What's New | Decker

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.

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

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 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.

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

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

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

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

Trauma