BILATERAL SERPIGINOUS-LIKE CHORIORETINITIS ASSOCIATED WITH CILIOCHOROIDAL MELANOMA: A Clinicopathologic Correlation.

Purpose: To report the clinicopathologic correlation of a case of bilateral serpiginous-like chorioretinitis (SLC) associated with unilateral ciliochoroidal melanoma.

Methods: A 71-year-old white woman was diagnosed with progressive SLC in both eyes associated with ciliochoroidal melanoma in the right eye. Clinical findings and imaging before and after enucleation in the right eye were correlated to histologic and immunohistochemistry sections.

Kidney Transplantation in Times of Covid-19: Decision Analysis in the Canadian Context.

Background: The coronavirus disease 2019 (COVID-19) pandemic impacted transplant programs across Canada.

Objective: We evaluated the implications of delays in transplantation among Canadian end-stage kidney disease (ESKD) patients to allow pretransplant vaccination.

Design: We used a Markov microsimulation model and ESKD patient perspective to study the effectiveness (quality-adjusted life years [QALY]) of living (LD) or deceased donor (DD) kidney transplantation followed by 2-dose SARS-CoV-2 vaccine versus delay in LD ("Delay LD") or refusal of DD offer ("Delay DD") to receive 2-dose SARS-CoV-2 vaccine pretransplant.

Clinical Practice Guideline for Solid Organ Donation and Transplantation During the COVID-19 Pandemic.

Unlabelled: The coronavirus 2019 (COVID-19) pandemic has disrupted health systems worldwide, including solid organ donation and transplantation programs. Guidance on how best to screen patients who are potential organ donors to minimize the risks of COVID-19 as well as how best to manage immunosuppression and reduce the risk of COVID-19 and manage infection in solid organ transplant recipients (SOTr) is needed.

Methods: Iterative literature searches were conducted, the last being January 2021, by a team of 3 information specialists.

Comparison of Patient Experience between a Practice for Homeless Patients and Other Practices Engaged in a Patient-Centered Medical Home Initiative.

Despite its increasing popularity, little is known about the patient-centered medical home (PCMH) model in primary care settings serving homeless populations. Our objective was to understand how patient experience differs between a PCMH demonstration practice designed for homeless people in Massachusetts and other practices participating in the same statewide initiative. The study population included 194 homeless patients and 1,868 patients from comparison practices.

Home infusion: Safe, clinically effective, patient preferred, and cost saving.

Background: As the U.S. healthcare payment system shifts from volume to value, identifying care approaches that improve outcomes while lowering costs are essential.

Impact of CVS Pharmacy's Discontinuance of Tobacco Sales on Cigarette Purchasing (2012-2014).

Objectives: To assess the impact of CVS Health's discontinuation of tobacco sales on cigarette purchasing.

Methods: We used households' purchasing data to assess rates at which households stopped cigarette purchasing for at least 6 months during September 2014 to August 2015 among 3 baseline groups: CVS-exclusive cigarette purchasers, CVS+ (CVS and other retailers), and other-exclusive (only non-CVS retailers). In state-level analyses using retailers' point-of-sale purchase data, an interrupted time series compared cigarette purchasing before (January 2012 to August 2014) and after (September 2014 to April 2015) tobacco removal in 13 intervention states with CVS market share of at least 15% versus 3 control states with no CVS stores.

Structure and Function of the Nuclear Pore Complex Cytoplasmic mRNA Export Platform.

The last steps in mRNA export and remodeling are performed by the Nup82 complex, a large conserved assembly at the cytoplasmic face of the nuclear pore complex (NPC). By integrating diverse structural data, we have determined the molecular architecture of the native Nup82 complex at subnanometer precision. The complex consists of two compositionally identical multiprotein subunits that adopt different configurations.

An Insurer's Care Transition Program Emphasizes Medication Reconciliation, Reduces Readmissions And Costs.

Adverse drug events and the challenges of clarifying and adhering to complex medication regimens are central drivers of hospital readmissions. Medication reconciliation programs can reduce the incidence of adverse drug events after discharge, but evidence regarding the impact of medication reconciliation on readmission rates and health care costs is less clear. We studied an insurer-initiated care transition program based on medication reconciliation delivered by pharmacists via home visits and telephone and explored its effects on high-risk patients.

Use of Pediatric Health Information System database to study the trends in the incidence, management, etiology, and outcomes due to pediatric acute liver failure in the United States from 2008 to 2013.

Data were collected of children admitted with ALF to 16 US pediatric liver transplant centers from 2008 to 2013 using the PHIS for a retrospective analysis of PALF trends. Patient data linked to the principal diagnosis code for acute necrosis of the liver (570.00) were analyzed for the following: demographics, regional differences, changes over time, pharmaceutical trends, procedural trends, associated diagnoses, and patient outcomes.

Hiring your next partner: AOA critical issues.

Hiring a new partner into an orthopaedic department or group can be a daunting task. A recent American Orthopedic Association symposium sought to address three major aspects of hiring that affect orthopaedic leaders: (1) when to hire-the chairperson's role; (2) generational issues that affect hiring; and (3) the development of an initial compensation package.How does the chairperson recruit new physicians? Hiring a new partner into the academic setting requires a good deal of foresight.

Influence of societal and practice contexts on health professionals' clinical reasoning: a scoping study protocol.

Introduction: In a context of constrained resources, the efficacy of interventions is a pivotal aim of healthcare systems worldwide. Efficacy of healthcare interventions is highly compromised if clinical reasoning (CR), the process that practitioners use to plan, direct, perform and reflect on client care, is not optimal. The CR process of health professionals is influenced by the institutional dimension (ie, legal, regulatory, administrative and organisational aspects) of their societal and practice contexts.

Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010.

Background: Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disability weights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensive debate about a range of conceptual and methodological issues concerning the definition and measurement of these weights. Our primary objective was a comprehensive re-estimation of disability weights for the Global Burden of Disease Study 2010 through a large-scale empirical investigation in which judgments about health losses associated with many causes of disease and injury were elicited from the general public in diverse communities through a new, standardised approach.

The Vermont diabetes information system: a cluster randomized trial of a population based decision support system.

Background: Optimal care for patients with diabetes is difficult to achieve in clinical practice.

Objective: To evaluate the impact of a registry and decision support system on processes of care, and physiologic control.

Participants: Randomized trial with clustering at the practice level, involving 7,412 adults with diabetes in 64 primary care practices in the Northeast.

Occurrence and prognosis of nonpenetrating injuries in eyes with Verisyse iris-supported phakic intraocular lens.

We report 8 cases of blunt trauma in patients with a Verisyse phakic intraocular lens (pIOL) (AMO). Two cases resulted in dislocation of the pIOL that required repositioning; the other 6 were managed conservatively. In all cases, the outcomes were satisfactory, with no further complications.

Accurate intraocular lens power calculation after myopic laser in situ keratomileusis, bypassing corneal power.

Purpose: To describe a novel method for calculating intraocular lens (IOL) power after myopic laser in situ keratomileusis (LASIK) without using the inaccuracies of the post-LASIK corneal power.

Setting: Department of Ophthalmology, Wake Forest University Eye Center, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA.

Methods: This retrospective chart review comprised 9 eyes of 9 patients who had phacoemulsification after LASIK using our method for IOL calculation.

Diabetes decision support: initial experience with the Vermont diabetes information system.

Interventions that have proven effective in the management of chronic illness have often been difficult to establish in widespread practice. The Chronic Care Model provides a framework for implementing interventions, but it is expensive and difficult to implement. We developed a decision support system based on this model to improve the care of adults who have diabetes and receive primary care in Vermont or adjacent New York.

Comparison of provincial and territorial legislation governing substitute consent for research.

In Canada, provincial and territorial laws address circumstances in which a substitute decision-maker may be appointed for an adult deemed legally incapable of making decisions in one or more areas of life. We searched for provincial and territorial laws that explicitly address substitute decision-making about research participation, and found significant differences among Canadian jurisdictions. In some provinces and territories there is no direct statutory guidance on the issue.

A case of acanthamoeba keratitis as a result of a cosmetic contact lens.

Purpose: To describe a case of Acanthamoeba keratitis that resulted from a cosmetic contact lens purchased from an unlicensed vendor.

Methods: Case report.

Results: A 26-year-old man developed Acanthamoeba keratitis from a cosmetic contact lens and ultimately required a penetrating keratoplasty.

The Vermont Diabetes Information System (VDIS): study design and subject recruitment for a cluster randomized trial of a decision support system in a regional sample of primary care practices.

Background: Despite evidence that optimal care for diabetes can result in reduced complications and improved economic outcomes, such care is often not achieved. The Vermont Diabetes Information System (VDIS) is a registry-based decision support and reminder system based on the Chronic Care Model and targeted to primary care physicians and their patients with diabetes.

Purpose: To develop and evaluate a regional decision support system for patients with diabetes.

Ocular surface injury from a microwave superheated egg resulting in a pseudopterygium.

Purpose: To describe the first case of ocular surface injury resulting in a pseudopterygium from a microwave superheated egg.

Methods: Case report.

Results: A 12-year-old girl sustained an ocular surface injury resulting in a pseudopterygium from a microwave superheated egg.

Delayed enophthalmos following a minimally displaced orbital floor fracture.

We describe a case of an orbital floor fracture resulting in obstruction of the maxillary sinus ostium by herniated orbital contents. Our patient had delayed enophthalmos in a manner similar to silent sinus syndrome or imploding antrum syndrome. Obstruction of the maxillary sinus ostium by orbital contents carries the potential for delayed-onset enophthalmos and therefore suggests an additional indication for orbital floor fracture repair.

Ocular surface injury from a microwave superheated liquid.

Purpose: To describe the ocular surface injury resulting from a microwave superheated liquid.

Methods: Case report.

Results: A 40-year-old man sustained an ocular surface injury from a microwave superheated liquid.

Endoscopic transethmoidal decompression of a thrombosed orbital venous malformation.

We describe the case of a 37-year-old woman who experienced a painful thrombosis of an orbital venous malformation. We successfully treated her with surgical decompression via a computer-assisted, endoscopic transethmoidal orbitotomy. Removal of the lamina papyracea and evacuation of the thrombus provided immediate symptomatic relief.