Τετάρτη 12 Μαΐου 2021

Personalized radioiodine therapy for thyroid cancer patients with known disease

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Fac Rev. 2021 Apr 7;10:36. doi: 10.12703/r/10-36. eCollection 2021.

ABSTRACT

Radioactive iodine (RAI) 131I is a targeted therapy for patients with RAI-avid follicular cell-derived thyroid cancer. However, the responsiveness to 131I therapy varies among thyroid cancer patients mainly owing to differential RAI uptake and RAI radiosensitivity among patients' lesions. A personalized approach to maximize 131I therapeutic efficacy is proposed based on rec ent scientific advances and future opportunities.

PMID:33977289 | PMC:PMC8103907 | DOI:10.12703/r/10-36

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Does Prematurity Play a Role in Newborn Microtia-Anotia?

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Ann Otol Rhinol Laryngol. 2021 May 12:34894211015735. doi: 10.1177/00034894211015735. Online ahead of print.

ABSTRACT

OBJECTIVE: Microtia-anotia (MA) describes a range of external ear anomalies which is commonly associated with various syndromes and malformations of the head and neck. Previous studies have suggested a strong association between MA and male sex, maternal diabetes, and Hispanic race/ethnicity. This study seeks to evaluate the associations between MA and preter m newborns in the United States.

METHODS: Population-based inpatient registry analysis was conducted. Kids' Inpatient Database (2016) was used to identify weighted in-hospital births with diagnosis of prematurity or MA. Demographic information was obtained, and odds ratios (ORs) were used to determine associations between prematurity and MA.

RESULTS: Among patients included in our dataset, 8.655% (326 285) were preterm and 0.016% (523) had MA. 0.003% (109) of patients were preterm and had MA. Preterm infants had 2.19 times the odds (95% C.I. = 1.78-2.69) of having MA when compared to the full-term population. The binary logistic regression model accounting for possible confounding variables produced an aOR of 1.48 (95% C.I. = 1.17-1.87) for the association between prematurity and MA.

CONCLUSION: Infants who are born preterm are more likely to have MA than full term infants. The current results will allow for improved risk stratification, maternal counseling, and in terventions in the case of prematurity.

PMID:33978496 | DOI:10.1177/00034894211015735

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Impact of Patient Socioeconomic Disparities on Time to Tympanostomy Tube Placement

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Ann Otol Rhinol Laryngol. 2021 May 12:34894211015741. doi: 10.1177/00034894211015741. Online ahead of print.

ABSTRACT

OBJECTIVES: Extensive literature exists documenting disparities in access to healthcare for patients with lower socioeconomic status (SES). The objective of this study was to examine access disparities and differences in surgical wait times in children with the most common pediatric otolaryngologic surgery, tympanostomy tubes (TT).

METHODS: A retrospect ive cohort study was performed at a tertiary children's hospital. Children ages <18 years who received a first set of tympanostomy tubes during 2015 were studied. Patient demographics and markers of SES including zip code, health insurance type, and appointment no-shows were recorded. Clinical measures included risk factors, symptoms, and age at presentation and first TT.

RESULTS: A total of 969 patients were included. Average age at surgery was 2.11 years. Almost 90% were white and 67.5% had private insurance. Patients with public insurance, ≥1 no-show appointment, and who lived in zip codes with the median income below the United States median had a longer period from otologic consult and preoperative clinic to TT, but no differences were seen in race. Those with public insurance had their surgery at an older age than those with private insurance (P < .001) and were more likely to have chronic otitis media with effusion as their indication for surgery (OR: 1.8 , 95% CI: 1.2-2.5, P = .003).

CONCLUSIONS: Lower SES is associated with chronic otitis media with effusion and a longer wait time from otologic consult and preoperative clinic to TT placement. By being transparent in socioeconomic disparities, we can begin to expose systemic problems and move forward with interventions.

LEVEL OF EVIDENCE: 4.

PMID:33978498 | DOI:10.1177/00034894211015741

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The Impact of Medical Comorbidities on Patient Satisfaction in Chronic Rhinosinusitis

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Ann Otol Rhinol Laryngol. 2021 May 12:34894211015736. doi: 10.1177/00034894211015736. Online ahead of print.

ABSTRACT

BACKGROUND: Patient satisfaction has a significant bearing on medical therapy compliance and patient outcomes. The purpose of this study was to (1) describe patient satisfaction, as characterized by the Patient Satisfaction Questionnaire-18 (PSQ-18), in the care of patients with chronic rhinosinusitis (CRS) and (2) analyze the impact of comorbidities on satis faction using the functional comorbidity index (FCI).

METHODS: Patient demographics, disease severity measures, and PSQ-18 scores for patients with CRS presenting to a tertiary rhinology clinic between November 2019 and April 2020 were collected and analyzed. FCI was calculated retrospectively using the electronic medical record; individual comorbidities were tabulated. Spearman's correlations followed by multivariate regression was used to assess the relationship between medical comorbidities and PSQ-18.

RESULTS: Sixty-nine patients met criteria for analysis. There were no significant differences in age, gender, and Sinonasal Outcomes Test-22 scores between CRS patients with (CRSwNP) and without (CRSsNP) nasal polyps. There was no significant difference in the mean FCI for patients with CRSwNP versus CRSsNP (5.1 and 4.3, respectively) (P = .843). Similarly, there was no significant difference in the mean sum PSQ-18 score (78/100 in both) between these cohorts (P = .148). The mean sum PSQ-18 score was not significantly associated with anxiety (P = .728), depression (P = .624), or FCI (P = .282), but was significantly associated with hearing impairment (P < .001).

CONCLUSION: Patient satisfaction in the care of CRS is generally high with a diagnosis of comorbid hearing impairment demonstrating a negative association with satisfaction in this cohort.

PMID:33978506 | DOI:10.1177/00034894211015736

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Virtual Resident Mentorship Groups for Fourth Year Medical Students Applying into Otolaryngology-Head and Neck Surgery

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Ann Otol Rhinol Laryngol. 2021 May 12:34894211015740. doi: 10.1177/00034894211015740. Online ahead of print.

ABSTRACT

OBJECTIVE: To create a longitudinal near-peer mentorship program for medical students applying to otolaryngology.

METHODS: A program for longitudinal near-peer mentorship was designed based on a needs analysis of senior medical students. Program objectives were to (1) provide didactic education on common otolaryngology consults, (2) facilitate resident- student networking, and (3) enable applicants to meet other students. Senior otolaryngology residents were matched with medical students from across the United States applying to otolaryngology for a series of online small group meetings. Sessions included resident-designed didactics covering high-yield clinical scenarios and a mentorship component focused on transition to residency topics. Program evaluation included anonymized pre- and post-tests for each didactic session and an anonymous post-program participant survey.

RESULTS: There were 40 student participants from across the United States, with an average attendance of 73% of sessions per participant. Performance on didactic testing improved for 2 of the 3 sessions. Participants stated they would be very likely to recommend each session to another student in the future (4.96/5.00, obs = 155). Participants stated the most valuable part of the program was interacting with residents (82% of responses), transition to reside ncy advice (28%), and learning about otolaryngology consults (28%). Suggestions for improvement included expanding content, increasing the number of sessions, and involving additional faculty and residents.

CONCLUSION: A longitudinal virtual experience can be valuable for near-peer mentorship for medical students applying to otolaryngology.

PMID:33978510 | DOI:10.1177/00034894211015740

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Evaluation of phoneme recognition skills in pediatric auditory brainstem implant users

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Eur Arch Otorhinolaryngol. 2021 May 11. doi: 10.1007/s00405-021-06840-3. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aims to evaluate the relationship between phoneme recognition skills and language development skills in pediatric auditory brainstem implant (ABI) users. It further intends to identify the delays and problems that may occur in the phoneme recognition skills of children with ABI and shed light on rehabilitation programs.

METHODS: Our study included 20 children using ABI and another 20 using cochlear implants (CI). They were aged between 6 and 8 years 11 months. The participants exhibited homogenous demographic and audiological characteristics. The Turkish version of the Test of Language Development-Primary: Fourth Edition (TOLDP:4) was used to evaluate the language development skills, and the Turkish version of the Phoneme Recognition Test (PRT) was applied to assess the phoneme recognition skills.

RESULTS: There was a statistically significant difference (p < 0.05) in the PRT values as well as in the language development skills between the children with ABI and those with CI. It was observed that the values of the children with CI were significantly higher than those of children with ABI.

CONCLUSION: Although children with ABI were not able to match the skills of their peers with CI, their language development and communication skills improved. It is believed that this study will contribute to the literature by demonstrating that the use of ABI improves phoneme recognition skills in children who are not eligible for CI or who do not adequately benefit from CI.

PMID:33977366 | DOI:10.1007/s00405-021-06840-3

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Comparison of vocal fatigue and vocal tract discomfort between teachers of normal pupils and teachers of mentally disabled pupils

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Eur Arch Otorhinolaryngol. 2021 May 12. doi: 10.1007/s00405-021-06863-w. Online ahead of print.

ABSTRACT

PURPOSE: This study aims to study the comparison of vocal fatigue and vocal tract discomfort between teachers of normal pupils and teachers of mentally disabled pupils.

STUDY DESIGN: Cross-sectional study METHODS: Participants were 179 teachers (50 male, 129 female) and 30 non-teachers (14 male, 16 female) who participated in the current study. The teachers work in elementary schools. Furthermore, 87 of the teachers work for mentally disabled pupils at special elementary schools. Non-teachers were Ahvaz Jundishapur University of Medical Sciences employees who consider as the control group. They completed the Persian VFI and VTDp questionnaires three times, at the beginning, middle, and end of their office hours for 1 workday.

RESULTS: The current study's findings indicate that the Persian VFI and VTD scores of non-teache rs were significantly lower than teachers' scores. Furthermore, teachers of mentally disabled pupils demonstrated higher values from teachers of normal pupils based on the Persian VFI and VTDp scores CONCLUSION: The study results showed that teachers experienced more vocal fatigue and vocal tract discomfort than non-teachers. Furthermore, teachers of mentally disabled pupils indicated more vocal fatigue, the larynx's physical discomfort, and vocal tract discomfort, but this difference was practically small.

PMID:33978817 | DOI:10.1007/s00405-021-06863-w

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