Risk factors for developing depressive symptoms in the immediate postoperative period after Mohs micrographic surgery.

PURPOSE: Mohs micrographic surgery (MMS) is a highly efficacious, tissue sparing method of skin cancer removal. Nevertheless, in the months to years after MMS, psychosocial distress has been described. The present study addressed the immediate period after MMS and assessed the frequency and risk factors for development of depressive symptoms. METHODS: Subjects undergoing MMS at two physician practices (JL, FS) were included in this prospective cohort study. Preoperatively, a standardized depression screening, the Patient Health Questionnaire-8 (PHQ-8), was administered. After MMS, the PHQ-8 was readministered at weeks 1, 2, 4, 6, and 12. Average PHQ-8 score by week and change from baseline PHQ-8 score were the primary outcomes. RESULTS: Sixty-three subjects were included of which 49 (78%) had a facial site. Twenty-two subjects (35%) had some increase in score during the 12-week follow-up period, of which 18 had a facial site. The oldest subjects (83-99 years, n = 14) had significantly higher PHQ-8 scores at week 4 (p < 0.01) and week 6 (p = 0.02) than all other age groups. There were no differences in scores between location groups. CONCLUSIONS: One-third of subjects had some increase in score during the follow-up period. Those in the oldest age cohort were at highest risk of increased score. In contrast to prior literature, those with facial sites were not at higher risk. This difference may be explained by increased masking during the ongoing COVID-19 pandemic. Ultimately, consideration of patients' psychologic status in the immediate postoperative period after MMS, particularly in the elderly population, may enhance perceived patient outcomes.

Association of Absent or Trace Fluid in the Maxillary Sinus and Inferior Rectus Muscle Entrapment in Patients With Orbital Floor Fracture.

Inferior rectus (IR) entrapment requires urgent surgical intervention in patients with traumatic orbital floor fracture (OFF). We evaluated 47 patients who underwent CT showing acute OFF, 10 of whom had surgically confirmed entrapment. Absent or trace dependent fluid in the ipsilateral maxillary sinus had sensitivity of 40% and specificity of 95% for entrapment. In comparison, sensitivity and specificity were 80% and 78% for IR thickening and 70% and 59% for sinus herniation of orbital contents.

Ultrasonographic Visualization of Bilaterally Fused Eyelids in a Premature Neonate.

In cases of significant prematurity, neonates born with eyelid fusion can undergo spontaneous eyelid disjunction. Here, the authors present such a case, along with ultrasound findings shortly before eyelid separation. All protected patient information extracted for this report was done so in accordance with the Health Insurance Portability and Accountability Act. This report was prepared in accordance with the tenants of the Declaration of Helsinki.

Treatment-Emergent Adverse Events in Gene Therapy Trials for Inherited Retinal Diseases: A Narrative Review.

Patient safety is a primary priority in the conduction of retinal gene therapy trials. An understanding of risk factors and mitigation strategies for post-procedure complications is crucial for the optimization of gene therapy clinical trial protocols. In this review, we synthesize the literature on ocular delivery methods, vector platforms, and treatment-emergent adverse effects in recent gene therapy clinical trials for inherited retinal diseases.

Correlating Ophthalmology Exposure in Medical School to Applying and Matching Into an Ophthalmology Residency.

PURPOSE: To correlate ophthalmology curricular exposure in medical school to the number of students who applied and matched into ophthalmology residency programs. Given the high curricular burden placed on medical schools, the authors sought to better characterize existing ophthalmology curricula and to delineate which offerings are closely related to high numbers of students applying and matching into ophthalmology residencies. METHOD: The authors reviewed the extent of ophthalmology curricula between 2007 and 2017 via a survey administered in 2018 to all U.S. Association of American Medical Colleges (AAMC)-affiliated medical schools. They obtained residency application and match data with permission from the Association of University Professors of Ophthalmology. The authors compared metrics of ophthalmology exposure with the number of students who applied and matched into ophthalmology during the corresponding year using mixed-effects Poisson regression analysis. RESULTS: This study includes 49 U.S. AAMC-affiliated medical schools. When adjusted for the number of applicants per year, the following were significantly (P < .05) associated with matching into an ophthalmology residency: the presence of an ophthalmology department, an ophthalmology residency program, an ophthalmology interest group, ophthalmologists on faculty, ophthalmology content in the preclinical curriculum, preclinical lectures taught by ophthalmologists, and the availability of an optional fourth-year ophthalmology elective. Multivariable analysis indicated both that the presence of an ophthalmology residency program was the only independent predictor of matching into an ophthalmology residency and that the presence of an ophthalmology residency program, ophthalmology content in the preclinical curriculum, and preclinical lectures taught by ophthalmologists are independent predictors for applying. CONCLUSIONS: A foundation in ophthalmology is crucial for all physicians, especially those who may encounter patients with eye problems in emergency or primary care settings. However, for those students considering a career in ophthalmology, choosing a medical school with an ophthalmology department and residency program is particularly important.