Objective: Electroencephalographic seizures (ES) are common in neonates with hypoxic-ischemic encephalopathy (HIE), but identification with continuous electroencephalographic (EEG) monitoring (CEEG) is resource-intensive. We aimed to develop an ES prediction model.
Methods: Using a prospective observational study of 260 neonates with HIE undergoing CEEG, we identified clinical and EEG risk factors for ES, evaluated model performance with area under the receiver operating characteristic curve (AUROC), and calculated test characteristics emphasizing high sensitivity.
World J Otorhinolaryngol Head Neck Surg
December 2024
Objectives: Postoperative pain medications and aspirin before undergoing functional endoscopic sinus surgery (FESS) are managed carefully due to concern for bleeding. Little is known regarding the increase in the risk of bleeding for patients unable to stop aspirin as trials are limited in this area. We compared outcomes for patients undergoing FESS who were managed postoperatively with nonsteroidal anti-inflammatory drugs (NSAIDs) versus opioids.
View Article and Find Full Text PDFObjectives: There is growing interest in assessing patient quality of life (QOL) following treatment of sinonasal tumors, including inverted papilloma (IP). We aimed to elucidate the natural history of postoperative QOL outcomes in IP patients treated with surgery.
Methods: Cases of sinonasal IP treated surgically at 4 tertiary academic rhinology centers were retrospectively reviewed.
Purpose: Multiple groups have created clinical practice guidelines (CPGs) for the management of primary hyperparathyroidism (PHPT). This report provides a rigorous quality assessment using the Appraisal of Guidelines for Research & Evaluation Instrument (AGREE II) to identify high-performing guidelines and areas for improvement.
Methods: A systematic review was conducted to isolate CPGs addressing the management of PHPT.
Objective: Wilson's disease (WD) is a metabolic disorder associated with abnormal copper metabolism that results in hepatic, psychiatric, and neurologic symptoms. No investigation of taste function has been made in patients with WD, although olfactory dysfunction has been evaluated.
Methods: Quantitative taste and smell test scores of 29 WD patients were compared to those of 790 healthy controls.
World J Otorhinolaryngol Head Neck Surg
December 2023
Objectives: The use of topical corticosteroids to manage postoperative sinonasal symptoms after endoscopic skull base surgery (ESBS) has not been well studied. We quantified long-term impact of postoperative steroid irrigations (SIs) on quality of life of patients after ESBS.
Methods: Retrospective review of patients at the University of Pennsylvania undergoing ESBS from 2010 to 2019.
Background: Socioeconomic variables including race, education, and income have been shown to affect vestibular schwannoma incidence, treatment, and outcomes. We sought to determine the impact of socioeconomic factors on quality of life at the time of vestibular schwannoma diagnosis.
Methods: Retrospective cohort study conducted at a tertiary academic center.
Background: While telehealth's presence in post-pandemic primary care appears assured, its exact role remains unknown. Value-based care's expansion has heightened interest in telehealth's potential to improve uptake of preventive and chronic disease care, especially among high-risk primary care populations. Despite this, the pandemic underscored patients' diverse preferences around using telehealth.
View Article and Find Full Text PDFOtolaryngol Head Neck Surg
January 2024
Objective: We sought to quantify trends in operative volumes and complications of endoscopic sellar surgery before and after the COVID-19 pandemic onset.
Study Design: We performed a retrospective analysis.
Setting: TriNetX database analysis.
Objective: To examine long-term (>5 yr) low-frequency hearing preservation after hybrid cochlear implantation.
Study Design: Retrospective cross-sectional study.
Setting: Tertiary care center outpatient clinic.
Introduction: Experts continue to debate how to increase COVID-19 vaccination rates. Some experts advocate for financial incentives. Others argue that financial incentives, especially large ones, will have counterproductive psychological effects, reducing the percent of people who want to vaccinate.
View Article and Find Full Text PDFPurpose Of Review: Craniopharyngiomas are rare tumors that that present with loss of pituitary function in most cases. They present in a bimodal age distribution and the most common treatment paradigms include gross total resection or subtotal resection followed by radiation. Endoscopic transnasal access to intradural tumors has become increasingly common due to improvements in equipment, increased familiarity with the surgical corridor and anatomy, and reconstruction techniques.
View Article and Find Full Text PDFAspirin exacerbated respiratory disease (AERD) is an inflammatory condition that consists of eosinophilic asthma, chronic rhinosinusitis with nasal polyps, and respiratory reactions to cyclooxygenase-1 inhibitors. Aspirin therapy after aspirin desensitization (ATAD) is the most extensively studied treatment paradigm for AERD. The objective was to identify which time point of ATAD was most predictive of long-term outcomes as measured by the 22-item Sino-Nasal Outcome Test (SNOT-22).
View Article and Find Full Text PDFObjective: To assess the impact of a novel flipped-classroom (FC) otolaryngology resident didactic curriculum on resident learning.
Methods: Based on the preferences elicited in a survey of preferred learning styles of residents, a hybrid web-based and in-person FC otolaryngology didactic curriculum was implemented over a 6-month period in 2020-2021. Resident reactions to the new curriculum were assessed via a second survey.
Oral Surg Oral Med Oral Pathol Oral Radiol
December 2022
Objective: To evaluate the current quality and utility of clinical practice guidelines (CPGs) issued for the diagnosis, prevention, and treatment of medication-related osteonecrosis of the jaw (MRONJ).
Study Design: We performed a systematic literature search of guidelines for MRONJ diagnosis, staging, prevention, or management. An appraisal of guidelines was completed using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument.
Objectives: Rathke cleft cysts (RCCs) arise from the development of the Rathke pouch. Recurrence is common after either drainage or cyst removal. The endoscopic endonasal approach (EEA) is increasingly utilized for the management of RCC.
View Article and Find Full Text PDFPurpose: Recurrent head and neck cancer (HNC) has a significant global disease burden and its treatment is complex. Multiple clinical practice guidelines (CPGs) have been developed to improve management of these patient populations; however, no study has systematically reviewed the quality and rigor in development of these guidelines. Here, we identify and systematically appraise existing recommendations for the management of recurrent HNC and assess their clinical applicability, methodologic rigor, and transparency of development.
View Article and Find Full Text PDFExperts debate whether COVID-19 vaccine mandates or financial incentives will reduce, rather than increase, interest in vaccination. Among 3,698 unvaccinated U.S.
View Article and Find Full Text PDF. It is hypothesized that normal weight individuals develop diabetes through different pathophysiological mechanisms and that methods of prevention may differ in the absence of overweight/obesity. In this study, we compared the effect of lifestyle health coaching (LHC) on fasting plasma glucose (FPG) in normal weight, overweight, and obese US adults with prediabetes.
View Article and Find Full Text PDFObjective: The goal of this study was to assess the validity of Current Procedural Terminology (CPT) claims data for the identification of intraoperative transesophageal echocardiography (TEE) during cardiac surgery.
Design: This study was a retrospective, cohort analysis.
Setting: This study used data from electronic medical records (EMRs), in combination with CPT billing claims data, from two hospitals within the Penn Medicine Health System-Penn Presbyterian Medical Center and the Hospital of the University of Pennsylvania.
J Interv Card Electrophysiol
June 2021
Purpose: Left atrial appendage occlusion (LAAO) involves a "tug test," in which implanters pull on the device delivery cable to ensure stable occluder placement. The aim of this study was to evaluate the recommendation to perform the tug test, by comparing forces exerted on the device during deployment and subsequent tug test. A secondary objective was to simulate forces experienced on left atrial appendage tissue by placement of a 20-mm device.
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