The Differential Diagnosis and Treatment of Mild Cognitive Impairment and Alzheimer Disease.

Identifying patients at risk for developing mild cognitive impairment (MCI) and Alzheimer disease (AD) remains challenging in clinical practice, even as scientific understanding of dementia advances generally. That said, successfully navigating the associated differential diagnosis in AD is essential, as various causes of cognitive impairment require different treatment strategies. In recent years, the armamentarium in AD has expanded with regulatory approval of a disease-modifying therapy-aducanumab-and may be shifting away from symptomatic treatments such as cholinesterase inhibitors and memantine.

Recent Advances in Screening for Mild Cognitive Impairment and Alzheimer Disease.

In recent years, scientific understanding of the pathophysiology underlying Alzheimer disease (AD) has advanced substantially. Among the most transformative of discoveries is the existence of biomarkers, such as Aβ42, which can manifest in the central nervous system decades before the onset of disease-associated dementia. By detecting these biological entities early, clinicians can close diagnostic delays and substantially improve outcomes for patients with AD.

Understanding Coding and Payment for Psychiatrists' Services: How We Got Here and Where We're Going.

Psychiatrists often have difficulty understanding how to document, code, and bill for their services in a way that expedites adequate payment and avoids billing problems or future issues. This is very understandable because many psychiatrists in small or solo practices do their own billing without any formal training in the vagaries of coding and reimbursement policies. For many years, the American Psychiatric Association (APA) has devoted substantial resources to guiding psychiatrists through this maze, with direct member assistance and resources publicly available at www.

Further validation of the Internet-based Dementia Risk Assessment.

Most approaches to the detection of presymptomatic or prodromal Alzheimer's disease require the costly collection and analysis of biological samples or neuroimaging measurements. The Dementia Risk Assessment (DRA) was developed to facilitate this detection by collecting self-report and proxy-report of dementia risk variables and episodic memory performance on a free Internet website. We now report two validation studies.

Internet-based screening for dementia risk.

The Dementia Risk Assessment (DRA) is an online tool consisting of questions about known risk factors for dementia, a novel verbal memory test, and an informant report of cognitive decline. Its primary goal is to educate the public about dementia risk factors and encourage clinical evaluation where appropriate. In Study 1, more than 3,000 anonymous persons over age 50 completed the DRA about themselves; 1,000 people also completed proxy reports about another person.

Cardiovascular centers of excellence program: a system approach for improving the care and outcomes of cardiovascular patients at HCA hospitals.

Background: A voluntary continuous quality improvement (CQI) effort, the cardiovascular Centers of Excellence (COE) program was implemented by HCA, Inc., to improve cardiovascular care in its hospital system.

Methods: The cardiovascular COE program targeted 165 hospitals that provide cardiovascular services in at least one major service area.

Pre-transplant level of soluble CD30 is associated with infection after heart transplantation.

Background: One immunologic element of the immune system is the CD30 molecule which belongs to the TNF-R superfamily. CD30 can serve as a T-cell signal transducing molecule and is expressed by a subset of activated T lymphocytes, CD45RO(+) memory T cells. Augmentation of soluble CD30 during kidney transplant (Tx) rejection has been reported.