• Enhanced understanding of ALECT2 amyloidosis
• Best practice for typing of amyloidosis
• Evidence for distinguising among diseases with organized deposits

• The nomenclature of disk herniation has evolved over the years; the current terminology is disk herniation, not disk rupture.
• The pathophysiology of lumbar disk-related pain or radiculopathy, although not well understood, has expanded and includes inflammation and ischemia of the spinal nerves, apart from compression.
• Radiographic assessment of disk abnormalities has progressed substantially, with a clear picture of various levels of disk herniation and nerve root abnormalities.
• Multiple advances have been made in managing lumbar disk herniation with conservative management, including interventional techniques, minimally invasive and endoscopic surgical decompression, and, finally, open decompression.
• With increasing levels of multiple interventions, various complications have been reported with all modalities, including surgical interventions, leading to post lumbar surgery syndrome and lifelong management in a significant proportion of patients.

• Antibiotic prophylaxis for all open extremity fractures is recommended.
• Washout and debridement of all open fractures within 24 hours of admission is recommended.
• Multidetector computed tomographic angiogram (MDCTA) has high sensitivity and specificity for identifying arterial injury in patients with soft signs of vascular injury due to blunt or penetrating extremity trauma
• Early tourniquet use can be life-saving when used to control active hemorrhage from severe extremity trauma and is associated with a low rate of complications
• If not immediately life threatening, the mangled extremity is best managed with a multi-disciplinary team approach.

• As patients with cystic fibrosis (CF) are living longer, gastrointestinal issues are becoming more evident.
• The CFTR genotype determines the CFTR phenotype.
• One episode of distal intestinal obstruction syndrome (DIOS) increases the risk of a future episode.
• In differentiating DIOS from constipation in CF, it is important to use an abdominal x-ray.
• CFTR potentiator and corrector medications may be helpful for nutritional outcomes in CF patients.

• Bariatric surgery is the most effective therapy for obesity and associated metabolic diseases
• 200,000 bariatric procedures are performed annually in the US with an overall low complication rate  
• Laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass are the most commonly performed procedures and each have unique complication profiles

• CT diagnosis of cholecystitis is not first line.
• Percutaneous cholecystostomy may be definitive treatment for acalculous cholecystitis.
• Point of care US is not suitable in ICU 
• Low-pressure pneumoperitoneum is safe for high-risk patients

Acute appendicitis remains a therapeutic challenge during active pregnancy. Both laparascopic and open approaches can be considered; the techniques remain largely the same, with a few caveats. Fetal monitoring may be performed using a transvaginal or left lateral abdominal wall approach. For open appendectomy, ultrasonography and magnetic resonance imaging may provide direction for the incision. Laparascopic appendectomies should be approached with a open trocar placement in the midline, with direct visualization. Late-term pregnancies may require alternative approaches in the subcostal region, and the patient may be rolled with their left side down to facilitate exposure of the appendix and relieve pressure on the inferior vena cava.

• Diagnostic technology is evolving for yeast infections, advancing to include nucleic acid testing and nanotechnology, although this may not be available at all centers.
• There are three general classes of antifungal agents, and the specific class used for an individual infection differs depending on the need to treat is superficial or invasive infection.
• The epidemiology of species responsible for an individual infection may depend on previous exposure and treatment to various antifungal agents.