Articles related to PRACTICE PEARLS

The $1.7 trillion spending bill signed by the president dramatically mitigates the expected cuts in Medicare payments. But any cut will still put an untenable strain on specialties like family medicine.

An important development in patient treatment occurs when indolent lymphomas develop an aggressive histology, which necessitates a shift in therapy. Although the prevalence of transformation is generally falling, it is still a very dangerous situation with a poor prognosis when compared to patients who do not have transformation. CAR-T has helped, but overall, the prognosis for patients with transformed lymphomas is still quite poor, especially if hematopoietic stem cell transplant (HSCT) or cellular therapy methods are not accessible or are ineffective. The top priority at this time should be to enroll the patient in a clinical trial.

This technique for placing an IOL without capsular support has a steep learning curve, but once mastered, it should take only 15 to 20 minutes to complete. The most difficult aspects of this technique are measuring for needle insertion sites and lacing the trailing haptic into the needle lumen. Lacing the trailing haptic is probably the most difficult intraocular maneuver. This is a difficult task, but with the right approach and equipment, unnecessary complications can be avoided.

Change is difficult, and it usually necessitates effort, struggle, and the challenge of those who are dragging their feet around us. Annual reflection is a good way to stay current, push the boundaries, and provide better patient care. Try these tips to help your practice thrive, whether you have a long-standing specialty contact lens practice or are looking to expand into more specialty areas.

Biomarkers may be used in the dementias to distinguish different aspects of the underlying pathology, detect presymptomatic pathological changes, predict decline or conversion between clinical disease states, and/or monitor disease progression and response to treatment. In this review, the authors discuss the currently available biomarkers, with a particular focus on the three most common neurodegenerative dementias: Alzheimer’s disease (AD), frontotemporal dementia (FTD), and dementia with Lewy bodies (DLB).

How do you decide between different atypicals for a patient who’s never been on an atypical before? What about carbamazepine and oxcarbazepine for bipolar disorder? Gregory Mattingly, MD, provides practical guidance on these questions posed at the Psych Congress Regional meeting.