What's New | Decker

Antihistamines to block the binding of histamine at target sites, aspirin and NSAIDs to block the synthesis of prostaglandin D2, and leukotriene antagonists blocking it’s downstream effects
Allergen immunotherapy to induce long-lasting clinical tolerance in sensitized patients in an antigen-specific approach
Monoclonal antibodies against IL-5 (mepolizumab, reslizumab), and IL-5 receptor (benralizumab) for treatment of hypereosinphilia and proposed for allergy diseases

Use of molecular testing of non-diagnostic thyroid nodule FNAs to increase the ability to obtain a diagnosis, decrease the need for repeated biopsies, and improve patient care
Refining the indications for total or complete thyroidectomy
Decreasing the use of radioactive iodine ablation based on risk stratification
Indications for lymphadenectomy approach in selected patients
Improving molecular targeted agents for iodine-refractory metastatic disease with improvements shown in progression free survival
Targeted therapy for recurrent, unresectable, iodine-refractory lesions

Orchiopexy without transparenchymal suturing is a new surgical approach for the treatment of acute testicular torsion.
There is a recent focus on the role of ischemia-reperfusion injury in acute testicular torsion and medications that may help prevent damage caused by ischemia-reperfusion injury.
Fasciotomy with tunica vaginalis flap is a new surgical technique aimed at preventing damage from ischemia reperfusion injury.
There is a new focus on immediate reconstruction with testicular prosthetic at the time of orchiectomy for testicular torsion.

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.

Novel treatment modalities include Negative Pressure Wound Therapy, bioengineered skin substitutes and placental derived constructs
Advances in microsurgical techniques including perforator flaps and understanding angiosomes
Improvements in management of vascular disease including advances in diagnostic methods and new non-invasive stenting techniques

Lance Griffin, MD, Cathline Layba, MD

Sarah Culbreth, PharmD, BCPS, Jessica Rimsans, PharmD, BCPS, Dirk Varelmann, MD

As the direct acting oral anticoagulants (DOACs) have short half-lives, they are able to be continued throughout low bleeding risk procedures, or for high bleeding risk procedures, they may be held 1 to 4 days depending on renal function.
Idarucizumab (Praxbind) is a new FDA-approved targeted reversal agent to reverse the effects of dabigatran (Pradaxa) in those with life-threatening bleeding or requiring urgent or emergent surgery.
Andexanet alfa is a modified decoy protein newly FDA approved for reversal of apixaban and rivaroxaban, based on results of the ANNEXA-4 trial.

Minimally invasive management strategies exist for treatment of gynecomastia
Various management strategies exist for treatment of Poland syndrome
Minimally invasive technologies exist for treatment of congenital breast anomaly reconstruction

Allergy