Lessons learned from implementing a diversity, equity, and inclusion curriculum for health research professionals at a large academic research institution.

Objective: Despite advances in incorporating diversity and structural competency into medical education curriculum, there is limited curriculum for public health research professionals. We developed and implemented a four-part diversity, equity, and inclusion (DEI) training series tailored for academic health research professionals to increase foundational knowledge of core diversity concepts and improve skills. Methods: We analyzed close- and open-ended attendee survey data to evaluate within- and between-session changes in DEI knowledge and perceived skills. Results: Over the four sessions, workshop attendance ranged from 45 to 82 attendees from our 250-person academic department and represented a mix of staff (64%), faculty (25%), and trainees (11%). Most identified as female (74%), 28% as a member of an underrepresented racial and ethnic minority (URM) group, and 17% as LGBTQI. During all four sessions, attendees increased their level of DEI knowledge, and within sessions two through four, attendees' perception of DEI skills increased. We observed increased situational DEI awareness as higher proportions of attendees noted disparities in mentoring and opportunities for advancement/promotion. An increase in a perceived lack of DEI in the workplace as a problem was observed; but only statistically significant among URM attendees. Discussion: Developing applied curricula yielded measurable improvements in knowledge and skills for a diverse health research department of faculty, staff, and students. Nesting this training within a more extensive program of departmental activities to improve climate and address systematic exclusion likely contributed to the series' success. Additional research is underway to understand the series' longer-term impact on applying skills for behavior change.

Impacto en la calidad de vida del tratamiento de disfonía espasmódica aductora con toxina botulínica A / Impact on the quality of life of the treatment of adductor spasmodic dysphonia with botulinum toxin A

Introducción. La distonía laríngea o disfonía espasmódica se caracteriza por con-tracciones involuntarias de los músculos laríngeos internos que se desencadenan al hablar, siendo la forma aductora la más frecuente. La inyección de toxina botulínica es el manejo de elección. Para evaluar la respuesta a la terapia existen varios instru-mentos validados, uno de ellos es el cuestionario Voice Handicap Index-10 (VHI-10). El objetivo de este estudio es caracterizar a los pacientes con disfonía espasmódica aductora y evaluar el impacto de la toxina en su calidad de vida.Método. Éste se centró en un estudio retrospectivo descriptivo en pacientes adultos con diagnóstico de disfonía espasmódica aductora tratados con toxina botulínica A, en el Hospital Clínico Universidad de Chile (HCUC), en el periodo comprendido en-tre 2013 y 2021. El mismo permitió la obtención de los datos epidemiológicos de los pacientes, a quienes se les solicitó responder la encuesta VHI-10 previo y posterior a un mes de cada inyección de la toxina.Resultados. Se incluyeron 55 pacientes (218 procedimientos). La dosis promedio utilizada fue de 9,18 UI con un intervalo promedio de 7,4 meses. El puntaje VHI-10 promedio en la evaluación inicial fue de 29,4 y posinfiltración de 14,96, siendo esta diferencia significativa (p < 0,000001). En nuestra serie casi un tercio tiene asociada alguna patología neurológica, y se reportó un 3,67% de complicaciones leves y transitorias.Conclusión. La disfonía espasmódica aductora tiene un gran impacto en la calidad de vida de los pacientes, que se reduce significativamente mediante la inyección de toxina botulínica A, procedimiento que ha demostrado ser seguro y eficaz

Introduction. Laryngeal dystonia or spasmodic dysphonia is characterized by in-voluntary contractions of internal laryngeal muscles that are triggered when speak-ing, being the adductor form the most frequent. Botulinum toxin injection is the management of choice. There are several validated instruments to assess response to therapy, one of them is the Voice Handicap Index-10 (VHI-10) questionnaire. The objective of this study is to characterize patients with adductor spasmodic dysphonia and evaluate the impact of the toxin in their quality of life.Method. A descriptive retrospective study was carried out in adult patients with a diagnosis of adductor spasmodic dysphonia treated with botulinum toxin A, between 2013-2021 at the Hospital Clínico Universidad de Chile. The epidemiological data of the patients and the VHI-10 survey were obtained before and after one month of each toxin injection was requested.Results. 55 patients (218 procedures) were included. The average dose used was 9.18 IU with an average interval of 7.4 months. The average VHI-10 score in the initial evaluation was 29.4 and post-infiltration was 14.96, being this difference sig-nificant (p <0.000001). In our series, almost a third had an associated neurological pathology, and 3.67% of mild and transitory complications were reported.Conclusion. Adductor spasmodic dysphonia has a great impact on the quality of life of patients, which is significantly reduced by injecting botulinum toxin A, a pro-cedure that has been shown to be safe and effective

Evaluación y diagnóstico de la disfonía en niños / Assesment and diagnosis of dysphonia in children

Dysphonia in children is a common symptom but not a cause of common query in pediatrics, and usually is underestimated by parents and physicians. Most of vocal symptoms are caused by vocal abuse, however hoarseness can be a symptom of a relevant health problem and even severe in children. The following paper aims to expand the diagnostic range in this group of patients.

La disfonía en el niño es un síntoma frecuente, no así un motivo de consulta habitual, ya que con frecuencia suele ser subestimado por padres y médicos. Si bien la mayoría de los cuadros son debido a hiperfunción o mal uso de la voz, la disfonía en el niño puede ser síntoma de un problema de salud relevante e incluso grave. La siguiente publicación busca ampliar el abanico diagnóstico en este grupo de pacientes.

[Reference intervals for peripheral blood lymphocyte subsets in healthy adults in Lima, Peru]. / Intervalos de referencia de subpoblaciones linfocitarias de sangre periférica en adultos sanos de Lima, Perú

In order to establish the reference intervals (RIs) of peripheral blood lymphocyte subsets (PBL) in healthy adults in Lima (Peru), a cross-sectional study was conducted among blood donors taken in between 2011 and 2012. Based on the criteria obtained from the guidelines of the Clinical and Laboratory Standards Institute (CLSI C28-A3), 318 samples were processed, 61.9% (197/318) coming from male donors. For PBL count, a flow cytometer with a simple platform was used. The RIs are established for each PBL in adults based on sex with their respective reference limits and 90% confidence intervals. Differences were found in CD3+ percentage counts (p=0.001) and in CD3-CD56+ absolute (p=0.003) and percentage counts (p?0.001). The RIs found are different to those described in studies conducted in other countries due to the characteristics of the population and the study model.

Intervalos de referencia de subpoblaciones linfocitarias de sangre periférica en adultos sanos de Lima, Perú / Reference intervals for peripheral blood lymphocyte subsets in healthy adults in Lima, Peru

Con el objetivo de establecer los Intervalos de Referencia (InR) de las subpoblaciones linfocitarias (SPL) de sangre periférica en adultos sanos de Lima (Perú), se realizó un estudio transversal en donantes de sangre captados entre el 2011-2012. Siguiendo criterios basados en las directrices del Clinical and Laboratory Standards Institute (CLSI C28-A3), se procesaron 318 muestras, el 61,9% (197/318) de ellas procedentes de donantes de sexo masculino. Para el recuento de las SPL se empleó un citómetro de flujo de plataforma simple. Se establecieron los InR de cada SPL en personas adultas según sexo con sus respectivos límites de referencia y sus intervalos de confianza al 90%. Se encontraron diferencias en los recuentos porcentuales de CD3+ (p<0,01); y en los recuentos absolutos (p<0,01) y porcentuales (p=0,01) de CD3-CD56+. Los InR hallados son diferentes a los descritos en estudios realizados en otros países. Dichas diferencias se deben a las características de la población y al modelo de estudio.

In order to establish the reference intervals (RIs) of peripheral blood lymphocyte subsets (PBL) in healthy adults in Lima (Peru), a cross-sectional study was conducted among blood donors taken in between 2011 and 2012. Based on the criteria obtained from the guidelines of the Clinical and Laboratory Standards Institute (CLSI C28-A3), 318 samples were processed, 61.9% (197/318) coming from male donors. For PBL count, a flow cytometer with a simple platform was used. The RIs are established for each PBL in adults based on sex with their respective reference limits and 90% confidence intervals. Differences were found in CD3+ percentage counts (p=0.001) and in CD3-CD56+ absolute (p=0.003) and percentage counts (p?0.001). The RIs found are different to those described in studies conducted in other countries due to the characteristics of the population and the study model.

[Laryngeal stenosis as late manifestation of rhinoscleroma. Case report]. / Estenosis subglótica como manifestación tardía de un rinoescleroma. Presentación de un caso.

Rhinoscleroma is a chronic, progressive, granulomatous disease resulting from infection with Klebsiella rhinoscleromatis. It is generally uncommon, but endemic in certain regions of the world. It typically affects the nasal cavity, but also other parts of the respiratory system, such as the laryngotracheal region, which may be life-threatening if compromised. We present a 46-year-old male patient with a history of rhinoscleroma diagnosed and treated 15 years ago, with subglottal stenosis as a late sequela of this disease.