Neurology Commons^™

What Are The Implications Of Accountable Care Organizations For Physical Medicine And Rehabilitation Practices?, John L. Melvin, Greg Worsowicz

Department of Rehabilitation Medicine Faculty Papers

The goal of delivering quality health care at a lower overall cost through accountable care organizations (ACO) as described as part of the Patient Protection and Affordable Care Act of 2010 (ACA) has gained momentum among payers, providers, and the public. The concept includes developing an organization that provides incentives for quality care while lowering the overall cost of the care. If the goals are met, then both providers and payers would be able to share in the financial savings produced by the lower health care costs achieved while improving the quality of care delivered. The Centers for Medicare and …

Hormonal Consequences Of Epilepsy And Its Treatment In Men., Kartik Sivaraaman, Scott Mintzer

Department of Neurology Faculty Papers

PURPOSE OF REVIEW: Epilepsy and anticonvulsant medications may substantially alter endocrine homeostasis, including the male reproductive hormonal system.

RECENT FINDINGS: Seizures in medial temporal lobe structures, through their connectivity to the hypothalamus, alter the secretion of gonadotropins. Levels of circulating bioavailable testosterone are affected by changes in the level of binding proteins, which in turn may be affected by seizure medications. The use of older generation medications that induce the cytochrome P450 system is associated with an increase in sex hormone-binding globulin and lower bioactive testosterone. Sexual dysfunction, including decreased libido and decreased potency, and infertility, is seen commonly in …