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Home / AAFP News / Practice & Professional Issues / Family Physicians Earn Respect in Remote Valdez, Alaska

He also reported photophobia (but no tearing), pain with eye movements, frontal headaches and a gray area on the sclera of the left eye that appeared to have gotten larger. He denied any previous similar episodes. No symptoms were reported in the right eye. The patient denied experiencing flashes of light, floaters, diplopia, permanent loss or transient loss of vision or any other changes in vision. He stated that he previously had a sinus infection (self-diagnosed) a few weeks earlier, which, based on his description, was presumed to be maxillary. He had done nothing to treat the infection.

Todd described a local businessman in the end stage of arterial lateral sclerosis who needed a few more days on earth — specifically, a few more days in Valdez — to sign legal papers and get his affairs in order.

External evaluation showed equal transillumination of the left and right frontal and maxillary sinuses. No proptosis was present, and both globes moved appropriately to retropulsion without resistance. The patient reported 3+ pain with palpation of the left globe and over the left frontal sinus. Slit lamp examination revealed trace diffuse injection of the bulbar conjunctiva in the left eye. The left eye also showed a patchy gray scleral hue superiorly and inferiorly. Anterior chambers were deep and quiet in each eye, and both corneas were clear without keratic precipitates. A dilated fundus exam of the left eye was unremarkable. There were no cells in the vitreous of the left eye.

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"I would love to have a single piece, every picture of my family from back then, so I just thought you know what maybe somebody’s like ‘I can’t believe that got given away, I gotta have it’," said Pearo.

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If Keuchel is willing to accept a one year contract, he’d likely push for at least $20 million for that one year. The yearly value should be slightly inflated if it’s just a one year contract.

"This high cost of preparing kids to go to college is one of the main reasons we are experiencing low fertility rates. It’s about quality over quantity. Parents would rather invest more in a small number of children."

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Its maker claims that it will share its hybrid technology with the upcoming Jeep Renegade and promise an "immersive driver experience", thanks to a driver-focussed cockpit that features a 12.3-inch digital instrument and a 10.25-inch touchscreen infotainment system.

The newest generation of CR pumps features improved efficiency and reliability, making them particularly suitable for pressure-boosting in food processing applications. The new line includes three extra-large flow sizes of up to 580 psi pump pressure. Energy efficiency is essential when you are working with large pumps. And the attendant CUE drives are specifically optimized for pump operation and available in all voltages and frequencies for pumps in the CR range. CR pumps up to 30 horsepower can be fitted with either integrated drives (CRE) or stand-alone drives (CUE). For the large CR/CRN range, the vendor offers plug-and-play drives that can even be preconfigured and tested to suit specific needs. Grundfos; Brookshire, Tex.; grundfos.us/cr

As of January 2018, everyday light bulbs for sale in California must meet new efficiency standards. Light-emitting diode, or LED, bulbs will be the bulb of choice for most consumers. However, it is often difficult to know which bulb to purchase as stores are filled with products that vary in terms of color appearance, dimming and longevity.

In most cases, treatment of acute sinusitis is not necessary, because it tends to be self-limiting and will resolve spontaneously in a few weeks. Palliative treatments include nasal sprays, decongestants and over-the-counter pain medications.


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