Latest Updates

Gastrointestinal Tract and Abdomen: Anal Neoplasms, Presacral Tumors, and Rare Malignancies

David E. Beck, MD, FACS, FASCRS
    • Chemoradiation therapy for epidermoid carcinoma of the anal canal
    • CT or MRI for preoperative evaluation of presacral tumors
    • Distal presacral tumors (below S3) can be removed with a perineal approach, whereas proximal lesions are managed with an abdominal approach

Anal Neoplasms, Presacral Tumors, and Rare Malignancies

David E. Beck, MD, FACS, FASCRS
    • Chemoradiation therapy for epidermoid carcinoma of the anal canal
    • CT or MRI for preoperative evaluation of presacral tumors
    • Distal presacral tumors (below S3) can be removed with a perineal approach, whereas proximal lesions are managed with an abdominal approach

Type II Diabetes Mellitus

Saul Genuth, MD, FACP, Matthew C. Riddle, MD
    • Cardiovascular and longterm microvascular complications are significantly associated with chronic hyperglycemia of diabetes
    • An A1C of 6.0% to 6.4%, impaired glucose tolerance or impaired fasting glucose all refer to prediabetes
    • Updated with new ADA 2021 guidelines

Type II Diabetes Mellitus

Saul Genuth, MD, FACP, Matthew C. Riddle, MD
    • Cardiovascular and longterm microvascular complications are significantly associated with chronic hyperglycemia of diabetes
    • An A1C of 6.0% to 6.4%, impaired glucose tolerance or impaired fasting glucose all refer to prediabetes
    • Updated with new ADA 2021 guidelines

Cervical Radiculopathy

Robert B Bolash, MD, Pavan Tankha, DO
    • Physical exam maneuvers have demonstrated high specificity and low sensitivity for cervical radiculopathy
    • CT myelography may offer better sensitivity for foraminal and bony abnormalities as compared to MRI
    • Cervical epidural steroid injections may result in the resolution of symptoms in 40-75% of patients
    • Failure to respond to conservative and interventional approaches in three months warrants a surgical consult

Physicians' Role in Curbing the Worst Drug Crisis in America: Prescription Opioid Abuse

Sairam Atluri, MD, FIPP, Gururau Sudarshan, MD, FRCA
    • Use of screening tools to stratify patients into different risk categories of opioid misuse to accomplish appropriate opioid prescribing
    • Emphasis on monitoring techniques to assess compliance of patients on opioids
    • Importance of opioid dose limitations in curbing opioid abuse

Role of Cannabis in Anxiety Disorders

    • Cannabis as a whole, and its spectrum of biochemicals, elicit variable response in both anxiogenesis and anxiolysis, dependent on the proportions of phytocannabinoids
    • CBD provides anxiolysis in most situations, while THC is generally accepted to produce anxiety mechanisms of cannabinoid action on anxiety pathways are complex and involve overlapping interplay of neurochemical pathways
    •  Additional studies are required to elucidate the effects of specific agents versus whole plant extract as well as administration routes in controlled environments

Viral Hepatitis A

Brittany L Kmush, PhD, Kenrad E Nelson, MD
    • Several safe and effective vaccines exist to prevent hepatitis A infections.
    • Significant morbidity continues to occur in the United States among international travelers, injection drug users, and persons with underlying liver disease.
    • In developing countries, the epidemiologic transition has increased the prevalence of clinically severe hepatitis A infections.
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