Latest Posts
March 4, 2026
A Paradigm Shift in Urology For much of modern medicine, a foundational assumption shaped the way clinicians approached urinary tract health: healthy urine is sterile. That assumption influenced how specimens were cultured, how infections were diagnosed, and how treatment decisions were made. It also meant that any bacterium detected in urine was presumed to be either a contaminant or a pathogen- with little consideration for a middle ground. Over the past decade, advances in molecular sequencing have dismantled this paradigm. Culture-independent techniques, particularly 16S ribosomal RNA (rRNA) gene sequencing, have revealed that the human urinary tract harbors a resident […]
January 27, 2026
DON’T PANIC The Clinician’s Guide to the Genomic Galaxy is designed to help you navigate the genomic landscape that is materializing beneath your feet as we speak. It is materializing quickly; we should learn to walk now so that we may run in the days ahead. When clinicians first encounter next-generation sequencing (NGS), or hear it discussed at conferences, the road is difficult to see through all the caution signs and while caution is certainly appropriate, these signs are often treated like “road closed” signs. Some of the cautionary statements that frequent discussions of molecular diagnostics are: NGS is too […]
January 23, 2026
A Structural Shift in Outpatient Orthopedics – and the Role of Diagnostics Beginning January 1, 2026, a fundamental shift will take place in outpatient orthopedic care. The Centers for Medicare & Medicaid Services (CMS) has finalized a rule expanding Ambulatory Surgical Center (ASC) eligibility to include select revision total knee and hip arthroplasty procedures. This decision moves some of the most complex orthopedic cases into outpatient settings for appropriately selected patients. While this policy change expands access and efficiency, it also raises the bar for diagnostic certainty. Revision arthroplasty carries inherently higher clinical risk-particularly related to occult infection-and the ASC environment allows far less tolerance for […]
December 30, 2025
A Critical Issue Affecting Millions of Women Intrauterine devices represent one of the most effective forms of long-acting reversible contraception available today, with efficacy rates comparable to sterilization methods. Yet despite their clinical advantages, a staggering 57% of IUD patients in the United States choose to have their devices removed before the recommended duration of use. This represents not just a contraceptive failure, but a missed opportunity to provide sustained, reliable reproductive health management to millions of women. For clinicians managing IUD patients, these premature removals translate into valuable clinical time spent addressing complications, counseling disappointed patients, and navigating alternative […]
December 3, 2025
Periprosthetic joint infections (PJI) remain one of the most serious and costly complications associated with total joint arthroplasty. Although they occur in 1–2% of cases, the consequences are severe—ranging from multiple revision surgeries and prolonged hospital stays to reduced patient mobility and increased mortality risk. Beyond clinical outcomes, the financial burden is substantial, with average cost of $100,000 per episode and lifetime costs reaching roughly $391,000 per patient. A particularly complex clinical challenge arises when PJIs are culture-negative, which occurs in an estimated 15–30% of cases. When standard microbiological cultures fail to identify a culprit pathogen, orthopedic surgeons and infectious […]