Role of depressive symptoms in patient satisfaction with visual quality after laser in situ keratomileusis.

PURPOSE: To assess the role of depressive symptoms in patient satisfaction with visual quality after laser in situ keratomileusis (LASIK). SETTING: Navy Refractive Surgery Center, Ophthalmology Department, Naval Medical Center, San Diego, California, USA. METHODS: This was a prospective study of active-duty military patients having bilateral conventional LASIK to treat low to moderate myopia with or without astigmatism. Patients completed the Armstrong Laboratory Personality Survey Depression scale preoperatively. Patients were also given a 10-point Navy questionnaire that included an assessment of patient satisfaction with visual quality at the 1- and 6-month follow-up examinations. Patients were stratified by their visual quality rating after LASIK as highly satisfied, satisfied, and less satisfied and by their depression scale score into low, medium, and high groups. A proportional odds model was developed to compare the visual quality rating between the 3 depression groups 1 and 6 months post LASIK. RESULTS: The study comprised 370 patients. An uncorrected visual acuity of at least 20/20 was achieved in 88.6% of eyes. Patients with higher levels of depressive symptoms had 3.0 times higher odds (95% confidence interval [CI], 1.2 to 7.4) of being less satisfied than those with low levels of depressive symptoms 1 month after LASIK (P

Post-traumatic stress disorder and depression in health care providers returning from deployment to Iraq and Afghanistan.

OBJECTIVE: This study examines risk factors for post-traumatic stress disorder (PTSD), depression, and mental health care use among health care workers deployed to combat settings. METHODS: Anonymous surveys were administered to previously deployed workers at a military hospital. PTSD and depression were assessed by using the PTSD Checklist and the Patient Health Questionnaire depression scale, respectively. Deployment exposures and perceived threats during deployment were also assessed. RESULTS: There were 102 respondents (36% response rate). Nine percent (n=9) met the criteria for PTSD and 5% (n=5) met the criteria for depression. Direct and perceived threats of personal harm were risk factors for PTSD; exposure to wounded or dead patients did not increase risk. Those who met the criteria for PTSD were more likely to seek mental health care after but not before their deployment. CONCLUSIONS: For health care workers returning from a warfare environment, threat of personal harm may be the most predictive factor in determining those with subsequent PTSD.

Use of the finite element method to assess impact of current on forearm and wrist during an electrical accident.

Using geometric primitives, a three dimensional finite element model has been developed to assess the pathway followed by electric current during an electrical accident assuming the entry point for the current was on one hand. Results indicate that the area where the risk of soft tissue injury is greatest is in the wrist region. Current entry on the palm or finger fronts was found to be more likely to yield injury to the median nerve than an entry point on the back of the hand. The lesser injury is theorized to result because of current shielding of the nerve by bone.

Diffuse electrical injury: comparison of physical and neuropsychological symptom presentation in males and females.

OBJECTIVE: Electrical injuries can produce physical, neurological, and neuropsychological sequelae that exist even in the total absence of a theoretical current path that includes the brain. Diffuse electrical injury (DEI) is a rarely occurring class of electrical injury (EI) that can occur even after low-voltage contact. The objective of the study was to compare the occurrence rate of symptoms reported retrospectively by a female DEI group with a male DEI group. METHODS: A Web-based interactive survey was completed by survivors of low-voltage injuries (<1000 V) regarding symptoms present six months or more following electrical shock. Chi square analysis of the occurrence of 65 symptoms was performed. RESULTS: The only significant differences were that unexplained moodiness, dizziness, and short-term memory loss were reported more often by the male group, and the diagnosis of chronic pain was more common in the female group. For the majority of symptoms, no significant difference between the two groups was revealed. CONCLUSIONS: Results suggest that DEI may present with certain differences in men compared with women. The results also confirm previous reports that patients may present with broad symptomatology after low-voltage contact.