The Expanding Role of Designated Institutional Officials in Graduate Medical Education.

The Accreditation Council for Graduate Medical Education (ACGME) plays a pivotal role in ensuring the quality of graduate medical education (GME) training across the United States. Central to the success of this mission are designated institutional officials (DIOs), who usually serve as chief GME officers within the ACGME-accredited sponsoring institutions (SIs). Despite the critical role of DIOs, the qualifications, level of administrative support, and responsibilities of DIOs are not defined and vary significantly among SIs.

Choroidal melanoma diagnosed by aspiration cytology: A case report with cyto-histologic correlation and review of the literature.

Histologic and cytologic features of uveal melanomas have been well characterized; however, cytologic-histologic correlation has rarely been described in detail in the literature. A 50-year old female presented at our institution with an intraocular mass which was diagnosed as choroidal melanoma by aspiration cytology. The patient subsequently proceeded to enucleation, confirming the diagnosis.

Successful management of epithelial ingrowth after sequential intracameral 5-fluorouracil and Descemet-stripping automated endothelial keratoplasty.

To describe the successful treatment of epithelial ingrowth using combined surgical excision with intracameral adjuvant 5-fluorouracil (5-FU) followed by Descemet-stripping automated endothelial keratoplasty (DSAEK). A 71-year-old man presented with epithelial ingrowth after clear corneal phacoemulsification. He underwent surgical excision of the membrane together with pars plana vitrectomy, air fluid exchange, and intracameral 5-FU.

Histopathological analysis of retinopathy of prematurity after intravitreal bevacizumab.

We report the case of a premature infant with end-organ failure who developed high-risk retinopathy of prematurity (ROP) bilaterally and was treated with intravitreal bevacizumab (IVB) injection therapy with regression noted on follow-up clinical examination. The infant died 3 weeks after IVB injection therapy. Histopathological analysis was conducted on bilateral globes and revealed persistent preretinal vessels.

Parsing the Behavioral and Brain Mechanisms of Third-Party Punishment.

Unlabelled: The evolved capacity for third-party punishment is considered crucial to the emergence and maintenance of elaborate human social organization and is central to the modern provision of fairness and justice within society. Although it is well established that the mental state of the offender and the severity of the harm he caused are the two primary predictors of punishment decisions, the precise cognitive and brain mechanisms by which these distinct components are evaluated and integrated into a punishment decision are poorly understood. Using fMRI, here we implement a novel experimental design to functionally dissociate the mechanisms underlying evaluation, integration, and decision that were conflated in previous studies of third-party punishment.

Implementation of competency-based medical education: are we addressing the concerns and challenges?

Context: Competency-based medical education (CBME) has emerged as a core strategy to educate and assess the next generation of physicians. Advantages of CBME include: a focus on outcomes and learner achievement; requirements for multifaceted assessment that embraces formative and summative approaches; support of a flexible, time-independent trajectory through the curriculum; and increased accountability to stakeholders with a shared set of expectations and a common language for education, assessment and regulation.

Objectives: Despite the advantages of CBME, numerous concerns and challenges to the implementation of CBME frameworks have been described, including: increased administrative requirements; the need for faculty development; the lack of models for flexible curricula, and inconsistencies in terms and definitions.

Nonimmunologic graft failure after Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) for presumed amantadine-induced corneal edema.

Context: With one exception, a case report of amantadine-induced corneal toxicity has described reversible corneal edema.

Objective: To report a patient with unrecognized amantadine-induced corneal edema.

Design: Patient with schizophrenia and tardive dyskinesia developed bilateral corneal edema while receiving chronic amantadine hydrochloride.

Retinal hemorrhages in children following fatal motor vehicle crashes: a case series.

Objective: To demonstrate the severity of ocular findings in young children who died of injuries due to motor vehicle crashes.

Methods: Case series of 10 children younger than 3 years who were fatally injured in motor vehicle crashes between January 1, 1994, and December 31, 2002. All children underwent autopsy that included eye examination.

Guidelines for postmortem protocol for ocular investigation of sudden unexplained infant death and suspected physical child abuse.

Postmortem examination is a cornerstone in identifying the cause of unexplained sudden death in children. Even in cases of suspected or known abuse, an autopsy may help characterize the nature of the abuse, which is particularly important in the forensic autopsy of children in the first 3 to 4 years of life when inflicted neurotrauma is most common. Forensic examinations are vital in cases that might otherwise be diagnosed as sudden infant death syndrome.

Massive extraocular extension and parotid lymph node metastasis of uveal melanoma.

A 22-year-old man, diagnosed with unilateral glaucoma and treated with trabeculectomy 6 years earlier, presented with an epibulbar nodule of 6 months' duration. MRI displayed intra- and extraocular tumor, and gross invasion of the medial rectus muscle. Biopsy demonstrated uveal melanoma, and staging revealed enhancing ipsilateral parotid lymph nodes.

Staphylococcus hominis endophthalmitis associated with a capsular hypopyon.

Purpose: To report a case of Staphylococcus hominis endophthalmitis associated with a capsular hypopyon.

Design: Interventional case report.

Methods: A 51-year-old man presented with chronic postcataract extraction inflammation and underwent vitrectomy, partial capsulectomy, and intravitreal antibiotic injections, followed by explantation of the intraocular lens and capsule.