The Laryngoscope
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To review the demographics, presentation, interventions, and outcomes of acute supraglottitis in the post-Haemophilus influenzae type B (Hib) vaccination era and make updated recommendations for treatment. ⋯ The patient demographics, presentation, and course of supraglottitis have changed since the widespread use of the Hib vaccine. Recognizing the signs and symptoms associated with airway obstruction is important in the safe and effective management of this condition.
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To examine demographic, histologic, and survival trends of oral cavity and oropharyngeal (OC/OP) squamous cell carcinoma (SCCA) patients over the past 3 decades. To test the hypothesis that decreased histologic differentiation and increased disease-specific survival is related to a decline in smoking rates and an increased percentage of human papillomavirus (HPV)-related tumors. ⋯ Comprehensive population-based analysis of oral cavity and oropharyngeal carcinoma from 1975 to 2006 demonstrated significant trends toward decreased tumor differentiation and increased survival over time. These findings support the influence of HPV in OC/OP carcinoma and may have implications for treatment, prognosis, and possibly prevention.
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Review Comparative Study
Racial/ethnic and socioeconomic disparities in the prevalence and treatment of otitis media in children in the United States.
Although racial/ethnic and socioeconomic disparities in child health are prevalent, little is known about them within common pediatric otolaryngic problems. Otitis media (OM) is a frequent diagnosis in children, and tympanostomy tube placement is the most common surgical treatment for OM. We sought to identify current knowledge regarding racial/ethnic and socioeconomic disparities in children with OM or tympanostomy tube placement. ⋯ Racial/ethnic and socioeconomic disparities exist for the prevalence and treatment of children with OM. Socioeconomic deprivation increases the risk of OM in children. Despite the frequency of tympanostomy tube insertion in children in the United States, few studies have addressed inequalities in access or utilization of surgical therapy. Given the changing healthcare climate and the social and economic impact of OM in children, further investigation of racial/ethnic and socioeconomic disparities targeting access to surgical treatment of OM should take precedence in health services research.
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Comparative Study
Development and pilot testing of an operative competency assessment tool for pediatric direct laryngoscopy and rigid bronchoscopy.
To develop and pilot test an objective assessment of technical skills instrument for evaluation of residents' surgical performance of pediatric direct laryngoscopy and rigid bronchoscopy, with emphasis on feasibility, validity, and interrater agreement. ⋯ This pilot study suggests that a reliable and valid instrument for objective evaluation of surgical competency can be developed for pediatric direct laryngoscopy and rigid bronchoscopy. This instrument can be used for formative and summative feedback of operative performance. In addition, it was easy to use and valid in a limited evaluation; however, larger studies are required to validate its utility.
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Comparative Study
Depression, sleepiness, and disease severity in patients with obstructive sleep apnea.
To determine if a relationship exists between depression, disease severity, and sleepiness in patients with obstructive sleep apnea (OSA). ⋯ Patients with OSA and daytime sleepiness are more likely to have depressive symptoms as compared with controls. OSA disease severity, as measured with the RDI score, is a weak predictor of BDI score, and no correlation was seen between the severity of OSA and BDI scores after controlling for other factors. However, there was a strong correlation between sleepiness (ESS) and disease severity (BDI). These data suggest that OSA patients with symptoms of excessive sleepiness have the highest risk of associated depressive symptoms and may benefit most from depression screening.