Geriatrics

Baruch Kuppermann, MD, PhD, and colleagues looked at gene expression modifications in retinal Müller cells treated with anti-VEGFs at the 34th Annual Scientific Meeting of the American Society of Retina Specialists (ASRS 2016) in San Francisco, California.

David Eichenbaum, MD, an ophthalmologist from Florida, presented data from the HARBOR study at the 34th Annual Scientific Meeting of the American Society of Retina Specialists (ASRS 2016) in San Francisco, California.

The rate of endophthalmitis after more than 90,000 intravitreal injections was found to be approximately 1 in 3000 in a retrospective study of a consecutive series of cases at a multicenter, retina-only practice. Prophylactic use of topical antibiotics was not found to decrease this rate.

Although intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents has become the therapeutic mainstay for diabetic macular edema and neovascular age-related macular degeneration, it poses a risk of noninfectious uveitis or infectious endopthalmitis.

A retrospective chart review study showed that the location of subfoveal fibrovascular scarring in relation to the retinal pigment epithelium correlated with visual outcome in eyes successfully treated with anti-vascular endothelial growth factor agents for neovascular age-related macular degeneration.

Regular users of oral bisphosphonates had a higher risk of developing wet age-related macular degeneration than non-users, according to results of a recent Canadian study, and the longer the use, the greater the increased risk.

Boosting the potency of broccoli-related compound indole-3-carbinol (I3C) ten-fold, proved to be a viable treatment for age-related macular degeneration (AMD).

Patients with neovascular age-related macular degeneration have shown a suboptimal response to ranibizumab over time. Several studies have established that switching from ranibizumab to aflibercept enhanced visual acuity and resulted in anatomic improvement in many of these patients, but the factors determining visual outcomes remained unclear.

Most patients are well-meaning and generally nice. But every now and then, you will get one who is a total pain to deal with. Maybe your patient lies to you, gets sarcastic, asks for special “favors,†or generally just pushes your buttons. We’ve all been there.

It is frustrating, to say the least, when your patients take their frustrations out on you. And, as if having to deal with an angry patient isn’t bad enough, providers now have to worry about the threat of legal action more than ever before.

Whether delivered intentionally or not, some physician comments are unhelpful at best and low-blows at worst. Saying certain things to patients can actually increase your risk of having a malpractice suit filed against you, making it especially important for you to always be mindful when speaking with patients.

Study results show that patients with diabetic macular edema are more likely to improve with treatment by a combination of ranibizumab and AKB-9778, as compared to treatment with either alone.

Five years of treatment with anti-VEGF (anti-vascular endothelial growth factor) drugs seems to hold considerable promise for those with neovascular age-related macular degeneration.

How often do tracheal injuries following intubation occur during surgery?

A patch that uses patients’ own stem cells to protect them from vision loss will soon begin phase 1 trials.

Results from the ATLAS study show that patients with wet AMD treated with Eylea experienced visual and anatomic improvements after 1 year that were sustained after 2 years.

Phase 2a trial of novel topical anti-angiogenic agent regorafenib shows lack of efficacy in neovascular age-related macular degeneration.

Study results show that transplanted human retinal stem cells rescue photoreceptors in rabbit retinas for 8 months.

Recent research has discovered evidence potentially supporting a parent-of-origin effect in psoriatic disease.

The Canadian Medical Association Journal (CMAJ) recently released a new guideline to help Canadian nurses, pharmacists, and physicians treat their adult and pediatric patients with acne.

Mark Twain said, "When I was a boy of 14, my father was so ignorant I could hardly stand to have the old man around. But when I got to be 21, I was astonished at how much the old man had learned in 7 years."

Do primary care physicians who are not geriatricians under-treat chronic pain in older patients due to lack of education, concerns over adverse effects, and other barriers to the use of opioids?

The recently released Institute of Medicine report Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research touched on several key issues in pain management in the geriatric population.

According to a recent systematic review, limited evidence exists to guide clinicians on the best approaches for managing pain in older (> 50 years of age) patients who have suffered a hip fracture. The strongest evidence supports nerve blockade to improve acute pain and to reduce risk for delirium. Data also suggest that preoperative traction does not improve relief from acute pain.

Presented at the 6th Annual Dartmouth Conference on Advances in Heart Failure at the Dartmouth Hitchcock Medical Center, Lebanon, N.H.

New research indicates that older patients with late-stage advanced macular degeneration are at increased risk of bleeding stroke.