Why Medical (and Dermatologic) Practice Has Become So Convoluted: The Complexity/Convolutional/Obfuscatory Kleptocracies.

Consider dermatology (or medical) practice from the aspect of those who manage, and seek to glean a profit from, medical management corporations, including but not limited to third party payers. Although much of the complexity burden thrust upon doctors’ offices is borne by the offices and doctors, there is also much that is borne by the companies, and the entire process appears to make no sense whatsoever. How can the business professionals who run these outfits make such blunders? Let us approach this question by examining another industry: fast food franchising

Ganglion cell complex loss in patients with type 1 diabetes: A 36-month retrospective study

BACKGROUND: To analyze changes over a 3-year period in ganglion cell complex (GCC) thickness in individuals with type 1 diabetes mellitus (T1DM) using spectral-domain optical coherence tomography (Optovue, Fremont, CA, USA). METHODS: Thirty-seven individuals from “Friends for Life Conference” with T1DM and a 3-year history of GCC thickness measurements were included in the study. Data analysis using SPSS 22 and Excel StatPlus was completed to note the subgroups that had a significant change. RESULTS: Significant decreases were noted in the following subgroups with slope in parenthesis. 1.Overall: GCC superior thickness OD (−0.48) 2.Male: GCC thickness OD (−0.86), GCC superior thickness OD (−0.735) 3.Body mass index (BMI) 25.0–29.9: GCC thickness OD (−0.48), GCC superior thickness OS (−0.915), GCC inferior thickness OD (−0.43) 4.Ages 10–20 years: GCC superior thickness OD (−0.635) 5.Duration of diabetes 10–20 years: GCC thickness OD (−1.055), GCC superior thickness OD (−0.99). CONCLUSION: GCC loss was noted in individuals who were males, those with BMIs of 25.0–29.9, and those who had diabetes for 10–20 years. Ganglion cell loss was also noted before the presence of any diabetic retinopathy, suggesting onset of neuronal loss before any vasculature changes

Global Current Practice Patterns for the Management of Central Retinal Artery Occlusion.

Global practice paradigms for central retinal artery occlusion (CRAO) were summarized. Responses were collected from specialists via survey. Management patterns for CRAO rely on physician and center-level preferences given the lack of evidence-based international guidelines