Novel In-Office KTP Laser Treatment of Anterior Glottic Webs.

Objective: Acquired anterior glottic webs are the result of trauma, iatrogenic, radiation, or inflammation to the anterior commissure, resulting in narrowing of the airway and elevated pitch. They are very challenging to treat, and contemporary management strategies typically involve repeat procedures under general anesthesia with high rates of web recurrence. We aim to describe a novel treatment for anterior glottic webs with potassium titanyl phosphate (KTP) laser treatment that are performed in-office under topical anesthesia.

Prospective Outcomes After Serial Platelet-Rich Plasma (PRP) Injection in Vocal Fold Scar and Sulcus.

Objective: Vocal fold scar and sulcus pose significant treatment challenges with no current optimal treatment. Platelet-rich plasma (PRP), an autologous concentration of growth factors, holds promise for regenerating the superficial lamina propria. This study aims to evaluate the potential benefits of serial PRP injections on mucosal wave restoration and vocal function.

Microvascular Endothelial Glycocalyx Surface Layer Visualization and Quantification.

As a primary interface between the blood and underlying vascular wall, the endothelial glycocalyx layer is common to all blood vessels and covers the luminal surface of all endothelial cells. The endothelial glycocalyx has important roles as a regulator of microvascular endothelial functions such as mechanotransduction, leukocyte adhesion, and microvascular permeability. Disruption of the molecular structure of the endothelial glycocalyx disturbs physiological, and hemodynamic processes associated with the microvascular wall leads to microvascular hyperpermeability.

Greater cost without greater benefit: The need to refine transfer criteria for patients with severe acute pancreatitis.

Background: Appropriate and timely care is essential in the management of severe acute pancreatitis (SAP). We hypothesized that transferred patients with SAP undergoing procedural intervention would have higher mortality compared to those managed directly at academic centers.

Methods: This was a retrospective analysis of Maryland's statewide claims database from 2009 to 2022 of adult patients admitted with a primary diagnosis of SAP (acute pancreatitis with organ failure).

Prospective >12 Months Outcomes After Vocal Fold Injection Medialization With Silk Microparticle-Hyaluronic Acid Material.

Objective: Vocal fold injection medialization (VFIM) is widely used as an initial treatment for unilateral vocal fold paralysis (UVFP). Current practices employ materials that share the limitation of temporary clinical effect from variable resorption rates. A novel silk protein microparticle-hyaluronic acid-based material (silk-HA) has demonstrated cellular infiltration and tissue deposition that may portend a durable medialization effect.

Results of a national survey of substance use treatment services for youth under community supervision.

Background: Despite the heightened risk for substance use (SU) among youth in the juvenile justice system, many do not receive the treatment that they need.

Objectives: The purpose of this study is to examine the extent to which youth under community supervision by juvenile justice agencies receive community-based SU services and the factors associated with access to such services.

Methods: Data are from a nationally representative sample of Community Supervision (CS) agencies and their primary behavioral health (BH) partners.

Case Report of Successful Bilateral Total Knee Arthroplasty: 46 Years and Still Going.

Case: A 63-year-old woman with 46-year-old bilateral cemented total knee arthroplasty (TKA) presented to our clinic for routine evaluation. She was diagnosed with idiopathic juvenile arthritis at the age of 17. Radiographically she had well-fixed implants bilaterally without bone-cement lucency.

3D-Printed Cardiac Models for Fetal Counseling: A Pilot Study and Novel Approach to Improve Communication.

A fetal cardiology consultation involves using two-dimensional drawings to explain the cardiac anatomy which can result in inherent variation in how the congenital heart disease (CHD) is conveyed. In this pilot study, we incorporated three-dimensional printed (3DP) models into fetal counseling to demonstrate feasibility and evaluate the impact on parental knowledge, understanding, and anxiety. Parents with a prenatal diagnosis of a muscular ventricular septal defect (VSD) and/or coarctation of aorta were enrolled.

Mortality postponement and compression at older ages in human cohorts.

A key but unresolved issue in the study of human mortality at older ages is whether mortality is being compressed (which implies that we may be approaching a maximum limit to the length of life) or postponed (which would imply that we are not). We analyze historical and current population mortality data between ages 50 and 100 by birth cohort in 19 currently-industrialized countries, using a Bayesian technique to surmount cohort censoring caused by survival, to show that while the dominant historical pattern has been one of mortality compression, there have been occasional episodes of mortality postponement. The pattern of postponement and compression across different birth cohorts explain why longevity records have been slow to increase in recent years: we find that cohorts born between around 1900 and 1950 are experiencing historically unprecedented mortality postponement, but are still too young to break longevity records.

Mobilizing digital technology to implement a population-based psychological support response during the COVID-19 pandemic in Lima, Peru.

Background: The COVID-19 pandemic caused considerable burden on mental health worldwide. To address this emergency in Peru, Socios en Salud (SES) implemented an innovative digital system for the diagnosis and psychological therapy in vulnerable populations. We describe the development, implementation, and participant outcomes of this intervention.

Sexual Addiction as a Legal Defense.

The term sexual addiction is used to describe a range of behaviors involving compulsive and maladaptive sexual behavior. There are mixed opinions in the medical literature regarding whether sexual addiction represents a valid psychiatric diagnosis or instead pathologizes behaviors in the expected range of human behavior. The opinions on sexual addiction in case law are similarly mixed.

Opioid use disorder Cascade of care framework design: A roadmap.

Unintentional overdose deaths, most involving opioids, have eclipsed all other causes of US deaths for individuals less than 50 years of age. An estimated 2.4 to 5 million individuals have opioid use disorder (OUD) yet a minority receive treatment in a given year.

Yoga and Cutaneous Functional Unit Recruitment for a Patient with Cervical and Upper Extremity Burn Scar Contracture: Case Report.

Burn scar contracture greatly limits function for burn survivors, particularly when the scarring crosses multiple joints. Previous research has identified fields of skin recruited during single joint motion, called cutaneous functional units (CFU), indicating that impairments may be seen distal to the injured tissue. This case report connects the principles of CFU and yoga-inspired therapy modalities in improving clinical outcomes for a burn survivor.

Management of SHDB positive patient with metastatic bilateral giant retroperitoneal paragangliomas.

Paragangliomas are rare neuroendocrine tumors that can vary in size and metabolic activity. We report a case of giant bilateral malignant retroperitoneal paragangliomas (PGL) in a patient with germline succinate dehydrogenase B (SDHB) mutation. This patient, who presented in an emaciated and debilitated state, was managed with adrenergic blockade followed by radical primary surgery.

Mutants of the ABCG Transporter in Have Deficient Olfactory Learning and Cholesterol Homeostasis.

's gene encodes an ATP-binding cassette G-subfamily (ABCG) half-transporter. White is closely related to mammalian ABCG family members that function in cholesterol efflux. Mutants of have several behavioral phenotypes that are independent of visual defects.

Orbital Varix Masquerading as an Intraorbital Lymphoma.

Clinical context was paramount to the diagnosis and management of a patient with periorbital pain and a history of systemic lymphoma.

Incidence of Secondary Hemophagocytic Lymphohistiocytosis in Critically-Ill COVID-19 Patients.

Objective Coronavirus disease 2019 (COVID-19) is associated with diffuse lung injury that can progress to acute respiratory distress syndrome, multisystem-organ failure, and death. The inflammatory storm seen in many COVID-19 patients closely resembles secondary hemophagocytic lymphohistiocytosis (sHLH) which has been described in other virus-associated severe sepsis. We sought to describe the incidence of sHLH in COVID-19 infected patients.

Substance use disorder approaches in US primary care clinics with national reputations as workforce innovators.

Background: Over the last decade, primary care clinics in the United States have responded both to national policies encouraging clinics to support substance use disorders (SUD) service expansion and to regulations aiming to curb the opioid epidemic.

Objective: To characterize approaches to SUD service expansion in primary care clinics with national reputations as workforce innovators.

Methods: Comparative case studies were conducted to characterize different approaches among 12 primary care clinics purposively and iteratively recruited from a national registry of workforce innovators.

Utilising an Accelerated Delphi Process to Develop Guidance and Protocols for Telepresence Applications in Remote Robotic Surgery Training.

Context: The role of robot-assisted surgery continues to expand at a time when trainers and proctors have travel restrictions during the coronavirus disease 2019 (COVID-19) pandemic.

Objective: To provide guidance on setting up and running an optimised telementoring service that can be integrated into current validated curricula. We define a standardised approach to training candidates in skill acquisition via telepresence technologies.