Physician-Patient Face Masking's Influence on Post-Intravitreal Injection Endophthalmitis Rates.

PURPOSE: We sought to determine if universal face mask guidelines implemented during the COVID-19 pandemic significantly influenced the incidence of endophthalmitis following intravitreal injections (IVI). METHODS: This retrospective cohort study reviewed the electronic health records from a retina-only practice located in Michigan. The study evaluated patients receiving IVIs over two distinct time periods of April 2019-March 2020, and April 2020-March 2021, which made up our unmasked and masked groups, respectively. We then calculated the incidence of endophthalmitis following IVI and evaluated cases of post-injection endophthalmitis for both time periods. RESULTS: There were a total of 121,384 intravitreal injections performed over the two year period of interest. Of these, there were 63,114 unmasked and 58,270 masked patient encounters. A total of 46 post-injection endophthalmitis cases were identified. Of these, 29 cases were from the unmasked period and 17 were from the masked period. This resulted in an incidence of endophthalmitis of 0.046% and 0.038% in the masked and unmasked groups, respectively. This difference did not rise to the level of statistical significance (p=0.1336). CONCLUSION: This study suggests that the incidence of post-injections endophthalmitis was not influenced by the implementation of ophthalmologist-patient face masking after intravitreal injection during the COVID-19 pandemic.

Cellular Reorganization Plays a Vital Role in Acupuncture Analgesia.

Background: Acupuncture has a long history of relieving many forms of pain. However, many of acupuncture's mechanisms are still unknown and/or misunderstood. Objective: This review looks at past research on many different methods and targets of study related to acupuncture. The main focus is upon the importance of connective-tissue planes in and around acupuncture points. Method: Relevant articles from journals as well as books on the topic were searched manually for information related to the topic. Results: Various studies offered different (and sometimes interrelated) mechanisms for how acupuncture needling results in analgesia among other effects. Emerging evidence, however, has shown the increasing importance of extracellular matrix rearrangements that result in lower mechanical stress states of surrounding tissues. This leads to lower constant stimulation of regional mechanoreceptors, in turn, reducing chronic pain and discomfort. Conclusions: The extracellular matrix has emerged as an important area of study on the effects of acupuncture needling.