomonas aeruginosa. Multidrug resistance is a significant problem in urinary pathogens
