Latest Updates

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. 

Primary and Metastatic Central Nervous System Malignancies

    • The main function of corticosteroids in CNS tumors is to control brain and spinal cord vasogenic edema and decrease intracranial pressure. Corticosteroids should be used with caution because of its significant side effects, such as insomnia, hyperglycemia, myopathy, psychiatric effects, and opportunistic infections. 
    • Maximal safe resection is recommended for all glioma grades and subtypes if the tumor is surgically accessible and there are no absolute medical contraindications to surgery. Nevertheless, even a macroscopic complete resection is almost never curative because grade II to IV gliomas infiltrate the normal brain.
    • The addition of WBRT to either surgical resection or radiosurgery decreases the risk of brain metastasis recurrence but does not improve survival in patients with one to three brain metastases.

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.

Approach to the Geriatric Patient

    • 2016 EAST practice management guideline on prevention of fall-related injuries in the elderly
    • 2016 CTF on Preventive Health Care recommendations on screening for cognitive impairment in older adults
    • 2016 USPSTF recommendation statement on screening for depression in adults
    • 2015 AGS Beers criteria for potentially inappropriate medication use in older adults
    • 2016 AAO preferred practice guideline on comprehensive adult medical eye evaluation

Macrovascular Complications of Diabetes Mellitus

    Atrial Fibrillation

      • Latest available ACC/AHA guidelines and ongoing controversy around optimal heart rate targets
      • Updated classification for patients with valvular and nonvalvular AF algorithm for maintenance of sinus rhythm
      • 2019 AHA/ACC/HRS and 2020 ESC/EACTS practice guidelines delineated new and modified anticoagulation recommendations pertaining to NOACs.

    Cardiac System

      • Contemporary understanding of ventricular mechanics with identification of the structure and function of the ventricular myocardial band
      • Detailed description of the anatomic proximity of cardiac structures and how knowledge of this proximity helps prevent intraoperative complications and damage to critical cardiac structures
      • Comprehensive description of aortic root anatomy and mechanics and application of how this anatomy dictates performance of transcatheter aortic valve replacement  

    Tuberculosis

      • Updated for 2024 treatment guidelines
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