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Parkinson’s Disease Motor Subtypes: Classification, Pathophysiology, Manifestations, and Tailored Treatment Strategies
No full textParkinson\u27s disease is a complicated neurodegenerative condition with distinct motor subtypes that require tailored management approaches. While levodopa remains the cornerstone of therapy, response rates and disease progression vary significantly among patients, particularly between tremor-dominant Parkinson\u27s disease (TD-PD) and postural instability/gait difficulty (PIGD) subtypes. Clinicians often struggle to distinguish these motor subtypes and apply evidence-based, subtype-specific management strategies. This reviews the latest research on the pathophysiology, clinical presentation, and treatment of PD motor subtypes, providing clinicians with practical guidance on optimizing pharmacologic and non-pharmacologic interventions to individualize treatment plans. Improved recognition and management of PD motor subtypes will ultimately lead to better patient outcomes, reducing fall risk, medication-related complications, and functional decline
Risk stratification strategies in patient selection for the prevention of bisphosphonate-related osteonecrosis of the jaw
No full textMRONJ (medication-related osteonecrosis of thejaw) is a condition that results in bone deathwithin the jaw, most commonly the mandible inpatients who are or have taken bisphosphonate orother antiresorptive drugs. There is a need to beequipped to educate patients on the topic ofbisphosphonates and the side effects, includingMRONJ, within numerous medical specialtiesincluding family medicine/general practice,gynecology/women’s health, oncology,rheumatology, orthopedics, and more. With oldermean populations, providers can expect to see anincrease in patients who are both on and askingabout the medication class. With numerousarticles resulting from research on the class and itsside effects, patients have been coming in withconcerns and weariness over the drugs partially atthe direction of other healthcare providers.Bisphosphonates have been prescribed to preventpathologic fractures resulting from bone pathologysuch as osteoporosis or metastatic bone lesions.There have been rising concerns amongstproviders and patients surrounding this potentialside effect. This article aims to clarify the trueprevalence of MRONJ and offers risks to stratifywhile appropriately selecting patients for the useof the medication. With a greater understanding ofwho is a poor candidate for bisphosphonatetherapy, there is greater prescription confidenceand medical advising to be had in a lower risk ofMRONJ in a patient that has been risk stratified
The Importance of Early Diagnosis & Treatment of HS in Attempt to Prevent Disease Progression
Full text linkHidradenitis Suppurativa (HS) is a chronic, inflammatory skin condition marked by painful nodules, abscesses, and scarring in intertriginous areas. Its physical and psychosocial impacts are significant, yet delayed diagnosis and suboptimal treatment remain common due to its complex, not fully understood pathogenesis. As HS progresses through Hurley stages I–III, it becomes increasingly resistant to treatment and poses higher risks of serious complications such as infection, sepsis, and malignant transformation. This presentation emphasizes the critical role of early recognition and appropriate, stage-based management to improve patient outcomes and quality of life. Drawing on current evidence-based guidelines, it explores the multifactorial etiology of HS—including autoinflammatory, hormonal, and microbial components—and outlines treatment options ranging from topical agents to systemic therapies and biologics. The talk also addresses the gaps in provider knowledge, the need for multidisciplinary care, and the urgent demand for continued research. Ultimately, the goal is to equip clinicians with the awareness and tools necessary to intervene early and prevent irreversible disease progression in HS patients
Diagnosing and Treating Secondary Attention-Deficit/Hyperactivity Disorder in Children and Adolescents Following Traumatic Brain Injury
No full textAccording to the CDC, traumatic brain injury (TBI) is a leading cause of death and disability in children and adolescents in the United States. Effects of these injuries can be short term or long term, causing children and adolescents to be at an increased risk of developing psychiatric disorders. Of these disorders, attention deficit/hyperactivity disorder is the most common. Secondary ADHD, or SADHD, can severely impact a person’s quality of life if not diagnosed or treated. Therefore, it’s critical that providers understand that SADHD could be a long-term sequelae when caring for patients post-brain injury
Addressing Cardiovascular Risk in Prediabetes
No full textWhile many providers are well aware of the harmful effects of diabetes on cardiovascular health, there is less acknowledgement of the damage that accumulates during the prediabetic stage. Studies show that patients with prediabetes have a higher plaque burden in the coronary arteries and a greater risk of all-cause mortality than those with normoglycemic levels. It is crucial for providers to recognize the dangers of prediabetes and address it promptly when identified to reduce the risk of cardiovascular damage. Additionally, providers should emphasize to patients that the term prediabetes does not exclude them from the well-documented harmful health effects of Type II Diabetes Mellitus. There are multiple ways to manage prediabetes, including both lifestyle modifications and pharmacologic therapies. Therefore, providers must be aware of these options and equipped to make tailored decisions that best meet their patients\u27 needs
Screening to surgery: A guide to the management of invasive breast cancer
No full textInvasive breast cancer is one of the most common malignancies world-wide, and frequently, diagnosis starts the pathway to surgical intervention. When planning breast surgeries, the progression of invasive breast cancer is one of the most influential factors for breast-conserving therapy versus mastectomy. As such, it is crucial that appropriate screening is performed to identify potentially malignant lesions. Such screening studies are often ordered by primary care providers, and patients should be well-informed regarding their risk factors, the indications for screening, and the results of their screening imaging prior to their first appointment with a breast surgeon. Furthermore, if invasive breast cancer is diagnosed and a patient proceeds to surgical intervention, a provider should be able to adjust their clinical assessment to identify critical symptoms or exam findings at any point in the surgical pathway. This article provides a holistic guide into the surgical pathway that a patient may follow for management of invasive breast cancer to allow for sufficient patient education and appropriate care from all providers
The efficacy and ramifications of elective prophylactic infant male circumcision
No full textElective infant male circumcision requires parents to commit their child to a lifelong decision without that child’s consent. Healthcare providers should be educated on the social pressures parents face in their religious and community sectors to better understand the process ahead for their patients. Additionally, provider education on circumcision practices allows for conversations focused on risk mitigation regarding ritual practices, surgical practices, and age of circumcision. Additionally, The decision to circumcise comes with medical risk, but overall has research supporting long term medical benefit and disease prevention from the absence of the prepuce. Furthermore, research supports stigma rather than the presence or absence of the prepuce correlate to both sexual and psychological satisfaction for the patient. In the absence of this, satisfaction with circumcision status was similar among both circumcised and uncircumcised patients. Overall, the role of the healthcare provider is navigating the conversation with research supported evidence to provide informed care without perpetrating stigma
Functional recovery of a patient in her home environment following a stroke using Proprioceptive Neuromuscular Facilitation and Task-specific Training: A Case Report
Full text linkAbstract Background and Purpose: Stroke is a growingly common disability that affects an individual’s bodily function, activity and participation levels and thus impacts the whole livelihood of that individual. Proprioceptive Neuromuscular Facilitation (PNF) and Task-specific Training have been shown to improve the overall functional recovery of a patient and affect neuroplasticity. Most studies tend to compare the individual effect of these techniques; hence the purpose of this case report is to describe how both PNF and task-specific training are used to improve the functional recovery of a patient in her home environment following an acute stroke. Case Description: The patient was a 75-year-old female with a known history of uncontrolled hypertension, who presented for home health physical therapy evaluation approximately one week post diagnosis of Left Ischemic Stroke with Right Hemiparesis after having been misdiagnosed previously for hypertensive crisis. The patient received 12 weeks of physiotherapy comprising of PNF and task-specific training to assist with hand function, self-care, mobility and transfers and ambulation. Outcome: The patient and family member’s goals were achieved, as patient was able to independently complete self-care and ambulate with the use of a quad cane safely within her home environment with some amount of compensation, especially for the upper extremity. Modified Barthel Index Scores improved from 20% to 85 %, with improvement also in the patient’s Chedoke Assessment. Discussion: This case report shows how two techniques commonly used within the specialized rehabilitation facility were used to rehabilitate a 75-year-old female to achieve her goals within her home environment following a stroke. Providing a comprehensive assessment and initiating appropriate treatment techniques can impact a patient’s outcome and function
Navigating Divergence: Principle or Pragmatism? The US’ Executive Order on AI and its Implications for US - EU Governance
Full text linkPresident Trump’s Executive Order 14179: Removing Barriers to American Leadership in Artificial Intelligence issued in January 2025, indicates a significant shift from the United States’ alignment with EU AI and Digital policies. Replacing former President Biden’s EO 14110, which emphasized the safe, secure, and trustworthy development of AI, interagency coordination, and oversight, the new directive favors deregulation, industry-led innovation and securing US global AI dominance. Grounded in America First principles, Executive Order 14179 signifies a clear departure from multilateral AI cooperation, raising significant concerns about the future of AI development and deployment. This article examines the implications of Executive Order 14179 through five dimensions: regulatory alignment disruption, governance fragmentation, corporate compliance burdens, ethical oversight erosion, and geopolitical norm-setting capacity. It argues that the US’ pivot weakens the evolving foundations of multilateral efforts on AI governance and suggests that both the US and EU embrace a more agile approach that balances principled commitments to human rights and ethics with pragmatic flexibility to foster both innovation and interoperable AI governance
Diagnosis, Treatment, and Prognosis of Post-Treatment Lyme Disease Syndrome
No full textLyme disease is a tick-borne illness caused by the bacteria Borrelia burgdorferi with approximately 30,000 new cases diagnosed annually since its discovery in 1977. Predominantly found in the Northeast United States, Lyme disease is often characterized by an erythema migrans rash and can cause fatigue, joint pain, and more severe symptoms as it progresses including Bell’s palsy and meningitis. Research has shown that even with treatment, typically with oral doxycycline, an estimated 10% of Lyme cases will have residual effects. Post-Treatment Lyme Disease Syndrome (PTLDS) is often associated with chronic fatigue, cognitive effects, pain, and effects on sleep. The average onset of PTLDS is about six months after completion of antibiotic treatment and can last indefinitely. Despite the potentially devastating effects of this condition, there is currently minimal guidance on diagnosis and treatment of PTLDS