Background: Fecal immunochemical test (FIT) is less effective in detecting advanced adenomas (AA) than colonoscopy. Increase in FIT for colorectal cancer (CRC) screening may lead to an increased number of undetected AAs which may develop into future CRCs.
Aim: We determined the potential impact of FIT expansion on missed AAs and future CRC diagnoses in an urban, tertiary-care, safety-net hospital.
Impaired insulin and incretin secretion underlie abnormal glucose tolerance (AGT) in pancreatic insufficient cystic fibrosis (PI-CF). Whether the incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) can enhance pancreatic islet function in cystic fibrosis (CF) is not known. We studied 32 adults with PI-CF and AGT randomized to receive either GLP-1 (n = 16) or GIP (n = 16) during glucose-potentiated arginine (GPA) testing of islet function on two occasions, with either incretin or placebo infused, in a randomized, double-blind, cross-over fashion.
View Article and Find Full Text PDFTransgender (trans) and non-binary people experience barriers to culturally competent healthcare and many have reported avoiding care. COVID-19 and related mitigation strategies may have exacerbated avoidance, and poor mental health may be bidirectionally related to avoiding care. This study estimated the prevalence of primary care avoidance during the pandemic in a national sample of trans and non-binary people in Canada with a primary care provider and examined the association between poorer self-rated mental health and avoidance.
View Article and Find Full Text PDFImplantation of a vagus nerve stimulator (VNS) can be an effective treatment for medically refractory seizures. Laryngeal side effects from a VNS can include hoarseness, cough, and shortness of breath. This report highlights a 5-year-old female who presented with stridor in the setting of acquired laryngomalacia, global developmental delay, and a VNS device.
View Article and Find Full Text PDFBackground: Ludwig's angina, a rapidly progressive cellulitis causing airway obstruction, has traditionally been managed with antibiotics and surgical intervention. More controversial is the use of steroids in the management of patients with this condition. This article summarizes the literature of steroid use in the management of Ludwig's angina.
View Article and Find Full Text PDFObjectives: Investigate the relationships between the Voice Handicap Index, laryngeal electromyography, and objective acoustic voice testing in order to determine the utility of these measures in the management of vocal fold movement disorders.
Methods: A retrospective review of patients who had completed a Voice Handicap Index-10 (VHI-10) questionnaire, laryngeal electromyography (LEMG), and objective acoustic measurements (including jitter, relative average perturbation, shimmer, noise-to-harmonic ratio, and standard deviation of fundamental frequency). All three tests had been completed within 30 days of the initial evaluation.
Objectives: Suspension microlaryngoscopy (SML) is generally a safe, same-day procedure. Complications have been linked to prolonged operative time and substantial force applied to the tongue. This report of two cases describes marked tongue edema following SML, a complication not yet reported in the literature.
View Article and Find Full Text PDFIntroduction: Type I thyroplasty is a common procedure used to improve dysphonia secondary to glottic insufficiency caused by vocal fold paralysis, paresis, or bowing. Revision often involves more complex procedures that can be complicated by mucosal violation, hemorrhage, infection, and shifted or extruded implants. Intraoperative challenges can be managed successfully using autologous strap muscle rotation flaps.
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