- Additional imaging and electrophysiologic studies prove helpful. Optical coherence tomography (OCT) provides high-resolution cross-sectional images of the retina that aid in distinguishing retinal pathology from optic neuropathy.
- When uncertainty prevails regarding the differentiation of anomalous optic disk elevation from papilledema, additional diagnostic tests can be helpful. Fluorescein angiography will demonstrate dye leakage at the optic nerve head in papilledema.
- MRI is essential to establish the cause of most visual field deficits. Although careful visual fields may suggest a specific localization, in many cases, imaging serves to establish whether the responsible lesion is vascular, neoplastic, or inflammatory.
Latest Updates
Neurology of Rheumatic Diseases
- Patients with lupus are more vulnerable than their peers to ischemic or hemorrhagic stroke. Among 1,249 lupus patients who were followed for up to 8 years, there were 36 strokes or TIAs, usually associated with active lupus.
- About 10% of patients with lupus have a seizure sometime during the course of their illness. The seizures are varied: single or recurrent, partial or generalized. The seizures are more likely in patients with anti-Smith or antiphospholipid antibodies and less likely in patients receiving chronic hydroxychloroquine therapy and can be associated with other cerebral abnormalities, such as focal brain lesions, strokes, or psychosis.
- Lumbar imaging is not indicated for initial management of most cases of low back or lumbar radiculopathy. Red flags that tag patients as more likely to need imaging are trauma, fever or other indication of infection, known malignancy that tends to metastasize to bone or epidural space, immunosuppression, significant leg weakness, or sphincter dysfunction. Lumbar MRI and CT, sometimes complemented by CT myelography, are the best modalities for delineating mechanisms of root compression, which can vary, including disk herniation, lateral recess stenosis, or foraminal stenosis.
Advance Directives, Do Not Resuscitate Orders, and Power of Attorney for Health Care
- Advance directives such as a living will, a do not resuscitate order, and a designation of a power of attorney for health care are legally binding mechanisms to preserve patient autonomy when patients have lost decision-making capacity. Although these directives are frequently used to make decisions regarding life-supporting therapy, surgeons may also need to refer to these documents or to patients’ surrogates for surgical decision making to treat patients in accordance with their autonomous wishes. There is some information to suggest that surgeons value the utility of an advance directive as it can serve as a guide to patients’ preferences in the postoperative setting when life-supporting therapy has become ineffective or patient survival is unlikely.
- The Physician Orders for Life-Sustaining Treatment (POLST) program was designed in Oregon in the 1990s to address the lack of advance directives in frail patients and those with chronic diseases. Although POLST is different from advance directives, both aim to address end-of-life care.
- When patients do not have decision-making capacity, physicians are obliged to find someone who can make decisions for the patient. If the patient has previously designated a durable POAHC agent, this agent is the first person health care providers should turn to for decision making.
Advance Directives, Do Not Resuscitate Orders, and Power of Attorney for Health Care
- Advance directives such as a living will, a do not resuscitate order, and a designation of a power of attorney for health care are legally binding mechanisms to preserve patient autonomy when patients have lost decision-making capacity. Although these directives are frequently used to make decisions regarding life-supporting therapy, surgeons may also need to refer to these documents or to patients’ surrogates for surgical decision making to treat patients in accordance with their autonomous wishes. There is some information to suggest that surgeons value the utility of an advance directive as it can serve as a guide to patients’ preferences in the postoperative setting when life-supporting therapy has become ineffective or patient survival is unlikely.
- The Physician Orders for Life-Sustaining Treatment (POLST) program was designed in Oregon in the 1990s to address the lack of advance directives in frail patients and those with chronic diseases. Although POLST is different from advance directives, both aim to address end-of-life care.
- When patients do not have decision-making capacity, physicians are obliged to find someone who can make decisions for the patient. If the patient has previously designated a durable POAHC agent, this agent is the first person health care providers should turn to for decision making.
Advance Directives, Do Not Resuscitate Orders, and Power of Attorney for Health Care
- Advance directives such as a living will, a do not resuscitate order, and a designation of a power of attorney for health care are legally binding mechanisms to preserve patient autonomy when patients have lost decision-making capacity. Although these directives are frequently used to make decisions regarding life-supporting therapy, surgeons may also need to refer to these documents or to patients’ surrogates for surgical decision making to treat patients in accordance with their autonomous wishes. There is some information to suggest that surgeons value the utility of an advance directive as it can serve as a guide to patients’ preferences in the postoperative setting when life-supporting therapy has become ineffective or patient survival is unlikely.
- The Physician Orders for Life-Sustaining Treatment (POLST) program was designed in Oregon in the 1990s to address the lack of advance directives in frail patients and those with chronic diseases. Although POLST is different from advance directives, both aim to address end-of-life care.
- When patients do not have decision-making capacity, physicians are obliged to find someone who can make decisions for the patient. If the patient has previously designated a durable POAHC agent, this agent is the first person health care providers should turn to for decision making.
Advance Directives, Do Not Resuscitate Orders, and Power of Attorney for Health Care
- Advance directives such as a living will, a do not resuscitate order, and a designation of a power of attorney for health care are legally binding mechanisms to preserve patient autonomy when patients have lost decision-making capacity. Although these directives are frequently used to make decisions regarding life-supporting therapy, surgeons may also need to refer to these documents or to patients’ surrogates for surgical decision making to treat patients in accordance with their autonomous wishes. There is some information to suggest that surgeons value the utility of an advance directive as it can serve as a guide to patients’ preferences in the postoperative setting when life-supporting therapy has become ineffective or patient survival is unlikely.
- The Physician Orders for Life-Sustaining Treatment (POLST) program was designed in Oregon in the 1990s to address the lack of advance directives in frail patients and those with chronic diseases. Although POLST is different from advance directives, both aim to address end-of-life care.
- When patients do not have decision-making capacity, physicians are obliged to find someone who can make decisions for the patient. If the patient has previously designated a durable POAHC agent, this agent is the first person health care providers should turn to for decision making.
Diagnosis and Treatment of States of Shock
New explanation for the pathogenesis of shock on the microvascular level, with detailed explanation of lethal corner and cellular death in different states of shock
The difference between systolic, diastolic, and mean blood pressure and their contribution to states of shock
Different vasopressors and their role in different types of shock
Advance Directives, Do Not Resuscitate Orders, and Power of Attorney for Health Care
- Advance directives such as a living will, a do not resuscitate order, and a designation of a power of attorney for health care are legally binding mechanisms to preserve patient autonomy when patients have lost decision-making capacity. Although these directives are frequently used to make decisions regarding life-supporting therapy, surgeons may also need to refer to these documents or to patients’ surrogates for surgical decision making to treat patients in accordance with their autonomous wishes. There is some information to suggest that surgeons value the utility of an advance directive as it can serve as a guide to patients’ preferences in the postoperative setting when life-supporting therapy has become ineffective or patient survival is unlikely.
- The Physician Orders for Life-Sustaining Treatment (POLST) program was designed in Oregon in the 1990s to address the lack of advance directives in frail patients and those with chronic diseases. Although POLST is different from advance directives, both aim to address end-of-life care.
- When patients do not have decision-making capacity, physicians are obliged to find someone who can make decisions for the patient. If the patient has previously designated a durable POAHC agent, this agent is the first person health care providers should turn to for decision making.
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