Clinical outcomes and characterization of intraocular foreign body injuries from a Canadian centre: a 20-year retrospective study and literature review.

OBJECTIVE: To analyse assessment and management patterns of intraocular foreign body (IOFB) injuries in an urban Canadian setting, providing valuable clinical insights to contextualize management. METHODS: Single-surgeon retrospective chart review from January 2002 to January 2023 examining IOFB patient demographics, investigations, treatments, complications, and best-corrected visual acuity (BCVA). RESULTS: This study evaluated IOFBs in 32 eyes from 31 patients (96.8% male). Sizes ranged from 1 to 12 mm; 28 (87.5%) were metallic and 15 (46.9%) were work-related injuries. For diagnosis, 19 patients (61.3%) underwent computed tomography (CT) imaging, and 8 (25.8%) received B-scans, with CT detecting IOFBs in 100% of cases and B-scan in 87.5%. At final follow-up, 17 eyes (53.1%) achieved BCVA ≥20/40, up from 7 (23.3%) initially. Presenting BCVA ≥20/200 was associated with a final BCVA ≥20/40 (P = 0.027). The IOFB was extracted in 27 eyes (84.4%), retained in 4 (12.5%), and 1 (3.1%) required enucleation. Intravitreal antibiotics were administered in 19 eyes (59.4%), resulting in one presumed case of drug toxicity. Complications were present in 30 eyes (93.8%), totalling 119 recorded overall, with 72 (60.5%) occurring within the first 24 hours. Traumatic cataracts were most common in 27 eyes (84.4%). Less-common complications included siderosis and retinal detachment with proliferative vitreoretinopathy, each occurring in one eye (3.1%). Four eyes (12.5%) developed secondary glaucoma, with 3 cases in retained or delayed extractions. CONCLUSIONS: The IOFB characteristics and patient demographics are consistent with other regions. CT scans were the most effective investigation tool. Extended follow-up is recommended to monitor complications, particularly in retained or significantly delayed extractions.

Evaluating equity, diversity, and inclusion in Canadian Postgraduate Medical Education: A cross-sectional analysis of online content.

BACKGROUND: Medical graduates applying to Residency through the Canadian Resident Matching System (CaRMS) utilize the internet to gather information on programs and their overarching Postgraduate Medical Education (PGME) Office. This study aims to evaluate how PGME websites across Canada convey their commitment to equity, diversity, and inclusion (EDI) through their website features. METHODS: Cross-sectional analysis of the 17 Canadian PGME websites against 20 EDI criteria based on contemporary literature, across five domains: leadership and governance, recruitment, accommodations, community engagement, and pathways to entry. Non-parametric testing was conducted to explore the relationship between EDI performance and municipal population diversity and geographic region. RESULTS: The evaluation of PGME websites, policies, reports, and plans revealed a mean score of 8.65/20 (SD = 3.00), with scores ranging from a minimum of 4/20 to a maximum of 13/20, indicating variability in EDI representation. Specifically, the domain of leadership and governance demonstrated the highest mean proportion of completed criteria (51%), while community engagement had the lowest (24%). Notably, 9 out of 17 PGME websites (53%) met at least 10 EDI criteria. Analysis by geographic region demonstrates significant mean differences (p = 0.02), with Ontario (10.50, SD = 2.17) and Western Provinces (11.00, SD = 0.00) scoring notably higher than Quebec (4.50, SD = 0.58), the Prairies (8.50, SD = 2.12), and the Atlantic region (8.00, SD = 2.83). CONCLUSIONS: The assessment of Canadian PGME websites reveals varying levels of commitment to EDI. While many programs exhibit strong EDI representation in mission statements, access to mental health services, and anti-discrimination policies, there are notable gaps in leadership messaging, diverse interview panels, family-friendly policies, and deliberate recruitment of underrepresented groups. Regional differences highlight the need for sharing best practices to promote inclusivity across the country. Improving EDI efforts on PGME websites can promote the recruitment and retention of a diverse resident population.

Cyanoacrylate glue as a novel skin substitute in periocular skin excisions: case series and literature review.

OBJECTIVE: Despite the widespread use of cyanoacrylate glue (CA) as an alternative for wound closure, its potential as a sole skin substitute material in periocular skin surgery remains unexplored. The primary objective was to determine the viability of CA as a sole skin substitute in periocular skin surgery after excision. DESIGN: Single-centre retrospective observational case series. METHODS: All patients were treated at the McGill University Health Centre from August 2023 to November 2023, where CA served as the sole skin substitute material after periocular skin excision. RESULTS: Three female and one male patient, with a mean age of 75 years, received treatment with CA after skin excision for both cancerous and benign skin lesions. Specifically, histopathology revealed 2 cases of basal cell carcinoma, 1 case of squamous cell carcinoma in situ, and 2 benign lesions. The skin defects after excision ranged from 4 × 3 mm to 15 × 30 mm. No complications were observed between CA graft insertion and final skin re-epithelization. Complete re-epithelization was achieved in all patients at final follow-up without evidence of excessive skin contraction. CONCLUSIONS: This study presents a novel approach by using CA as a skin substitute material in periocular skin excisions. Its liquid form allows for easy application and conforms well to irregular wound surfaces. CA may offer economic advantages, including lower material cost and shorter surgical operating times, compared with traditional skin substitutes. Further research is needed to comprehensively evaluate CA's role as a skin substitute in periocular skin reconstruction.

Gender trends in match rate to surgical specialties in Canada: A retrospective study from 2003-2022.

BACKGROUND: In Canada, there is a recognized underrepresentation of women in the field of surgery. However, the extent to which this trend applies across various surgical specialties is not well delineated. The aim of this study is to identify existing disparities and trends over time to inform the need for future interventions to make the match process more equitable for applicants. METHODS: Data regarding surgical specialty applicants was extracted from the Canadian Resident Matching Service (CaRMS)'s 2003 to 2022 reports. RESULTS: A total of 9,488 applicants ranked surgical specialties as their first choice from 2003-2022. Increases in the proportion of women applicants comparing periods 2003-2007 to 2018-2022 were significant for cardiac surgery (22% to 43%, p = 0.03), general surgery (46% to 60%, p<0.001), orthopedic surgery (23% to 35%, p<0.001), urology (23% to 38%, p<0.001), and all aggregated surgical specialties ('all surgery') (45% to 55%, p<0.001). An increase in the proportion of women applicants who matched over the same periods was observed for general surgery (+47% to 60%, p<0.001), orthopedic surgery (24% to 35%, p<0.01), urology (21% to 34%, p<0.001), and all surgery (46% to 54%, p<0.001). From 2003-2022, a lower match rate for women compared to men was observed for otolaryngology (0.60 v 0.69, p = 0.008), urology (0.61 v 0.72, p = 0.003), and all surgery (0.71 v 0.73, p = 0.038), while higher match rates were observed for ophthalmology (0.65 v 0.58, p = 0.04). No statistically significant differences in match rate were observed from 2018-2022. CONCLUSIONS: While the proportion of women applicants to surgical specialties in Canada has been increasing, women remain underrepresented in several surgical specialties. This underrepresentation cannot be solely attributed to fewer women applying to these specialties, as women experience lower success rates when matching to specific surgical specialties. Further research is essential to identify and address the underlying causes of these disparities.

Trends in ophthalmology applicants going unmatched in the Canadian Resident Matching Service.

Background: Applicants to ophthalmology have high rates of going unmatched during the CaRMS process, but how this compares to other competitive or surgical specialties remains unclear. Our research aims to examine this phenomenon by identifying trends and comparing match data with other specialties, to identify disparities that may inform the need for future interventions to improve the match process for applicants. Methods: We used a cross-sectional analysis of data provided by CaRMS on the residency match from 2013 to 2022. Results: We obtained data from 608 ophthalmology, 5,153 surgery, and 3,092 top five (most competitive) specialty first choice applicants from 2013-2022. Ophthalmology applicants were more likely to go unmatched (18.9% [120/608]) than applicants to the top five (11.9% [371/3,092]) and surgical (13.5% [702/5,153]) specialties (p<0.001) and were twice as likely to rank no alternate disciplines (31.8%, p < 0.001) over the study period. In the first iteration, when alternate disciplines were ranked, the match rate to alternate disciplines was highest for ophthalmology applicants (0.41, p < 0.001). The majority (57.8%) of unmatched ophthalmology applicants do not participate in the second iteration. Conclusion: Compared to other competitive specialties, first choice ophthalmology applicants were more likely to go unmatched, rank no alternate disciplines, and choose not to participate in the second iteration. Ophthalmology applicant behaviours should be further studied to help explain these study findings.

Contexte: Les candidats à l'ophtalmologie ont un taux élevé de non-jumelage au cours du processus CaRMS, mais une comparaison avec d'autres spécialités compétitives ou chirurgicales reste à faire. Notre travail a pour but d'examiner ce phénomène en identifiant des tendances et en comparant les données de jumelage avec celles d'autres spécialités, à la recherche de disparités susceptibles d'éclairer le besoin d'interventions futures pour améliorer le processus de jumelage pour les candidats. Méthodes: Nous avons procédé à une analyse transversale des données fournies par CaRMS sur le jumelage des résidents de 2013 à 2022. Résultats: Nous avons obtenu des données sur 608 candidats en ophtalmologie, 5 153 en chirurgie et 3 092 candidats dont le premier choix était l'une des cinq spécialités les plus compétitives de 2013 à 2022. Les candidats en ophtalmologie étaient plus susceptibles de ne pas être jumelés (18,9 % [120/608]) que les candidats aux cinq spécialités les plus compétitives (11,9 % [371/3 092]) et aux spécialités chirurgicales (13,5 % [702/5 153]) (p<0,001), et étaient deux fois plus susceptibles de ne classer aucune autre discipline (31,8 %, p<0,001) au cours de la période d'étude. Lors du premier tour, lorsque des disciplines alternatives ont été classées, le taux de jumelage avec les disciplines alternatives était le plus élevé pour les candidats en ophtalmologie (0,41, p<0,001). La majorité (57,8 %) des candidats non jumelés en ophtalmologie ne participent pas au deuxième tour. Conclusion: Comparativement à d'autres spécialités compétitives, les candidats dont le premier choix étaient l'ophtalmologie étaient plus susceptibles de ne pas être jumelés, de ne pas classer d'autres disciplines et de choisir de ne pas participer au deuxième tour. Les comportements des candidats en ophtalmologie devraient faire l'objet d'études plus approfondies afin d'expliquer nos résultats.

Health Care Workers Online YouTube Content Compared to AUA Prevention of Recurrent Urinary Tract Infections in Women Guidelines: An Integrative Review of Quality and Comprehensiveness Analysis.

INTRODUCTION: We document the quality, veracity, and comprehensiveness of recurrent UTI information on YouTube to increase health care workers' (HCWs') awareness of UTI-related content online, and to identify deficits in understanding, clarify misconceptions, and reduce stigmatization risk. METHODS: High-traffic topic search terms were curated by Google Trends to extract 200 videos, of which 45 met inclusion criteria. Five independent reviewers used a standardized questionnaire based on the AUA recurrent UTI guidelines to assess the definition of UTI, marketing content, prophylaxis/prevention strategies, and antibiotic use/stewardship. RESULTS: Incongruent or incomplete guideline UTI definitions were found in 78% (35/45) of videos (K = 0.40), despite 80% (36/45) being authored by HCWs. Forty-two percent (19/45) promoted nonguideline-based hygiene practices; 25% (11/45) advocated front-to-back wiping (K = 0.71). Descriptors identified within the videos included the mention of women with UTI as unclean. Only 55% (25/45) discussed increasing fluid intake (K = 0.59), while 33% (15/45) discussed the use of cranberry supplementation (K = 0.81). CONCLUSIONS: Discussion of hygiene practices which lack a specific guideline statement is particularly evident. Descriptors that characterize women with UTI as "unclean" may create a health equity concern for women experiencing UTIs. These findings should alert HCWs to the scope and emphasis in online education that patients may view to self-educate; both the errors and the issues of equity are problematic. Educational materials on UTI should be based on evidence-based guidelines, such as those by the AUA.

Incidence of Sympathetic Ophthalmia after Intraocular Surgery: A Systematic Review and Meta-analysis.

TOPIC: Sympathetic ophthalmia (SO) is a rare bilateral granulomatous panuveitis that can present after trauma or intraocular surgery (IOS). The incidence of SO after IOS varies among studies. The purpose of this review was to determine the incidence proportion of SO after IOS. CLINICAL RELEVANCE: The incidence proportion of SO after IOS can provide physicians and patients with information on the risk of SO during the consent process before surgery. METHODS: In this systematic review and meta-analysis, MEDLINE, EMBASE, and Cochrane databases were searched from inception to January 1, 2023 for population-based studies of SO after IOS. Two reviewers independently screened the results. Random-effects meta-analyses calculated incidence proportion. Subgroup analysis assessed SO incidence based on IOS type and technological advancements. Study quality and bias were assessed using the Newcastle-Ottawa scale and the Grades of Recommendation, Assessment, Development, and Evaluation framework. RESULTS: The final meta-analyses included 19 studies, with 118 cases of SO occurring after 505 178 inciting events. The estimated overall incidence proportion of SO after IOS was 0.061% (95% confidence interval [CI], 0.033%-0.111%; I2 = 83%), and the estimated incidence rate was 9.24 cases per 100 000 person-years (95% CI, 4.03-21.19; I2 = 88%). The average study duration across these studies was 10.8 years. Within the reviewed literature, SO after glaucoma and vitreoretinal IOS was studied most, with 9 and 6 studies, respectively. Observed differences in incidence between glaucoma (0.098%; 95% CI, 0.042%-0.232%; I2 = 40%) and vitreoretinal (0.043%; 95% CI, 0.022%-0.085%; I2 = 88%) IOS were not statistically significant (P = 0.14). Also, no significant difference was found in the incidence proportion before and after 1975, when modern intraocular surgical techniques emerged (0.060% vs. 0.058%; P = 0.98). The outcome measures showed low-certainty Grades of Recommendation, Assessment, Development, and Evaluation evidence. DISCUSSION: Sympathetic ophthalmia after IOS is rare and might not have changed over the past 5 decades. The estimated incidence proportion of SO may be useful during the consent process before surgery. Also, no significant difference may exist in the incidence of SO between glaucoma and vitreoretinal IOS, based on low-certainty evidence. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Gender Representation on North American Ophthalmology Societies' Governance Boards.

Purpose We examined the gender distribution and academic productivity of North American ophthalmology societies' board members. Methods Cross-sectional and retrospective study of board members on American and Canadian ophthalmology societies. In December 2022, data was gathered from society webpages, online archives, and the Scopus database for publication information. Results Of the identified 73 board presidents and 876 other board members, 49 (67.1%) board presidents were men and 24 (32.9%) were women, while 554 (63.2%) other board members were men and 322 (36.8%) were women ( p = 0.53). Overall, board members who were men had significantly higher median h-indexes (men vs. women: 10 [interquartile range [IQR] = 22] vs. 7 [IQR = 12], p = 0.03) and median publication numbers (men vs. women: 23 [IQR = 84] vs. 14 [IQR = 52.3], p = 0.01). However, m-quotients (h-index divided by length of academic career) were not significantly different (men vs. women: 0.46 [IQR = 0.74] vs. 0.50 [IQR = 0.55], p = 0.67). Overall, a significant increase in the proportion of women board presidents comparing periods 1942 to 1961 and 2002 to 2021 was observed for all societies combined (3.1% [2/65] to 23.6% [210/888], p < 0.001). Conclusion The fraction of women on the academic boards in North American ophthalmology societies has increased sevenfold over the past 83 years. The gender composition of ophthalmology society boards is consistent with the gender composition of practicing ophthalmologists in the United States. Women in board or society positions have comparable academic output to men. Existing and new efforts to sustain progress in promoting women's representation and leadership opportunities must continue.

Evaluation of commitment to equity, diversity, and inclusion on Canadian ophthalmology residency program websites.

OBJECTIVE: Program websites play a crucial role in providing information to prospective residency applicants. This research assesses the extent to which Canadian ophthalmology residency programs demonstrate their commitment to equity, diversity, and inclusion (EDI) through their websites and identifies areas for potential improvement. METHODS: A cross-sectional analysis of websites affiliated with 15 accredited Canadian ophthalmology residency training programs was performed. A score was assigned based on 16 EDI elements derived from recent literature. The relationship between program website EDI elements with language, geography, and regional population diversity was explored. RESULTS: Of the 15 Canadian ophthalmology residency programs, 12 (80%) met at least 1 of 16 EDI elements, with a mean program score of 2.4 (SD = 1.92). The program that attained the highest score met 7 of 16 EDI elements. Anglophone programs had a higher mean score (2.92; SD = 1.78) when compared with their Francophone counterparts (0.33; SD = 0.58; p = 0.023). No significant difference was found between programs in western, central, and eastern Canada (p = 0.86). The regional minorities proportion associated with each program was not found to influence scores (p = 0.088). CONCLUSIONS: EDI elements were seldom addressed on Canadian ophthalmology residency program affiliated websites. We propose recommendations in 4 domains: showcasing team diversity, clear discourse in recruitment, inclusive resources, and program organization. Improving EDI visibility on program websites through revisions of existing websites or through creation of new promotional websites may foster recruitment of a diverse resident body.

Antitumor and Protective Activity of TVLE against CdCl2-Induced Renal Damage in Rats.

<b>Background and Objective:</b> Cadmium is a heavy metal that has a wide range of applications in human existence. Cadmium may bind to the protein metallothionein and decrease kidney function once it enters the body. The purpose of this study was to investigate the renal protective activity of TVLE against CdCl₂-induced renal toxicity in rats. <b>Materials and Methods:</b> TVLE was prepared and characterized using instrumental analysis and spectral data. Furthermore, the IC₅₀ of TVLE against the Vero renal carcinoma cell line was calculated. Adult albino rats were used to assess the renal protective activity of TVLE (150 and 300 mg kg¹ b.wt.) in CdCl₂-treated rats. <b>Results:</b> IC₅₀of TVLE against Vero cell line equals 148.25 µg mL¹. The daily oral administration of TVLE at concentrations of 150 and 300 mg kg¹ b.wt. for 21 days to CdCl₂-treated rates resulted in a significant improvement in tumour volume and tumour weight, urea, creatinine, uric acid, TNF-α, NOx, TBARs, GSH, CAT, SOD, GPx and VEGF-C gene expression in CdCl₂-treated rats. Furthermore, TVLE almost normalized these effects in renal histoarchitecture. <b>Conclusion:</b> The biochemical, histological and MRI examinations of the current study suggested that TVLE have renal protective activity against CdCl₂-induced renal toxicity in rats.