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https://www.readbyqxmd.com/read/29120717/cataract-surgery-after-proton-beam-irradiation-for-uveal-tumors
#1
Zeba A Syed, Roberto Pineda
PURPOSE: To study the risks associated with cataract surgery in patients with previous proton-beam irradiation (PBI), focusing on preoperative risk factors, intraoperative findings, and postoperative complications. SETTING: Massachusetts Eye & Ear Infirmary, Boston, Massachusetts, USA. DESIGN: Retrospective case series. METHODS: Electronic medical records of patients who had PBI and cataract surgery between January 1, 2006, and October 1, 2016, were reviewed...
October 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/29049518/long-term-outcomes-after-proton-beam-irradiation-in-patients-with-large-choroidal-melanomas
#2
Thanos D Papakostas, Anne Marie Lane, Margaux Morrison, Evangelos S Gragoudas, Ivana K Kim
Importance: Although radiotherapy has been used more frequently in past decades for the management of large melanomas, long-term efficacy of proton beam irradiation (PBI) of large choroidal melanomas has not been reported. Objective: To evaluate long-term outcomes in patients who underwent PBI for the treatment of large choroidal melanomas. Design, Setting, and Participants: Data were obtained at a single Boston, Massachusetts, academic tertiary referral practice for this retrospective cohort study...
November 1, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29049436/minimal-nasolabial-incision-technique-for-nasolabial-fold-modification-in-patients-with-facial-paralysis
#3
Callum Faris, Alyssa Heiser, Nate Jowett, Tessa Hadlock
Importance: Creation of symmetrical nasolabial folds (NLFs) is important in the management of the paralyzed face. Established techniques use a linear incision in the NLF, and technical refinements now allow the linear incision to be omitted. Design, Setting, and Participants: This retrospective case series was conducted in a tertiary care setting from February 2, 2017, to June 7, 2017. Participants were all patients (N = 21) with peripheral facial paralysis who underwent NLF modification that used the minimal nasolabial incision technique at the Massachusetts Eye and Ear Infirmary Facial Nerve Center from February 1, 2015, through August 31, 2016...
October 12, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/29023340/associations-between-disinfection-by-product-exposures-and-craniofacial-birth-defects
#4
John A Kaufman, J Michael Wright, Amanda Evans, Zorimar Rivera-Núñez, Amy Meyer, Michael G Narotsky
OBJECTIVE: Examine associations between craniofacial birth defects (CFDs) and disinfection by-product (DBP) exposures, including the sum of four trihalomethanes (THM4) and five haloacetic acids (HAA5) (i.e., DBP9). METHODS: We calculated first trimester adjusted odds ratios (aORs) for different DBPs in a matched case-control study of 366 CFD cases in Massachusetts towns with complete 1999-2004 THM and HAA data. RESULTS: We detected elevated aORs for cleft palate with DBP9 (highest quintile aOR = 3...
October 11, 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28991115/preventing-adverse-events-in-cataract-surgery-recommendations-from-a-massachusetts-expert-panel
#5
Karen C Nanji, Sarah A Roberto, Michael G Morley, Joseph Bayes
Massachusetts health care facilities reported a series of cataract surgery-related adverse events (AEs) to the state in recent years, including 5 globe perforations during eye blocks performed by 1 anesthesiologist in a single day. The Betsy Lehman Center for Patient Safety, a nonregulatory Massachusetts state agency, responded by convening an expert panel of frontline providers, patient safety experts, and patients to recommend strategies for mitigating patient harm during cataract surgery. The purpose of this article is to identify contributing factors to the cataract surgery AEs reported in Massachusetts and present the panel's recommended strategies to prevent them...
October 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28991108/patient-harm-in-cataract-surgery-a-series-of-adverse-events-in-massachusetts
#6
Sarah A Roberto, Joseph Bayes, Paul E Karner, Michael G Morley, Karen C Nanji
Massachusetts state agencies received reports of 37 adverse events (AEs) involving cataract surgery from 2011 to 2015. Fifteen were anesthesia related, including 5 wrong eye blocks, 3 cases of hemodynamic instability, 2 retrobulbar hematoma/hemorrhages, and 5 globe perforations resulting in permanent loss of vision. While Massachusetts' reported AEs likely underrepresent the true number of AEs that occur during cataract surgery, they do offer useful signal data to indicate the types of patient harm occurring during these procedures...
October 5, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28924418/optical-coherence-tomography-findings-and-successful-repair-of-retina-detachment-in-knobloch-syndrome
#7
Nazanin Ebrahimiadib, Bobeck S Modjtahedi, Kevin Ferenchak, Thanos D Papakostas, Jason S Mantagos, Demetrios G Vavvas
A 7-year-old Afghani girl was referred to the retina clinic of Massachusetts Eye and Ear for a chronic-appearing, macula-off retinal detachment in the left eye. On examination, best-corrected visual acuity was 20/400 in the right eye and 20/800 in the left eye. She had bilateral horizontal nystagmus. Ophthalmoscopy revealed prominent choroidal vessels, chorioretinal atrophy in the macular area, attenuated retinal vasculature, and pale optic discs bilaterally. Spectral domain optical coherence tomography demonstrated atrophy of the choriocapillaris and the retinal pigment epithelium, retinal thinning, and abnormal foveal contour...
2017: Digital Journal of Ophthalmology: DJO
https://www.readbyqxmd.com/read/28910436/integrating-data-collection-into-office-work-flow-and-electronic-health-records-for-clinical-outcomes-research
#8
C Alessandra Colaianni, Patricia A Levesque, Robin W Lindsay
Meticulous collection of clinical outcomes metrics in patients undergoing elective surgery is important to ensure quality care; it is also increasing in importance as the Centers for Medicare & Medicaid Services moves to tie reimbursement to outcomes and insurance approval. This study assesses a systematic method for gathering preoperative and postoperative data on patients with nasal obstruction who undergo functional septorhinoplasty that was developed at the Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts...
December 1, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28895450/identifying-occupations-at-risk-for-laryngeal-disorders-requiring-specialty-voice-care
#9
Matthew C Mori, David O Francis, Phillip C Song
Objective To identify occupational groups' use of specialty voice clinic evaluation. Study Design Retrospective cohort study. Setting Tertiary subspecialty clinic. Subjects and Methods We analyzed data collected on patients presenting to the Massachusetts Eye and Ear Infirmary Voice and Speech Laboratory over a 20-year period (1993-2013). The relative risk (RR) and 99% confidence interval (CI) of presentation were calculated for each occupational category in the greater Boston population using year-matched data from the Bureau of Labor Statistics (BLS)...
October 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28810039/distinguishing-white-dot-syndromes-with-patterns-of-choroidal-hypoperfusion-on-optical-coherence-tomography-angiography
#10
Jay C Wang, Inês Laíns, Lucia Sobrin, John B Miller
BACKGROUND AND OBJECTIVE: To compare patterns of choroidal hypoperfusion in white dot syndromes (WDS) using optical coherence tomography angiography (OCTA). PATIENTS AND METHODS: Consecutive patients with WDS were imaged with either the Zeiss AngioPlex OCT Angiography (Carl Zeiss AG, Oberkochen, Germany) or the AngioVue OCT Angiography (Optovue, Fremont, CA) from February to November 2016. Four patients with acute posterior multifocal placoid pigment epitheliopathy (APMPPE), birdshot chorioretinopathy (BCR), presumed ocular histoplasmosis syndrome (POHS), and multiple evanescent white dot syndrome (MEWDS) were selected...
August 1, 2017: Ophthalmic Surgery, Lasers & Imaging Retina
https://www.readbyqxmd.com/read/28688550/a-quality-study-of-family-centered-care-coordination-to-improve-care-for-children-undergoing-tracheostomy-and-the-quality-of-life-for-their-caregivers
#11
Christopher Hartnick, Gillian Diercks, Vanessa De Guzman, Elizabeth Hartnick, Jeanne Van Cleave, Kevin Callans
IMPORTANCE: Approximately 4000 U.S. children undergo tracheostomy yearly [1], and these surgeries often result in hospital re-admissions that have definite cost and caregiver burdens due to complications that are avoidable with proper training and support. OBJECTIVE: To assess the impact of a Family-Centered Care Coordination (FCCC) program on the quality of care received by children undergoing tracheostomy and their caregivers. DESIGN: Caregivers of children undergoing tracheostomies from January 2012 to January 2013 and then a different set of caregivers of children undergoing tracheostomies from January 2015 to January 2016 completed both the Pediatric Tracheostomy Health Status Instrument (PTHSI) 1 month after discharge and the Medical Complications Associated with Pediatric Tracheostomy (MCAT) questionnaire 6 months after initial tracheostomy...
August 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28635036/time-driven-activity-based-costing-to-estimate-cost-of-care-at-multidisciplinary-aerodigestive-centers
#12
Jordan A Garcia, Bipin Mistry, Stephen Hardy, Mary Shannon Fracchia, Cheryl Hersh, Carissa Wentland, Joseph Vadakekalam, Robert Kaplan, Christopher J Hartnick
OBJECTIVES/HYPOTHESIS: Providing high-value healthcare to patients is increasingly becoming an objective for providers including those at multidisciplinary aerodigestive centers. Measuring value has two components: 1) identify relevant health outcomes and 2) determine relevant treatment costs. Via their inherent structure, multidisciplinary care units consolidate care for complex patients. However, their potential impact on decreasing healthcare costs is less clear. The goal of this study was to estimate the potential cost savings of treating patients with laryngeal clefts at multidisciplinary aerodigestive centers...
September 2017: Laryngoscope
https://www.readbyqxmd.com/read/28576522/pd-l1-expression-and-cd8-infiltration-shows-heterogeneity-in-juvenile-recurrent-respiratory-papillomatosis
#13
Tingyu Liu, Max Greenberg, Carissa Wentland, Brandon Sepe, Sarah Bowe, Gillian Diercks, Tiffany Huynh, Mari Mino-Kenudson, Richard Schlegel, David Kodack, Cyril Benes, Jeffrey Engelman, Christopher Hartnick
INTRODUCTION: Tumor immunotherapy have broadened therapeutic options for tumor treatment. The role of immune function in juvenile recurrent respiratory papillomatosis (JRRP) has not been investigated. Applying immunoblockade inhibitors as a novel disease treatment is unclear. Our study, for the first time, evaluates immune infiltration and immuno-suppressive molecule expression in JRRP. Our study provides insights in possibly treating this disease with tumor immunotherapies. We aimed to determine expression of programmed death-ligand 1 (PD-L1), a cancer escape protein, and presence of CD8+ T cell infiltration in tumor microenvironment...
April 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28434885/early-performance-on-an-eye-surgery-simulator-predicts-subsequent-resident-surgical-performance
#14
Ramak Roohipoor, Mehdi Yaseri, Amir Teymourpour, Carolyn Kloek, John B Miller, John I Loewenstein
OBJECTIVE: To examine early performance on an eye surgery simulator and its relationship to subsequent live surgical performance in a single large residency program. DESIGN: Retrospective study. SETTING: Massachusetts Eye and Ear, Harvard Medical School, Department of Ophthalmology. METHODS: In a retrospective study, we compared performance of 30 first-year ophthalmology residents on an eye surgery simulator to their surgical skills as third-year residents...
April 20, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28426852/an-outbreak-of-endogenous-fungal-endophthalmitis-among-intravenous-drug-abusers-in-new-england
#15
MULTICENTER STUDY
Aubrey R Tirpack, Jay S Duker, Caroline R Baumal
Importance: Intravenous drug abuse (IVDA) is a known risk factor for endogenous fungal endophthalmitis (EFE), a severe intraocular infection caused by hematogenous seeding of mycotic organisms to the eye. Reporting significant increases in heroin-related deaths since 2014, the New England region is in the midst of an opioid crisis that has led to a substantial increase in patients at risk for this vision-threatening disease. Objective: To present an update on characteristics, management, and visual outcomes in patients with EFE...
June 1, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28328735/building-workforce-capacity-abroad-while-strengthening-global-health-programs-at-home-participation-of-seven-harvard-affiliated-institutions-in-a-health-professional-training-initiative-in-rwanda
#16
Corrado Cancedda, Robert Riviello, Kim Wilson, Kirstin W Scott, Meenu Tuteja, Jane R Barrow, Bethany Hedt-Gauthier, Gene Bukhman, Jennifer Scott, Danny Milner, Giuseppe Raviola, Barbara Weissman, Stacy Smith, Tej Nuthulaganti, Craig D McClain, Barbara E Bierer, Paul E Farmer, Anne E Becker, Agnes Binagwaho, Joseph Rhatigan, David E Golan
A consortium of 22 U.S. academic institutions is currently participating in the Rwanda Human Resources for Health Program (HRH Program). Led by the Rwandan Ministry of Health and funded by both the U.S. Government and the Global Fund to Fight AIDS, Tuberculosis and Malaria, the primary goal of this seven-year initiative is to help Rwanda train the number of health professionals necessary to reach the country's health workforce targets. Since 2012, the participating U.S. academic institutions have deployed faculty from a variety of health-related disciplines and clinical specialties to Rwanda...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28267396/quantitative-efficacy-of-external-and-internal-browpexy-performed-in-conjunction-with-blepharoplasty
#17
COMPARATIVE STUDY
Ali Mokhtarzadeh, Guy G Massry, Elena Bitrian, Andrew R Harrison
Browpexy surgery is a minimally invasive surgical adjunct to upper blepharoplasty. The traditional internal (IB) approach is well documented, while the newer external (EB) variant has only recently been described. To date, there is little quantitative data to evaluate the efficacy of either procedure, and no data to compare results between the two. We determine the efficacy of, and compare surgical results between, internal and external browpexy surgery in lifting the central and lateral brow. A 3.5-year retrospective review of patients undergoing internal and external browpexy surgery to assess the amount of central and lateral lift to the brow was performed...
April 2017: Orbit
https://www.readbyqxmd.com/read/28255228/rituximab-as-a-monotherapy-or-in-combination-therapy-for-the-treatment-of-non-paraneoplastic-autoimmune-retinopathy
#18
Arash Maleki, Neerav Lamba, Lina Ma, Stacey Lee, Alexander Schmidt, C Stephen Foster
PURPOSE: To examine the efficacy of rituximab as a monotherapy or in combination therapy for the treatment of patients with non-paraneoplastic autoimmune retinopathy. METHODS: Twelve eyes of six patients with non-paraneoplastic autoimmune retinopathy who were treated with rituximab and had at least 6 months of follow-up were included. Demographic data, clinical data, visual field parameters, electroretinography parameters, and anti-retinal and anti-optic nerve autoantibody bands were collected from the Massachusetts Eye Research and Surgery Institution database between September 2010 and January 2015...
2017: Clinical Ophthalmology
https://www.readbyqxmd.com/read/28253231/baseline-prevalence-of-birth-defects-associated-with-congenital-zika-virus-infection-massachusetts-north-carolina-and-atlanta-georgia-2013-2014
#19
Janet D Cragan, Cara T Mai, Emily E Petersen, Rebecca F Liberman, Nina E Forestieri, Alissa C Stevens, Augustina Delaney, April L Dawson, Sascha R Ellington, Carrie K Shapiro-Mendoza, Julie E Dunn, Cathleen A Higgins, Robert E Meyer, Tonya Williams, Kara N D Polen, Kim Newsome, Megan Reynolds, Jennifer Isenburg, Suzanne M Gilboa, Dana M Meaney-Delman, Cynthia A Moore, Coleen A Boyle, Margaret A Honein
Zika virus infection during pregnancy can cause serious brain abnormalities, but the full range of adverse outcomes is unknown (1). To better understand the impact of birth defects resulting from Zika virus infection, the CDC surveillance case definition established in 2016 for birth defects potentially related to Zika virus infection* (2) was retrospectively applied to population-based birth defects surveillance data collected during 2013-2014 in three areas before the introduction of Zika virus (the pre-Zika years) into the World Health Organization's Region of the Americas (Americas) (3)...
March 3, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28196198/en-face-doppler-optical-coherence-tomography-measurement-of-total-retinal-blood-flow-in-diabetic-retinopathy-and-diabetic-macular-edema
#20
COMPARATIVE STUDY
ByungKun Lee, Eduardo A Novais, Nadia K Waheed, Mehreen Adhi, Talisa E de Carlo, Emily D Cole, Eric M Moult, WooJhon Choi, Mark Lane, Caroline R Baumal, Jay S Duker, James G Fujimoto
Importance: Alterations in ocular blood flow play an important role in the pathogenesis and progression of diabetic retinopathy (DR). However, the measurement of retinal blood flow in clinical studies has been challenging. En face Doppler optical coherence tomography (OCT) provides an effective method for measuring total retinal blood flow (TRBF) in the clinic. Objective: To investigate TRBF in eyes with DR of varying severity, with or without diabetic macular edema (DME), using en face Doppler OCT...
March 1, 2017: JAMA Ophthalmology
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