What's New | Decker

For patients undergoing surgical procedures requiring the implantation of foreign bodies, colonization with MRSA should be assessed. Hospitalized hemodialysis patients and their health care workers are frequently colonized.
Updated CDC diagnostic criteria for surgical site infection, catheter-associated urinary tract infection, central line–associated bloodstream infection, and ventilator-associated pneumonia
Although no single surveillance system captures all HAIs that occur within US acute care hospitals, recent Centers for Disease Control and Prevention (CDC) estimates suggest that 648,000 patients experienced at least one HAI during their hospital stay in 2011. This represents 4.0% of the hospitalized population. Among surgical patients, the rate of reported HAIs is even higher at 10.6%

2020 ATS and 2019 CTS practice guidelines delineating pharmacologic management of COPD.
Introduced the new Global Initiative for Chronic Obstructive Lung Disease (GOLD) Combined COPD Assessment using symptoms of breathlessness, spirometric classification, and risk of exacerbation to evaluate patients with chronic obstructive pulmonary disease (COPD) and guide treatment
Epidemiology section updated to reflect new data suggesting a decline in the age-adjusted prevalence of COPD, likely as a result of decreased smoking rates
Multiple new common genetic risk factors associated with COPD described, including a recently discovered functional genetic variant
Discussion about the long-term care of patients with COPD extensively revised to include the most recent trials assessing indications for long-acting inhaled bronchodilators and inhaled corticosteroids, among other therapies
Recent evidence supporting lung cancer screening in patients with COPD reviewed

In an attempt to minimize postoperative discomfort while maintaining the benefits of saphenous vein ablation, RF alternating current has been employed to effect rapid thermic electrocoagulation of the vein wall and its valves.
Ligation of the GSV at the saphenofemoral junction has been widely practiced in the belief that it would control gravitational reflux while preserving the vein for subsequent arterial bypass.
Over the years, surgical treatises have devoted a great deal of space to clinical examination of the patient with varicose veins. Numerous clinical tests have been described, many of which carry the names of famous persons interested in venous pathophysiology.

The contribution of genetics to Parkinson disease (PD) is suggested by the increased risk of disease associated with a family history, and community-based studies that found a 1.5- to threefold increased risk of PD in persons with an affected first-degree relative. However, the most convincing evidence to date has come with the discovery of monogenic forms of PD. Highly penetrant mendelian forms of PD have now been associated with mutations in different genes but, in most populations, causative mutations in these genes have been found in fewer than 5% of patients. Nevertheless, different variants with incomplete penetrance in the LRRK2 and the GBA gene are strong risk factors for PD, and are especially prevalent in some populations. Mutations of the GBA gene are indeed the most important risk factor yet discovered for PD; the presence of a GBA mutation in homozygous or heterozygous form is associated with an approximately 20-fold increase in the risk for PD.

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.

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.

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.

Cultural sensitivity and openness is more important than cultural ‘competence’ when treating migrants from diverse backgrounds
Guidelines are available for effective and appropriate use of qualified medical interpreters
Mental health screening is not only to assess effects of prior trauma but to determine challenges in acculturation
There is increasing recognition of the need for preventive counseling and chronic care in migrant women

Scientific Foundations