Reporting results of obstructive sleep apnea syndrome surgery trials.

Obstructive sleep apnea syndrome surgery studies largely evaluate single procedures or procedure combinations in case series designs, but it can be difficult to compare results across studies. The authors present a standardized format for presentation of surgical study results to facilitate pooled analyses and subgroup analyses. The format includes thorough characterization of baseline subject characteristics and the use of outcome measures that reflect the spectrum of obstructive sleep apnea and its consequences.

Low-frequency repetitive transcranial magnetic stimulation to the temporoparietal junction for tinnitus.

Objective: To examine the effectiveness and safety of low-frequency repetitive transcranial magnetic stimulation (rTMS) to the temporoparietal junction in a cohort of patients with bothersome tinnitus.

Design: Crossover, double-blind, randomized clinical trial.

Setting: Outpatient academic medical center.

Predictive capability of historical data for diagnosis of dizziness.

Objective: The study examines categorical responses to questions on a comprehensive dizziness questionnaire, to find the overall predictive power of the questionnaire, and to identify which question(s) are most predictive of each diagnosis.

Study Design: Retrospective chart review.

Setting: Specialized dizziness and balance center at a tertiary care hospital.

The Benefit of Adjuvant Chemotherapy in Elderly Patients with Stage III Colorectal Cancer is Independent of Age and Comorbidity.

OBJECTIVES: To determine the combined effect of age and comorbidity on receipt of chemotherapy and its impact on survival in elderly patients with stage III colorectal cancer (CRC). MATERIALS AND METHODS: All patients over age 65 with Stage III CRC diagnosed 1996-2006 were identified from the Barnes-Jewish Hospital Oncology Data Services registry. An age/comorbidity staging system was created using the ACE-27 comorbidity index and data from both Stage II and III CRC.

Postoperative myocardial injury after major head and neck cancer surgery.

Background: Patients with head and neck cancer often have multiple risk factors for coronary artery disease. Yet, little is known about the incidence of postoperative myocardial injury after major head and neck cancer surgery and its clinical relevance. The aim of this study was to determine the risk of postoperative myocardial injury in patients undergoing major head and neck cancer surgery.

Unilateral hearing loss is associated with worse speech-language scores in children.

Objective: To determine whether children with unilateral hearing loss (UHL) demonstrate worse language skills than their siblings with normal hearing, and whether children with UHL are more likely to receive extra assistance at school.

Patients And Methods: We conducted a case-control study of 6- to 12-year-old children with UHL compared with sibling controls (74 pairs, n = 148). Scores on the oral portion of the Oral and Written Language Scales (OWLS) were the primary outcome measure.

Iatrogenic esophageal perforation in patients with head and neck cancer: evaluation of the SEER-Medicare database.

Objective: 1) Determine rate of iatrogenic esophageal perforation in head and neck cancer patients. 2) Identify risk factors for perforation. 3) Determine effect of perforation on mortality.

Conditional relative survival in head and neck squamous cell carcinoma: Permanent excess mortality risk for long-term survivors.

Background: Dynamic predictions on head and neck cancer survival could offer, besides improved patient counseling, insight into long-term effects of tumor- and patient-based characteristics on survival. Theoretically, there could be a certain time period after diagnosis after which the patient returns to a population risk on survival.

Methods: In all, 7255 patients with a primary head and neck squamous cell carcinoma (HNSCC) aged 25 to 90 years, diagnosed between January 1980 and January 2004 in The Netherlands, were included.

Future of the TNM classification and staging system in head and neck cancer.

Staging systems for cancer, including the most universally used TNM classification system, have been based almost exclusively on anatomic information. However, the question arises whether staging systems should be based on this information alone. Other parameters have been identified that should be considered for inclusion in classification systems like the TNM.

Azithromycin extended release vs amoxicillin/clavulanate: symptom resolution in acute sinusitis.

Objective: The aim of the study was to compare early symptom resolution with a single 2-g dose of azithromycin extended release or 10 days of amoxicillin/clavulanate 875 mg/125 mg every 12 hours in patients with acute sinusitis.

Materials And Methods: This was a prospective, randomized, open-label, observational study to mimic "real-world" conditions, including patients with symptoms of acute bacterial sinusitis lasting between 7 and 30 days. Key symptoms were assessed twice daily by patient diary, and patients were interviewed by telephone at 12 and 28 days.

The effect of nasally administered budesonide respules on adrenal cortex function in patients with chronic rhinosinusitis.

Objectives: To evaluate whether nasal administration of budesonide in adults with chronic rhinosinusitis for 30 days suppresses adrenal function and to assess its clinical efficacy.

Design: An open-label prospective study.

Setting: Academic medical center.

The incidence and impact of comorbidity diagnosed after the onset of head and neck cancer.

Objective: To investigate the incidence and prognostic impact of comorbidities diagnosed after the onset of head and neck cancer.

Design: Retrospective review of medical records.

Patients: One hundred eighty-three patients diagnosed as having head and neck cancer at Washington University School of Medicine from January 1, 1997, through December 31, 1998.

Methodological and statistical problems in uvulopalatopharyngoplasty research: a follow-up study.

Objectives: To review the published literature on uvulopalatopharyngoplasty (UPPP) and assess the methodological quality of the research and compare it with a similar article published in 1995; and to determine what, if any, improvement in the methodological quality of the research resulted during the ensuing 10 years.

Design: Methodological and statistical evaluation of the published literature on UPPP. Thirty articles representing the clinical studies on UPPP and related procedures written from January 1996 to August 2005 were reviewed.

Impact of comorbidity on overall survival in patients surgically treated for renal cell carcinoma.

Objectives: Although the classification of cancer has traditionally focused on the gross and microscopic characteristics of the tumor, the overall health of patients can affect their survival. Because patients with renal cell carcinoma often have other medical conditions, we explored the effect of preexisting medical disease on survival after radical and partial nephrectomy.

Methods: From January 1995 to August 2003, the comorbidity status of 697 patients with nonmetastatic renal cell carcinoma who had undergone radical or partial nephrectomy was prospectively coded using the Adult Comorbidity Evaluation-27.

The changing prevalence of comorbidity across the age spectrum.

The purpose of the research was to demonstrate that comorbid health conditions disproportionately affect elderly cancer patients. Descriptive analyses and stacked area charts were used to examine the prevalence and severity of comorbid ailments by age of 27,506 newly diagnosed patients treated at one of eight cancer centers between 1998 and 2003. Hypertension was the most common ailment in all patients, diabetes was the second most prevalent ailment in middle-aged patients, and previous solid tumor(s) were the second most prevalent ailment in patients aged 74 and older.

HLA alleles determine differences in human natural killer cell responsiveness and potency.

Epidemiological studies have associated certain human disease outcomes with particular killer cell Ig-like receptor (KIR) and HLA genotypes. However, the functional explanation for these associations is poorly understood, because the KIRs were initially described as natural killer (NK) cell inhibitory receptors with specificity for HLA molecules on their cellular targets. Yet resolution of infections is often associated with genotypic pairing of inhibitory KIRs with their cognate HLA ligands.

Impact of gender, age, and comorbidities on quality of life in patients with chronic rhinosinusitis.

Statement Of The Problem: To evaluate the impact of gender, age and comorbidities of health-related quality of life (HR-QOL) assessments in patients with chronic rhinosinusitis.

Methods: The prospective administration of the German Adapted Version of the Sino-Nasal Outcome Test 20 (SNOT-20 GAV) to patients with chronic rhinosinusitis. Two hundred and two patients with chronic rhinosinusitis filled out the questionnaire before functional endoscopic sinus surgery (FESS) and again at the 3-month follow-up.

Prognostic impact of comorbidity in patients with bladder cancer.

Objective: To determine the impact of comorbidity on survival of bladder cancer patients.

Methods: The population included 675 patients with newly diagnosed bladder cancer whose medical information was abstracted from a hospital cancer registry. Adult Comorbidity Evaluation-27, a validated instrument, was used to prospectively categorize comorbidity.

Melatonin.

Melatonin is a neurohormone that is secreted by the pineal gland and known to impact the sleep-wake cycle. Melatonin is regarded to be a safe and natural sleep aid. Since many people with tinnitus suffer sleep disturbance, melatonin has been studied as a therapeutic agent for tinnitus.

Relief of idiopathic subjective tinnitus: is gabapentin effective?

Objective: To assess the therapeutic benefit of gabapentin (Neurontin) for subjective idiopathic troublesome tinnitus.

Design: An 8-week, double-blind, randomized clinical trial.

Setting: Academic otolaryngology clinic in St Louis, Mo.

Chronic rhinosinusitis patients with polyps or polypoid mucosa have a greater burden of illness.

Background: Recent studies suggest chronic rhinosinusitis without nasal polyposis (CRSsNP) and CRS with nasal polyposis (CRScNP) represent distinct pathological entities. The aim of this study was to determine whether patients with CRSsNP, CRScNP, and polypoid CRS could be distinguished by clinical features, radiologic extent of disease or use of medications.

Methods: New patients with CRS (n = 126) were enrolled in a prospective outcomes study.

Clinical outcomes of chronic rhinosinusitis in response to medical therapy: results of a prospective study.

Background: Little information exists regarding the outcome of medical management of chronic rhinosinusitis (CRS) in adults. The aim of this study was to examine whether baseline patient demographics, symptoms, objective findings, or treatment strategies were associated with improved CRS outcomes over time.

Methods: Eighty-four new patients with CRS were evaluated and medically treated for up to 12 months.

Using comorbidity indexes to predict costs for head and neck cancer.

Objective: To determine whether the general Charlson Comorbidity Index (CCI) and the head and neck cancer-specific Washington University Head and Neck Cancer Comorbidity Index (WUHNCCI) were useful for predicting cost of treatment for elderly patients with head and neck cancer.

Design: Retrospective, observational study.

Patients: A total of 1780 Medicare patients with head and neck cancer, who were treated between 1984 and 1994, were analyzed using the Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked database.

Comorbidity in patients with cancer of the head and neck: prevalence and impact on treatment and prognosis.

At the time of diagnosis, many patients with head and neck cancer have other medical conditions, referred to as comorbidity. These other medical conditions may affect treatment and prognosis. Several valid instruments are available to capture the individual comorbid ailments and their prognostic impact.