What's New | Decker

There is a shift to change the definition of massive transfusion to focus on units per time as opposed to total units administered.
While laparotomy is still considered the gold standard treatment for gunshot wounds to the abdomen, selective NOM of penetrating abdominal wounds is possible. NOM can only be performed in centers that have the staffing and resources to perform serial examinations and the ability to take the patient to the OR at any time should they decompensate.
Resuscitation of the trauma patient, like much of critical care, is a sophisticated art of balancing the needs of competing organ systems in a patient with multiple injuries. Resuscitation of the trauma patient focuses on prevention of the lethal triad of trauma and secondary injury. The term refers to a triad of acidosis, coagulopathy, and hypothermia resulting from injury and blood loss.

Catatonia was considered a subtype of schizophrenia in DSM-I through DSM-III-R.
Catatonia is listed as a specifier in DSM-5 and ICD-10.
Most persons with catatonia have a mood disorder, most commonly bipolar disorder.
There is no known cause, but the condition is probably mediated by GABAergic neurotransmission.
Catatonia is effectively treated with benzodiazepines and/or electroconvulsive therapy.

An interesting advance in the treatment of advanced basal cell carcinoma is the use of inhibitors of the sonic hedgehog pathway. The vast majority of basal cell carcinomas harbor genetic mutations in the hedgehog signaling pathway, which results in constitutive activation and basal cell proliferation.
SLNB is generally not recommended unless the lesion is between 0.75 and 1.0 mm, high risk based on histologic features (e.g., ulcerated or with > 1 mitoses/mm2), or inadequately staged (e.g., positive deep margin).
An important variable in the prognosis of melanoma is the thickness of the primary tumor as assessed using the Breslow system. Tumor thickness in the Breslow system is measured from the epidermal surface to the deepest point of the tumor with a calibrated ocular micrometer.

There is a shift to change the definition of massive transfusion to focus on units per time as opposed to total units administered.
While laparotomy is still considered the gold standard treatment for gunshot wounds to the abdomen, selective NOM of penetrating abdominal wounds is possible. NOM can only be performed in centers that have the staffing and resources to perform serial examinations and the ability to take the patient to the OR at any time should they decompensate.
Resuscitation of the trauma patient, like much of critical care, is a sophisticated art of balancing the needs of competing organ systems in a patient with multiple injuries. Resuscitation of the trauma patient focuses on prevention of the lethal triad of trauma and secondary injury. The term refers to a triad of acidosis, coagulopathy, and hypothermia resulting from injury and blood loss.

Imaging modalities in the assessment of NAFLD
Controlled attenuation parameter as a point of care measure for hepatic steatosis
Proton density fat fraction as MRI based measure for hepatic steatosis
Liver stiffness measurement on elastography as a correlate of hepatic fibrosis or cirrhosis
Active clinical trials in phase 2b and 3, yet no FDA approved therapy
Intense lifestyle changes with 5-10% weight loss can improve fibrosis and steatosis

An interesting advance in the treatment of advanced basal cell carcinoma is the use of inhibitors of the sonic hedgehog pathway. The vast majority of basal cell carcinomas harbor genetic mutations in the hedgehog signaling pathway, which results in constitutive activation and basal cell proliferation.
SLNB is generally not recommended unless the lesion is between 0.75 and 1.0 mm, high risk based on histologic features (e.g., ulcerated or with > 1 mitoses/mm2), or inadequately staged (e.g., positive deep margin).
An important variable in the prognosis of melanoma is the thickness of the primary tumor as assessed using the Breslow system. Tumor thickness in the Breslow system is measured from the epidermal surface to the deepest point of the tumor with a calibrated ocular micrometer.

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%

Trauma and Thermal Injury