What's New | Decker

The paradigm for injectables has shifted towards a more pan-facial, integrated approach.
A combination of chemodenervation and injectable fillers should be used to avoid treatment of stigmata of aging in isolation
Botulinum toxin has shown potential benefit in wound healing and rosacea
The use of filler injections in nonsurgical rhinoplasties is an effective approach to temporary augmentation rhinoplasties
Deoxycholic acid may have other cosmetic applications including facial contouring, lipodystrophy, and reduction of lipomatous tumors
The development of new synthetic fillers can provide a wider armamentarium in facial rejuvenation.

Updated Review
Barbara Dworetzky, MD, Jong Woo Lee, MD, PhD
- Brain imaging has made significant progress in recent years and is a cornerstone of diagnosis and characterization of epilepsy.
- The diagnosis and management of psychogenic non-epileptic seizures has significantly evolved in recent years.
- Current practice is to use the drug as monotherapy. The dose is progressively increased until seizures are controlled or adverse effects develop. If seizure control cannot be achieved without significant adverse effects, the drug is considered a failure, and a second drug is chosen and the process is repeated. If the second drug fails, either a third monotherapy trial or a combination therapy can be attempted.

It is essential that the placement of the patient, the table, heat-generating devices in the operating room (OR), and drapes take into account the possibility that any malfunctioning device might become a source of ignition.... The two most important principles in maintaining a clean environment are, first, to ensure that all the procedures, antiseptics, and cleaning agents are compatible and that they are used correctly, and, second, to monitor the OR and patient outcomes regularly.... There is a small but measurable risk of hypoglycemia with intensive intravenous insulin therapy, but this risk can be mitigated with continuous or near-continuous glucometry or dynamic scale nomograms.

It is essential that the placement of the patient, the table, heat-generating devices in the operating room (OR), and drapes take into account the possibility that any malfunctioning device might become a source of ignition.... The two most important principles in maintaining a clean environment are, first, to ensure that all the procedures, antiseptics, and cleaning agents are compatible and that they are used correctly, and, second, to monitor the OR and patient outcomes regularly.... There is a small but measurable risk of hypoglycemia with intensive intravenous insulin therapy, but this risk can be mitigated with continuous or near-continuous glucometry or dynamic scale nomograms.

It is essential that the placement of the patient, the table, heat-generating devices in the operating room (OR), and drapes take into account the possibility that any malfunctioning device might become a source of ignition.... The two most important principles in maintaining a clean environment are, first, to ensure that all the procedures, antiseptics, and cleaning agents are compatible and that they are used correctly, and, second, to monitor the OR and patient outcomes regularly.... There is a small but measurable risk of hypoglycemia with intensive intravenous insulin therapy, but this risk can be mitigated with continuous or near-continuous glucometry or dynamic scale nomograms.

Sylvia Botros-Brey, MD, MSCI, K. Christopher McMains, MD, PhD, MS, Jo Shapiro, MD, FACS

The central feature of medical ethics is the primacy of the patient’s interests.
The ethical obligations of a for-profit corporation include maximizing profit and growth.
The rise of entrepreneurialism and the growing corporatization of medicine also challenge the traditions of virtue-based medical care. When these processes are allowed to dominate medicine, health care becomes a commodity.
The different obligations of business and medical ethics call the appropriateness of applying industrial models to provision of health care into question. It is no less than each of our professional duties to address these tensions where they exist.

Detailed physiology of acid-base homeostasis to provide a clearer understanding of the pathophysiology of acid-base disorders
Updated information on the treatment of metabolic acidosis, including the use of tromethamine and bicarbonate

The FDA first approved cochlear implantation in 1985, since then the criteria have expanded and now include infants as young as 9-months-old and single-sided deafness.
All cochlear implant recipients should receive vaccination against Streptococcus pneumoniae according to guidelines set forth by the Center for Disease Control (CDC).
The majority of cochlear implant surgeons utilize the round window insertion technique to minimize intracochlear trauma. Cochleostomy location and insertion technique may vary based on electrode design and patient anatomy.

Facial Plastics and Reconstructive Surgery