Socioeconomic Status Drives Racial Disparities in HPV‐negative Head and Neck Cancer Outcomes

xlomafota13 shared this article with you from Inoreader Socioeconomic Status Drives Racial Disparities in HPV‐negative Head and Neck Cancer Outcomes Via The Laryngoscope Objectives/Hypothesis To determine drivers of the racial disparity in stage at diagnosis and overall survival (OS) between black and white patients with HPV‐negative head and neck squamous cell carcinoma (HNSCC). Study Design Retrospective cohort study. Methods Data were examined from of a population‐based HNSCC study in North Carolina. Multivariable logistic regression and Cox proportional hazards models were used to assess racial disparities in stage at diagnosis and OS with sequential adjustment sets. Results A total of 340 black patients and 864 white patients diagnosed with HPV‐negative HNSCC were included. In the unadjusted model, black patients had increased odds of advanced T stage at diagnosis (OR 2.0; 95% CI [1.5–2.5]) and worse OS (HR 1.3, 95% CI 1.1–1.6) compared to white patients. After adjusting for age, sex, tumor site, tobacco use, and alcohol use, the racial disparity persisted for advanced T‐stage at diagnosis (OR 1.7; 95% CI [1.3–2.3]) and showed a non‐significant trend for worse OS (HR 1.1, 95% CI 0.9–1.3). After adding SES to the adjustment set, the association between race and stage at diagnosis was lost (OR: 1.0; 95% CI [0.8–1.5]). Further, black patients had slightly favorable OS compared to white patients (HR 0.8, 95% CI [0.6–1.0]; P = .024). Conclusions SES has an important contribution to the racial disparity in stage at diagnosis and OS for HPV‐negative HNSCC. Low SES can serve as a target for interventions aimed at mitigating the racial disparities in head and neck cancer. Level of Evidence 4 Laryngoscope, 2020 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Digital Otoscopy Videos Versus Composite Images: A Reader Study to Compare the Accuracy of ENT Physicians

xlomafota13 shared this article with you from Inoreader Digital Otoscopy Videos Versus Composite Images: A Reader Study to Compare the Accuracy of ENT Physicians Via The Laryngoscope Objectives/Hypothesis With the increasing emphasis on developing effective telemedicine approaches in Otolaryngology, this study explored whether a single composite image stitched from a digital otoscopy video provides acceptable diagnostic information to make an accurate diagnosis, as compared with that provided by the full video. Study Design Diagnostic survey analysis. Methods Five Ear, Nose, and Throat (ENT) physicians reviewed the same set of 78 digital otoscope eardrum videos from four eardrum conditions: normal, effusion, retraction, and tympanosclerosis, along with the composite images generated by a SelectStitch method that selectively uses video frames with computer‐assisted selection, as well as a Stitch method that incorporates all the video frames. Participants provided a diagnosis for each item along with a rating of diagnostic confidence. Diagnostic accuracy for each pathology of SelectStitch was compared with accuracy when reviewing the entire video clip and when reviewing the Stitch image. Results There were no significant differences in diagnostic accuracy for physicians reviewing SelectStitch images and full video clips, but both provided better diagnostic accuracy than Stitch images. The inter‐reader agreement was moderate. Conclusions Equal to using full video clips, composite images of eardrums generated by SelectStitch provided sufficient information for ENTs to make the correct diagnoses for most pathologies. These findings suggest that use of a composite eardrum image may be sufficient for telemedicine approaches to ear diagnosis, eliminating the need for storage and transmission of large video files, along with future applications for improved documentation in electronic medical record systems, patient/family counseling, and clinical training. Level of Evidence 3 Laryngoscope, 2020 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spontaneous Involution of Juvenile Nasopharyngeal Angiofibromas: Report of a Case

xlomafota13 shared this article with you from Inoreader Spontaneous Involution of Juvenile Nasopharyngeal Angiofibromas: Report of a Case Via The Laryngoscope Juvenile nasopharyngeal angiofibroma (JNA) is a locally aggressive tumor that predominantly affects adolescent males. Surgical resection is generally considered the standard treatment for both primary and recurrent tumors, regardless of staging. The natural history of these tumors, particularly when untreated or in the setting of residual tumor, is not well characterized. In this article, we report a case of true spontaneous JNA involution. Although the involution of residual tumor after surgical resection has previously been reported, to our knowledge, this is the first documented case of spontaneous JNA involution following a period of tumor growth post‐treatment. Laryngoscope, 2020 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Multispecialty Critical Airway Simulation Course for Medical Students

xlomafota13 shared this article with you from Inoreader A Multispecialty Critical Airway Simulation Course for Medical Students Via The Laryngoscope Objectives To develop a novel multispecialty simulation‐based course that teaches both technical and nontechnical skills in the management of adult and pediatric critical airways to graduating medical students and 2) to encourage a collaborative, multispecialty approach to the management of a difficult airway amongst fourth‐year medical students who have enrolled in otolaryngology, anesthesia, and emergency medicine residency programs. Methods Fourth‐year medical student who had matched into otolaryngology, anesthesia, and emergency medicine participated in an intensive half‐day course consisting of a series of hands‐on skills stations with increasing complexity, followed by simulated complex patient scenarios designed for shared management of airway emergencies. Participants completed questionnaires prior to and immediately after the course. Fischer's exact test was utilized to compare data between the precourse and postcourse surveys. Free‐text responses were qualitatively assessed to inform course development. Results Thirty‐four medical students were enrolled (6 otolaryngology, 15 anesthesia, 13 emergency medicine), and 30 students completed both surveys. Fisher's exact test demonstrated improved confidence (P < .05) for every skill. More than 85% of participants strongly agreed or agreed that the intervention was useful in developing their knowledge, technical skills, and self‐confidence and in improving clinical performance prior to residency. Conclusions This critical airway course introduces a multispecialty simulation‐based course designed to impart graduating medical students with the necessary knowledge, skills, and behaviors for critical airway management while fostering interprofessional collaboration. Our course was successful in improving confidence and was perceived as useful in developing knowledge, technical skills, self‐confidence, and clinical performance prior to residency. Level of evidence NA. Laryngoscope, 2020 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Rectal Cancer With Synchronous Tonsillar Metastasis: A Case Report and Literature Review.

xlomafota13 shared this article with you from Inoreader Rectal Cancer With Synchronous Tonsillar Metastasis: A Case Report and Literature Review. Via ear nose throat Related Articles Rectal Cancer With Synchronous Tonsillar Metastasis: A Case Report and Literature Review. Ear Nose Throat J. 2020 Nov 09;:145561320971928 Authors: Huang YJ, Chen CT, Hsieh YW, Wu SH Abstract Colorectal cancer is the third most common cancer globally and nearly one fourth of distant metastases are found at the time of the primary diagnosis. Synchronous metastasis of colorectal cancer to the palatine tonsil is rare. To date, only 5 cases have been published in the English literature. In such cases, the prognosis is worse than in other common metastatic sites. Herein, we report a case of rectal adenocarcinoma who presented with a tonsillar mass initially. PMID: 33167683 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prothrombotic Factors in Obstructive Sleep Apnea: A Systematic Review With Meta-Analysis.

xlomafota13 shared this article with you from Inoreader Prothrombotic Factors in Obstructive Sleep Apnea: A Systematic Review With Meta-Analysis. Via ear nose throat Related Articles Prothrombotic Factors in Obstructive Sleep Apnea: A Systematic Review With Meta-Analysis. Ear Nose Throat J. 2020 Nov 09;:145561320965208 Authors: Qiu Y, Li X, Zhang X, Wang W, Chen J, Liu Y, Fang X, Ni X, Zhang J, Wang S, Tai J Abstract BACKGROUND: Previous studies revealed that the prothrombotic factors in patients with obstructive sleep apnea (OSA) remain controversial. AIM/OBJECTIVE: The aim of the systematic review is to elucidate the relationship between prothrombotic factors and OSA. MATERIALS AND METHODS: This systematic review was performed under the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The literature we investigated was extracted from 4 main medical databases (PubMed, Web of Science, Cochrane Library, and Chinese databases) as of February 2020. We used significant weighted mean differences (SMDs) with 95% CIs from random-effects model. RESULTS: A total of 15 studies comprising 2190 patients were available for the meta-analysis. The pooled results showed that the levels of fibrinogen (SMD = 0.95, 95% CI = 0.26 to 1.65, P = .000), vascular endothelial growth factor (SMD = 0.37, 95% CI = -0.90 to 1.63, P = .000), and plasminogen activator inhibitor 1 (SMD = 0.61, 95% CI = 0.29 to 0.92, P = .040) increased in patients with OSA. There were no statistical differences between groups in terms of d-dimer (P = .108) and platelet counts (P = .233). Subgroup analyses demonstrated that specimen types and age could account for the heterogeneity. CONCLUSIONS AND SIGNIFICANCE: This meta-analysis indicated the relationship between prothrombotic factors in OSA hypopnea. Obstructive sleep apnea-related effects may underline the importance of considering the dysfunction of the hemostatic system. The prothrombotic factors in OSA can influence making a choice of appropriate therapy. PMID: 33167693 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intraoperative Applications of Topical Corticosteroid Therapy for Chronic Rhinosinusitis.

xlomafota13 shared this article with you from Inoreader Intraoperative Applications of Topical Corticosteroid Therapy for Chronic Rhinosinusitis. Via ear nose throat Related Articles Intraoperative Applications of Topical Corticosteroid Therapy for Chronic Rhinosinusitis. Ear Nose Throat J. 2020 Nov 10;:145561320970100 Authors: Lelegren MJ, Bloch RA, Lam KK Abstract OBJECTIVES: To provide an overview of recent techniques and technologies for the application of topical corticosteroid therapy immediately following endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). METHODS: A comprehensive search in the PubMed and Google Scholar databases was conducted to identify publications between January 2000 and December 2019 detailing clinical trials that have evaluated the efficacy and safety of intraoperative applications of topical corticosteroids for CRS. RESULTS: A total of 21 articles, all of which highlight a variety of corticosteroid-infused products, including Propel corticosteroid-eluting stents, NasoPore, Merocel, SinuBand, calcium alginate, and bioresorbable gel-type products, are included for review. Propel stents are the only devices that have achieved level 1A evidence in terms of efficacy and have data to support their safety. The remaining products have shown mixed results in terms of efficacy and safety. CONCLUSION: A wide range of techniques and technologies have been introduced to enhance the topical delivery of corticosteroids into the neosinuses after ESS for CRS. Regarding efficacy, there is level 1A evidence to support the use of Propel stents. Most of the remaining strategies show some degree of efficacy. Direct comparisons across the different strategies are limited owing to the varied uses of delivery vectors, corticosteroid choices, and doses of corticosteroids. Propel stents and SinuBand have sufficient data to support systemic and ocular safety, whereas the remaining products have limited data to support their safety. PMID: 33170026 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.