Characteristics of adults with potential refractory chronic cough identified using an algorithm designed for administrative claims databases: A descriptive study.

As population-based studies describing the characteristics of patients with refractory chronic cough (RCC) are sparse, the objective of this descriptive study was to identify and describe such patients using an algorithm developed for administrative claims databases and requiring validation in future. We identified adults with chronic cough (N = 782,121) from Optum Clinformatics™ Data Mart as individuals with a 'cough event' (primary cough event; based on ICD codes/relevant prescriptions) and ≥2 cough events in the 56-180 preceding days. We applied several exclusion criteria to identify potential RCC cases and stratified them into probable, possible, and unlikely RCC cohorts by the number of cough events during 1-year follow up (≥3, 1-2 or 0 events, respectively).

Importance of PET/CT in Initial Workup of Head and Neck Squamous Cell Carcinoma.

Objective: Assess the impact of positron emission tomography/computed tomography (PET/CT) on disease staging at presentation in patients with head and neck squamous cell carcinoma.

Study Design: Retrospective cross-sectional review.

Setting: Academic multicenter single institution (Geisinger Health System).

Interdisciplinary collaboration in the diagnosis and management of chronic cough: the role and importance of primary care providers.

Chronic cough (CC) is associated with many conditions, so identifying contributing causes poses a diagnostic challenge. However, guidelines written for US physicians do not explicitly outline suggested roles for primary care providers (PCPs) in the approach to patients with CC, including refractory or unexplained CC. The objective of this review is to describe the role of PCPs in the diagnosis and treatment of CC in adults.

Depression and anxiety in patients with head and neck cancer undergoing free flap reconstruction.

Purpose: To determine the prevalence and severity of depression and anxiety in patients with head and neck cancer (HNC) undergoing treatment with free-flap (FF) reconstruction.

Methods: Participants with HNC undergoing FF reconstruction were given the validated 9-item Patient Health Questionnaire (PHQ-9) and a 7-item Generalized Anxiety Disorder (GAD-7) questionnaire prior to surgery. Patient factors and responses were analyzed.

The Role of the Otolaryngologist in Sexual Health.

Sexual health is an often neglected topic in otolaryngology. Ironically, most sexually transmitted diseases (STDs) demonstrate head and neck manifestations. Furthermore, many aspects of human sexuality, both pathologic and nonpathologic, are also integral to the head and neck.

Cancer Risk in Barrett's Esophagus: A Clinical Review.

Esophageal adenocarcinoma (EAC) is rapidly increasing in incidence and is associated with a poor prognosis. Barrett's esophagus (BE) is a known precursor of esophageal adenocarcinoma. This review aims to explore Barrett's esophagus, esophageal adenocarcinoma, and the progression from the former to the latter.

Incidence and Prevalence of Cough in a Rural Health System: A 20-Year Study.

Objective: Understanding the cough population is critical to addressing clinical needs and gaps in best practice. We sought to characterize and stratify cough patients with the hypothesis that there are opportunities to improve access to care in our health system and characterize the population.

Methods: Following institutional review board exempt status, a retrospective electronic record review was performed on all patients coded with ICD-9 786.

Pepsinogen/Proton Pump Co-Expression in Barrett's Esophageal Cells Induces Cancer-Associated Changes.

Educational Objective: At the conclusion of this presentation, participants should better understand the carcinogenic potential of pepsin and proton pump expression in Barrett's esophagus.

Objective: Barrett's esophagus (BE) is a well-known risk factor for esophageal adenocarcinoma (EAC). Gastric H /K ATPase proton pump and pepsin expression has been demonstrated in some cases of BE; however, the contribution of local pepsin and proton pump expression to carcinogenesis is unknown.

Laryngeal Leukoplakia: State of the Art Review.

Objective: This state-of-the-art article reviews the epidemiology, diagnosis, and management of vocal fold leukoplakia, with focus on recent advances. It focuses on the clinical challenges that otolaryngologists face balancing both oncological efficacy and functional outcomes in leukoplakia and presents the current philosophies and techniques to consider when managing such patients.

Data Sources: PubMed/MEDLINE.

Relationship between Dysarthria and Oral-Oropharyngeal Dysphagia: The present evidence.

There is a high prevalence of dysphagia in patients with neuromuscular diseases and stroke, and consequences can be profound. However, the correlation of dysarthria and oral-oropharyngeal dysphagia remains unclear. This review aimed to define the clinical co-presentation of dysarthria and dysphagia in this population.

Biomarkers for Malignant Potential in Vocal Fold Leukoplakia: A State of the Art Review.

Objective: To explore biomarkers that are candidates for understanding potential degeneration to malignancy of vocal fold leukoplakia (VFL), with the goal of guiding future diagnostic and treatment recommendations.

Data Sources: PubMed and Medline search engines.

Review Methods: A systematic review was conducted by searching the following key words: or , coupled with or , and combined with the term .

Tracheotomy Timing and Outcomes in the Critically Ill: Complexity and Opportunities for Progress.

Objectives/hypothesis: To characterize the effects of tracheotomy timing at our institution on intensive care unit (ICU) length of stay (LOS) and overall hospital LOS.

Study Design: Retrospective cohort study.

Methods: A retrospective study was performed at a tertiary care medical center for patients undergoing tracheotomy over 2.

H+/K+ATPase Expression in the Larynx of Laryngopharyngeal Reflux and Laryngeal Cancer Patients.

Objectives: The gastric H+/K+ ATPase proton pump has previously been shown to be expressed in the human larynx, however its contribution to laryngopharyngeal reflux (LPR) signs, symptoms and associated diseases such as laryngeal cancer is unknown. Proton pump expression in the larynx of patients with LPR and laryngeal cancer was investigated herein. A human hypopharyngeal cell line expressing the proton pump was generated to investigate its effects.

Mercury bioaccumulation in Tilefish (Lopholatilus chamaeleonticeps) from offshore waters of South Carolina, USA.

Mercury (Hg) concentrations in Tilefish (Lopholatilus chamaeleonticeps) have been reported to be one of the highest of all fish species, resulting in advisories that, historically, have recommended zero consumption. The current study assesses Hg bioaccumulation in Tilefish targeted by the commercial fisheries operating off the coast of South Carolina, USA. We provide results for an under-sampled region and explore how life history potentially impacts Hg uptake in Tilefish.

Otolaryngology Aspects of Chronic Cough.

Cough is an increasingly important public health concern, and diagnosis and treatment can be challenging in these complex patients. The purpose of this review is to address the roles of otolaryngology in understanding pathophysiology, and unique aspects in their diagnosis and management. Evidence-based best practice through clinical practice guidelines for cough is emphasized.

Esophageal pepsin and proton pump synthesis in barrett's esophagus and esophageal adenocarcinoma.

Objectives/hypothesis: Gastroesophageal reflux disease and associated metaplasia of the esophagus (Barrett's esophagus [BE]) are primary risk factors for esophageal adenocarcinoma (EAC). Widespread use of acid suppression medications has failed to stem the rise of EAC, suggesting that nonacid reflux may underlie its pathophysiology. Pepsin is a tumor promoter in the larynx and has been implicated in esophageal carcinogenesis.

Laryngeal inflammatory response to smoke and vape in a murine model.

Purpose: To build a murine model for tobacco smoke and electronic cigarette vapor exposure to characterize the inflammatory and immune responses in the larynx.

Materials And Methods: In this pilot study, twenty-four wild-type C57BL/6 mice were divided into four groups: smoke, vapor with nicotine, vapor without nicotine, and air only. Following daily exposure for 4 months, larynges were dissected and processed with cytokine detection arrays.

Relationship between dysarthria and oral-oropharyngeal dysphagia: The current evidence.

There is a high prevalence of dysphagia among patients with neuromuscular diseases and cerebrovascular diseases, and its consequences can be profound. However, the correlation between dysarthria and oral-oropharyngeal dysphagia remains unclear. We conducted a literature review to define the clinical presentation of both dysarthria and dysphagia in patients with neuromuscular and cerebrovascular diseases.

Classification of Cough as a Symptom in Adults and Management Algorithms: CHEST Guideline and Expert Panel Report.

Background: We performed systematic reviews using the population, intervention, comparison, outcome (PICO) format to answer the following key clinical question: Are the CHEST 2006 classifications of acute, subacute and chronic cough and associated management algorithms in adults that were based on durations of cough useful?

Methods: We used the CHEST Expert Cough Panel's protocol for the systematic reviews and the American College of Chest Physicians (CHEST) methodological guidelines and Grading of Recommendations Assessment, Development, and Evaluation framework. Data from the systematic reviews in conjunction with patient values and preferences and the clinical context were used to form recommendations or suggestions. Delphi methodology was used to obtain the final grading.

The Changing Impact of Gastroesophageal Reflux Disease in Clinical Practice.

Objectives: The National Ambulatory Medical Care Survey (NAMCS) database was utilized to understand evolving national trends in diagnosis and management of reflux.

Methods: The NAMCS database was queried for visits related to gastroesophageal reflux diagnosis and management. Analysis performed for time periods 1998-2001, 2002-2005, and 2006-2009 was weighted to provide national estimates of care.