Does CPAP Affect Patient-Reported Voice Outcomes?

Upper aerodigestive tract symptoms are common in patients with obstructive sleep apnea (OSA). It remains unclear whether continuous positive airway pressure (CPAP) improves or worsens these otolaryngology symptoms. As therapy-related side effects limit CPAP adherence, this study aimed to determine if CPAP negatively affects voice, sinonasal, and reflux symptoms of the upper airway.

Endothelial dysfunction in pulmonary arterial hypertension: an evolving landscape (2017 Grover Conference Series).

Endothelial dysfunction is a major player in the development and progression of vascular pathology in pulmonary arterial hypertension (PAH), a disease associated with small vessel loss and obstructive vasculopathy that leads to increased pulmonary vascular resistance, subsequent right heart failure, and premature death. Over the past ten years, there has been tremendous progress in our understanding of pulmonary endothelial biology as it pertains to the genetic and molecular mechanisms that orchestrate the endothelial response to direct or indirect injury, and how their dysregulation can contribute to the pathogenesis of PAH. As one of the major topics included in the 2017 Grover Conference Series, discussion centered on recent developments in four areas of pulmonary endothelial biology: (1) angiogenesis; (2) endothelial-mesenchymal transition (EndMT); (3) epigenetics; and (4) biology of voltage-gated ion channels.

Implementation of a Psychosocial Intervention Program for Working Caregivers.

The overall aim of this pilot study was to examine the feasibility and acceptability of a multicomponent, psychosocial intervention specifically designed to meet the unique needs of caregivers who are balancing caregiving duties with work responsibilities. Seventy-one family caregivers employed at a private, nonprofit institution in South Florida were randomized to either the Caregiver Workstation condition ( = 35) or a control condition ( = 36). Sixty-two caregivers completed the 5-month follow-up.

Examining Anosognosia of Neglect.

Unilateral neglect (neglect) and anosognosia often co-occur post stroke. It is unknown whether anosognosia of neglect varies for different types of daily activities. The objective is to examine the frequency of anosognosia of neglect for items on the Catherine Bergego Scale (CBS) and to determine the level of agreement between participant/assessor item ratings and total scores.

Mental Models of Cause and Inheritance for Type 2 Diabetes Among Unaffected Individuals Who Have a Positive Family History.

Using the familial risk perception (FRP) model as a framework, we elicited causal and inheritance explanations for type 2 diabetes (T2D) from people who do not have T2D but have a family history for it. We identified four composite mental models for cause of T2D: (a) purely genetic; (b) purely behavioral/environmental; (c) direct multifactorial, in which risk factors interact and over time directly lead to T2D; and (d) indirect multifactorial, in which risk factors interact and over time cause a precursor health condition (such as obesity or metabolic syndrome) that leads to T2D. Interestingly, participants described specific risk factors such as genetics, food habits, lifestyle, weight, and culture as "running in the family.

High-Content Screening Comparison of Cancer Drug Accumulation and Distribution in Two-Dimensional and Three-Dimensional Culture Models of Head and Neck Cancer.

High cancer drug development attrition rates have provoked considerable debate about whether the two-dimensional tumor growth inhibition high-throughput screening assays used in pre-clinical lead discovery adequately reflect solid tumor complexity. We used automated high-content screening image acquisition and analysis methods to compare fluorescent drug uptake, accumulation, and distribution in Cal33 and FaDu head and neck cancer (HNC) monolayer and multicellular tumor spheroid (MCTS) models. Ellipticine, idarubicin, daunorubicin, and doxorubicin were studied because of their fluorescent properties and broad anti-tumor activities.

Minimal Custom Pack Design and Wide-Awake Hand Surgery: Reducing Waste and Spending in the Orthopedic Operating Room.

Background: The US health care sector has substantial financial and environmental footprints. As literature continues to study the differences between wide-awake hand surgery (WAHS) and the more traditional hand surgery with sedation & local anesthesia, we sought to explore the opportunities to enhance the sustainability of WAHS through analysis of the respective costs and waste generation of the 2 techniques.

Methods: We created a "minimal" custom pack of disposable surgical supplies expressly for small hand surgery procedures and then measured the waste from 178 small hand surgeries performed using either the "minimal pack" or the "standard pack," depending on physician pack choice.

Coagulation Management During Liver Transplantation: Use of Fibrinogen Concentrate, Recombinant Activated Factor VII, Prothrombin Complex Concentrate, and Antifibrinolytics.

Coagulation management, and transfusion practice in liver transplantation (LT) have been evolving in the recent years due to better understanding of coagulation abnormalities in end-stage liver disease, and clinical management of LT patients. Avoidance of allogeneic blood components is feasible in some patients, but multi-modal coagulation therapies may be necessary in others who develop complex coagulopathy due to hemorrhage, hemodilution, hypothermia, and acid-base disturbances. Transfusions of plasma and cryoprecipitate remain to be the mainstay therapy for procoagulant factor replacement during LT.

Viscoelastic Monitoring to Guide Hemostatic Resuscitation in Liver Transplantation Surgery.

Coagulopathic bleeding must be anticipated during liver transplantation (LT) surgery. Patients with end-stage liver disease (ESLD) often present with disease-related hematologic disturbances, including the loss of hepatic procoagulant and anticoagulant clotting factors and thrombocytopenia. Transplantation surgery itself presents additional hemostatic changes, including hyperfibrinolysis.

Proximal Phalanx Fracture Management.

Background: The goal of proximal phalangeal fracture management is to allow for fracture healing to occur in acceptable alignment while maintaining gliding motion of the extensor and flexor tendons.

Methods: We reviewed the most current literature on various treatment methods of proximal phalanx fractures, focusing on the indications and outcomes of nonoperative as well as operative interventions.

Results: Stable fractures can be successfully treated nonoperatively, whereas unstable injuries benefit from surgery.

Arterial Stiffness Is Associated With QTc Interval Prolongation in Patients With Heart Failure.

Background: A prolonged corrected QT (QTc) interval is a known risk factor for adverse cardiac events. Understanding the determinants and physiologic correlates of QTc is necessary for selecting proper strategies to reduce the risk of adverse events in high-risk patients. We sought to evaluate the role of arterial stiffness in heart failure as a determinant of QTc prolongation.

Influence of Wrist Position on the Metacarpophalangeal Joint Motion of the Index Through Small Finger.

Background: The metacarpophalangeal joints exhibit range of motion that is influenced by wrist position. Synergistic motion occurs between the wrist and the metacarpophalangeal joints with different static wrist positions affecting joints' motion capability. The aim of this study was to determine how different wrist positions influence the active range of motion of the index through small finger metacarpophalangeal joints.

Features of Simultaneous Scalp and Intracranial EEG That Predict Localization of Ictal Onset Zone.

Objective: To assess the utility of simultaneous scalp EEG in patients with focal epilepsy undergoing intracranial EEG evaluation after a detailed presurgical testing, including an inpatient scalp video EEG evaluation.

Methods: Patients who underwent simultaneous scalp and intracranial EEG (SSIEEG) monitoring were classified into group 1 or 2 depending on whether the seizure onset zone was delineated or not. Seizures were analyzed using the following 3 EEG features at the onset of seizures latency, location, and pattern.

An Interactive Web-Based Intervention to Achieve Healthy Weight in Young Children.

This prospective, randomized, controlled trial for parents of overweight and obese 3- to 7-year-olds was performed to assess the feasibility of a program promoting healthy eating and lifestyle by targeting parents as agents of change. The intervention was composed of 6-in-person group sessions and a customized website over 12 months. The control group received customary care.

Sharing Extraordinary Experiences Fosters Feelings of Closeness.

Every social relationship begins somewhere. Yet, little is known about which initial encounters bring people closer. This article investigates whether feelings of closeness are shaped by the type of experience shared between two individuals.

Tezacaftor/Ivacaftor in Subjects with Cystic Fibrosis and F508del/F508del-CFTR or F508del/G551D-CFTR.

Rationale: Tezacaftor (formerly VX-661) is an investigational small molecule that improves processing and trafficking of the cystic fibrosis transmembrane conductance regulator (CFTR) in vitro, and improves CFTR function alone and in combination with ivacaftor.

Objectives: To evaluate the safety and efficacy of tezacaftor monotherapy and of tezacaftor/ivacaftor combination therapy in subjects with cystic fibrosis homozygous for F508del or compound heterozygous for F508del and G551D.

Methods: This was a randomized, placebo-controlled, double-blind, multicenter, phase 2 study (NCT01531673).

Response of Human Fetal Liver Progenitor Cell Types to Temperature and pH Stresses In Vitro.

Prolonged physiological stresses, including abnormal pH and temperature, are deleterious. However, human hepatic progenitors have been shown to be quite tolerant of temporary temperature stress such as in cold ischemia. We aimed at identifying how various stresses affect liver progenitors, and at determining whether distinct effects exist on different progenitor cells of the human liver.

Cognitive and Occupational Function in Survivors of Adolescent Cancer.

Purpose: Adolescents with cancer have unique developmental considerations. These include brain development, particularly in the frontal lobe, and a focus on completing education and entering the workforce. Cancer and treatment at this stage may prove to uniquely affect survivors' experience of cognitive and occupational function.

Fibrin Glue Increases the Tensile Strength of Conduit-Assisted Primary Digital Nerve Repair.

Background: An ideal peripheral nerve repair construct does not currently exist. Our primary goal was to determine whether fibrin glue adds to the tensile strength of conduit-assisted primary digital nerve repairs. Our secondary goal was to evaluate the impact of varying suture number and location on the tensile strength.

The combined impact of social support and perceived stress on quality of life in adults with autism spectrum disorder and without intellectual disability.

Identifying modifiable correlates of good quality of life in adults with autism spectrum disorder is of paramount importance for intervention development as the population of adults with autism spectrum disorder increases. This study sought to examine social support and perceived stress as potential modifiable correlates of quality of life in adults with autism spectrum disorder. We hypothesized that adults with autism spectrum disorder without co-occurring intellectual disabilities ( N = 40; aged 18-44 years) would report lower levels of social support and quality of life than typical community volunteers who were matched for age, sex, and race ( N = 25).

Characterization of Guideline Evidence for Off-label Medication Use in the Intensive Care Unit.

Background: Non-Food and Drug Administration (FDA) or off-label medication prescribing occurs commonly in the intensive care unit (ICU). Off-label medication use creates a concern for untoward adverse effects; however, this worry may be alleviated by supportive literature.

Objective: To evaluate the evidence behind off-label medication use by determining the presence of guideline support and compare graded recommendations to an online tertiary resource, DRUGDEX.

Osimertinib: A third-generation tyrosine kinase inhibitor for treatment of epidermal growth factor receptor-mutated non-small cell lung cancer with the acquired Thr790Met mutation.

Osimertinib is a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) approved for the treatment of metastatic EGFR T790M mutation-positive non-small cell lung cancer (NSCLC) in patients failing previous TKI therapy. The T790M mutation is an acquired resistance mechanism found in over half of patients with NSCLC progressing on first-generation TKIs. First- and second-generation TKIs do not inhibit the T790M mutation at clinically relevant concentrations.