J Natl Med Assoc
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To understand perceived quality of obstetric care following changes to the structure of care in a safety-net institution during the COVID-19 pandemic. ⋯ To improve satisfaction with changes to care, health systems should ensure that relationship building remains a priority and offer patients information about the reason behind changes.
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Breast cancer (BC) is a common and often life-altering diagnosis for affected women and their families. Studies have indicated approximately 10% of breast cancer cases are inheritable. When patients are aware of their genetic status early, they are better equipped to make therapy decisions related to their cancer. ⋯ Although our institution employs genetic counselors on staff, the national shortage of counselors with this expertise has led to a disproportionate availability of providers to meet the clinical volume. This can lead to genetic counseling consultation often occurring beyond the patient's cancer treatment phase. Therefore, we sought to evaluate our referral patterns in an effort to determine whether qualifying patients were scheduled, evaluate delays in consultation, examine completion rates for genetic testing, and assess whether genetic counseling affected their subsequent care.
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We report the successful treatment of angle closure glaucoma and plateau iris with combined early cataract surgery/lensectomy, goniotomy, and transscleral cyclophotocoagulation. The underlying mechanism of angle closure and plateau iris was addressed with cataract extraction and goniosynechiolysis. ⋯ The unique combinations of these procedures restored the iridocorneal angle anatomy to normalize IOP and prevent vision loss from glaucoma in patients with plateau iris. This is a cost-effective option with longer term efficacy.