Test-Retest Reliability of Audiometric Assessment in Individuals With Mild Dementia

xlomafota13 shared this article with you from Inoreader Test-Retest Reliability of Audiometric Assessment in Individuals With Mild Dementia Via JAMA Otolaryngology–Head & Neck Surgery Current Issue This cross-sectional study obtains quantitative measures of reliability to evaluate the degree to which audiologic testing can be accurately conducted for older adults with mild dementia. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Early vs Late Tracheotomy for Pneumonia and Ventilator Days

xlomafota13 shared this article with you from Inoreader Early vs Late Tracheotomy for Pneumonia and Ventilator Days Via JAMA Otolaryngology–Head & Neck Surgery Current Issue This meta-analysis compares clinical outcomes of early vs late tracheotomy among patients undergoing ventilator support for critical illness. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Mysterious Odor After Nose Blowing

xlomafota13 shared this article with you from Inoreader A Mysterious Odor After Nose Blowing Via JAMA Otolaryngology–Head & Neck Surgery Current Issue A 15-year-old male patient presented with several years o f bilateral congestion and hyposmia; medical history and nasal endoscopy findings were unremarkable, but a foul smell emanated when blowing his nose. What is your diagnosis? View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Laryngeal and Tracheal Pressure Injuries in Patients With COVID-19

xlomafota13 shared this article with you from Inoreader Laryngeal and Tracheal Pressure Injuries in Patients With COVID-19 Via JAMA Otolaryngology–Head & Neck Surgery Current Issue To the Editor The important study by Fiacchini and colleagues of laryngotracheal complications in ventilated patients with coronavirus disease 2019 (COVID-19) reported a staggering 47% incidence of full-thickness tracheal erosion (FTTE) and tracheoesophageal fistulae (TEF). These findings raise critical questions about ensuring safe, high-quality care for intubated patients. Although intense research has focused on the molecular basis of COVID-19, pathogenesis of pneumonitis, and novel therapeutics; far less work has addressed the prevalence and pathogenesis of iatrogenic injury—particularly with respect to airway device-related pressure injuries. Injury at the level of the tracheal cuff likely accounts for the preponderance of FTTE and TEF reported, and tissue injury may occur at any site where there is contact between a device and the aerodigestive tract. Risk is highest in patients with overzealous cuff inflation, high-dose steroids, prone ventilation, prolonged intubation, feeding tubes, or impaired wound healing from diabetes or radiation—a perfect storm for patients with COVID-19. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Considerations for Integrating Cognitive Testing Into Adult Cochlear Implant Evaluations

xlomafota13 shared this article with you from Inoreader Considerations for Integrating Cognitive Testing Into Adult Cochlear Implant Evaluations Via JAMA Otolaryngology–Head & Neck Surgery Current Issue This Viewpoint proposes integrating cognitive testing with adult cochlear implant evaluations and discusses anticipated challenges. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association Between Habitual Snoring and Cognitive Performance in Preadolescent Children

xlomafota13 shared this article with you from Inoreader Association Between Habitual Snoring and Cognitive Performance in Preadolescent Children Via JAMA Otolaryngology–Head & Neck Surgery Current Issue This cross-sectional study uses a baseline data set from the ongoing Adolescent Brain and Cognitive Development study to examine the extent to which potential confounding factors modify the association between parent-reported habitual snoring and cognitive outcomes among preadolescent children. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Outpatient Parotidectomy, a Safety and Financial Review

xlomafota13 shared this article with you from Inoreader Outpatient Parotidectomy, a Safety and Financial Review Via otol rhinol Ann Otol Rhinol Laryngol. 2021 May 12:34894211016714. doi: 10.1177/00034894211016714. Online ahead of print. ABSTRACT OBJECTIVE: The objective of this study is to investigate the safety, efficacy, and potential cost-savings of the outpatient parotidectomy procedure. METHODS: This is a retrospective chart review of all patients who underwent a parotidectomy at a large academic center from 2015 through 2019 including demographic data, postoperative complications, drain p lacement, readmission, and financial cost. A comparison was performed between patients who underwent an outpatient vs inpatient parotidectomy. RESULTS: A total of 335 patients underwent parotidectomy (136 outpatient; 199 inpatient). Comparison of patient demographics, common comorbidities, tumor size, tumor type, postoperative complications, and readmission rate was similar between the inpatient and outpatient cohorts. The overall mean cost difference between inpatient parotidectomy and outpatient parotidectomy for all years was $1528.58 (95%CI: $1139-$1916). CONCLUSION: The outpatient parotidectomy procedure has a comparable safety profile to the inpatient procedure while providing a significant cost-savings benefit. PMID:33980056 | DOI:10.1177/00034894211016714 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Peritonsillar Abscess Size as a Predictor of Medical Therapy Success

xlomafota13 shared this article with you from Inoreader Peritonsillar Abscess Size as a Predictor of Medical Therapy Success Via otol rhinol Ann Otol Rhinol Laryngol. 2021 May 12:34894211015590. doi: 10.1177/00034894211015590. Online ahead of print. ABSTRACT OBJECTIVE: To evaluate the success of sole medical therapy (MT) versus surgical therapy (ST) in patients with both clinically and radiographically confirmed peritonsillar abscess (PTA). To also determine treatment safety based on abscess size, and identify predictors of treatment failure. METHODS: This was a retrospective cohort of 3 hospitals in a sing le academic health system. A total of 214 immunocompetent patients diagnosed with uncomplicated PTA underwent a contrasted CT scan of the neck. About 87 patients were treated with sole MT (intravenous antibiotics and steroids), and 127 patients were treated with ST (MT plus drainage). RESULTS: Treatment failure occurred in 8.0% of the MT group and 7.9% of the ST group (P = 1.00). In PTAs <2 cm, treatment failure occurred in 5.3% of the MT group and 5.0% of the ST group (P = 1.00). In PTAs ≥2 cm, treatment failure occurred in 13.3% of the MT group and 9.0% treated with ST (P = .53). Size ≥2 cm (OR - 3.46, P = .08) and IV clindamycin as sole IV antibiotic (OR - 2.46, P = .15) trended toward predicting treatment failure. In addition to those considered failures, 7.0% of the ST group returned to the ED with pain versus 0% of the MT group (P = .01). CONCLUSION: Frequency of treatment failure was not significantly different amon g patients receiving MT and ST. Abscesses ≥2 cm in size were more likely to fail in both groups and ST was not statistically superior. Sole MT for uncomplicated PTA may help reduce unnecessary procedures and healthcare costs. PMID:33980073 | DOI:10.1177/00034894211015590 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

How to identify indolent thyroid tumors unlikely to recur and cause cancer death immediately after surgery-Risk stratification of papillary thyroid carcinoma in young patients

xlomafota13 shared this article with you from Inoreader How to identify indolent thyroid tumors unlikely to recur and cause cancer death immediately after surgery-Risk stratification of papillary thyroid carcinoma in young patients Via radioactive iodine Endocr J. 2021 May 11. doi: 10.1507/endocrj.EJ21-0018. Online ahead of print. ABSTRACT Current histopathological diagnosis methods cannot distinguish the two types of thyroid carcinoma: clinically significant carcinomas with a potential risk of recurrence, metastasis, and cancer death, and clinically insignificant carcinomas with a slow growth rate. Both thyroid tumors are diagnosed as "carcinoma" in current pathology practice. The clinician usually recommends surgery to the patien t and the patient often accepts it because of cancer terminology. The treatment for these clinically insignificant carcinomas does not benefit the patient and negatively impacts society. The author proposed risk stratification of thyroid tumors using the growth rate (Ki-67 labeling index), which accurately differentiates four prognostically relevant risk groups based on the Ki-67 labeling index, ≥30%, ≥10 and <30%, >5 and <10%, and ≤5%. Indolent thyroid tumors with an excellent prognosis have the following four features: young age, early-stage (T1-2 M0), curatively treated, and low proliferation index (Ki-67 labeling index of ≤5%), and are unlikely to recur, metastasize, or cause cancer death. Accurate identification of these indolent tumors helps clinicians select more conservative treatments to avoid unnecessary aggressive (total thyroidectomy followed by radio-active iodine) treatments. Clinicians can alleviate the fears of patients by confirming these four featu res, including the low proliferation rate, in a pathology report immediately after surgery when patients are most concerned. PMID:33980775 | DOI:10.1507/endocrj.EJ21-0018 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Risk and outcome of subsequent malignancies after radioactive iodine treatment in differentiated thyroid cancer patients

xlomafota13 shared this article with you from Inoreader Risk and outcome of subsequent malignancies after radioactive iodine treatment in differentiated thyroid cancer patients Via radioactive iodine BMC Cancer. 2021 May 13;21(1):543. doi: 10.1186/s12885-021-08292-8. ABSTRACT BACKGROUND: We identified differentiated thyroid cancer (DTC) survivors from SEER registries and performed Poisson regression to calculate the relative risks (RRs) of subsequent malignancies (SMs) by different sites associated with radioactive iodine (RAI) treatment, and the attributable risk proportion of RAI for developing different SMs. RESULTS: We identified 4628 of 104,026 DTC patients developin g a SM after two years of their DTC diagnosis, with a medium follow-up time of 113 months. The adjusted RRs of developing SM associated with RAI varied from 0.98 (0.58-1.65) for neurologic SMs to 1.37 (1.13-1.66) for hematologic SMs. The RRs of developing all cancer combined SMs generally increased with age at DTC diagnosis and decreased with the latency time. We estimated that the attributable risk proportion of RAI treatment is only 0.9% for all cancer combined SMs and 20% for hematologic SMs, which is the highest among all SMs. The tumor features and mortalities in patients treated with and without RAI are generally comparable. CONCLUSION: With the large population based analyses, we concluded that a low percentage of DTC survivors would develop SMs during their follow-up. Although the adjusted RR of SMs development increased slightly in patients receiving RAI, the attributable risk proportion associated with RAI was low, suggesting the absolute number of SMs induced by RAI in DTC survivors would be low. The attributable risk proportion of RAI treatment is the highest in hematological SMs, but when in consideration of its low incidence among all DTC survivors, the absolute number of hematological SMs was low. PMID:33980182 | DOI:10.1186/s12885-021-08292-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reduction in Pediatric Ambulatory Adenotonsillectomy Length of Stay Using Clinical Care Guidelines

xlomafota13 shared this article with you from Inoreader Reduction in Pediatric Ambulatory Adenotonsillectomy Length of Stay Using Clinical Care Guidelines Via The Laryngoscope Objective Standardization of postoperative care using clinical care guidelines (CCG) improves quality by minimizing unwarranted variation. It is unknown whether CCGs impact patient throughput in outpatient adenotonsillectomy (T&A). We hypothesize that CCG implementation is associated with decreased postoperative length of stay (LOS) in outpatient T&A. Methods A multidisciplinary team was assembled to design and implement a T&A CCG. Standardized discharge criteria were established, including goal fluid intake and parental demonstration of medication administration. An order set was created that included a hard stop for discharge timeframe with choices "meets criteria," "4‐hour observation," and "overnight stay." Consensus was achieved in June 2018, and the CCG was implemented in October 2018. Postoperative LOS for patients discharged the same day was tracked using control chart analysis with standard definitions for centerline shift being utilized. Trends in discharge timeframe selection were also followed. Results Between July 2015 and August 2017, the average LOS was 4.82 hours. This decreased to 4.39 hours in September 2017 despite no known interventions and remained stable for 17 months. After CCG implementation, an initial trend toward increased LOS was followed by centerline shifts to 3.83 and 3.53 hours in March and October 2019, respectively. Selection of the "meets criteria" discharge timeframe increased over time after CCG implementation (R2 = 0.38 P = .003). Conclusions Implementation of a CCG with standardized discharge criteria was associated with shortened postoperative LOS in outpatient T&A. Concurrently, surgeons shifted practice to discharge patients upon meeting criteria rather than after a designated timeframe. Level of Evidence NA Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.