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1.
Otolaryngol Head Neck Surg ; 164(2): 229-233, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33045901

RESUMEN

Academic centers embody the ideals of otolaryngology and are the specialty's port of entry. Building a diverse otolaryngology workforce-one that mirrors society-is critical. Otolaryngology continues to have an underrepresentation of racial and ethnic minorities. The specialty must therefore redouble efforts, becoming more purposeful in mentoring, recruiting, and retaining underrepresented minorities. Many programs have never had residents who are Black, Indigenous, or people of color. Improving narrow, leaky, or absent pipelines is a moral imperative, both to mitigate health care disparities and to help build a more just health care system. Diversity supports the tripartite mission of patient care, education, and research. This commentary explores diversity in otolaryngology with attention to the salient role of academic medical centers. Leadership matters deeply in such efforts, from culture to finances. Improving outreach, taking a holistic approach to resident selection, and improving mentorship and sponsorship complement advances in racial disparities to foster diversity.


Asunto(s)
Centros Médicos Académicos , Educación de Postgrado en Medicina/organización & administración , Docentes Médicos/organización & administración , Internado y Residencia/métodos , Mentores , Otolaringología/educación , Procedimientos Quirúrgicos Otorrinolaringológicos/educación , Etnicidad , Humanos , Estados Unidos , Recursos Humanos
3.
Otolaryngol Head Neck Surg ; 158(6): 979-980, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29436259

RESUMEN

Rates of burnout, mental illness, and suicide are disproportionately elevated among physicians, and surgical specialists, including otolaryngologists, are at even higher risk for professional burnout. These trends have been identified at both the trainee and attending level. To combat resident burnout, the Accreditation Council for Graduate Medical Education (ACGME) Council of Review Committee Residents (CRCR) designed the Back to Bedside Initiative, the goals of which are to foster meaning in the learning environment and to help trainees to engage more deeply with patients. Two funded Back to Bedside proposals involve otolaryngology training programs. Herein, we discuss these 2 approaches in an effort to foster additional novel resident wellness initiatives and awareness thereof across our subspecialty.


Asunto(s)
Agotamiento Profesional/prevención & control , Agotamiento Profesional/psicología , Promoción de la Salud/métodos , Internado y Residencia , Otorrinolaringólogos/educación , Otorrinolaringólogos/psicología , Grupos Focales , Humanos , Relaciones Médico-Paciente , Consejos de Especialidades , Estados Unidos
4.
Int Forum Allergy Rhinol ; 6(8): 783-91, 2016 08.
Artículo en Inglés | MEDLINE | ID: mdl-27309535

RESUMEN

BACKGROUND: Sinonasal biofilms have been demonstrated in specimens collected from chronic rhinosinusitis (CRS) patients. Mounting evidence suggests that biofilms contribute to therapeutically recalcitrant CRS. Recently, the bitter taste receptor T2R38 has been implicated in the regulation of the sinonasal mucosal innate immune response. TAS2R38 gene polymorphisms affect receptor functionality and contribute to variations seen in sinonasal innate defense as well as taste perception reflected in gustatory sensitivity to the bitter compound phenylthiocarbamide (PTC). In a population of CRS patients with active infection or inflammation, we sought to determine if a correlation between T2R38 phenotype and in vitro biofilm formation existed. METHODS: Endoscopically guided sinonasal swabs were obtained prospectively from CRS (±polyp) patients with evidence of persistent inflammation or mucopurulence. In vitro biofilm formation was assessed with a modified Calgary Biofilm Detection Assay. Patients' phenotypic (functional) expression of the bitter taste receptor T2R38 was evaluated with a taste test including the compound PTC. Linear regression was used to determine the level of significance between mean in vitro biofilm formation levels and mean PTC taste test intensity ratings across CRS patients. RESULTS: Sinonasal swabs were obtained from 59 patients, with 42 of the 59 samples demonstrating in vitro biofilm formation. Analysis revealed an inverse linear association between in vitro biofilm formation and PTC taste intensity ratings (p = 0.019) for all patients. This association was exclusively driven by nonpolypoid CRS patients (p = 0.0026). CONCLUSION: In vitro biofilm formation from sinonasal clinical isolates is inversely correlated with PTC taste sensitivity in nonpolypoid CRS patients.


Asunto(s)
Biopelículas , Pseudomonas/fisiología , Receptores Acoplados a Proteínas G/fisiología , Rinitis/fisiopatología , Sinusitis/fisiopatología , Gusto , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedad Crónica , Femenino , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Feniltiourea , Receptores Acoplados a Proteínas G/genética , Adulto Joven
5.
J Vasc Interv Radiol ; 24(3): 347-50, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23433410

RESUMEN

PURPOSE: To compare the amount of sedation medication administered during radiofrequency (RF) ablation versus cryoablation of small renal masses. MATERIALS AND METHODS: Records were retrospectively reviewed in patients who underwent percutaneous computed tomography-guided RF ablation and cryoablation of small renal masses from January 2002 to June 2011 for patient and tumor characteristics, amount of medications used for moderate sedation, and complications. Sedation was performed by giving patients titrated doses of midazolam and fentanyl. Additional medications were given if the desired level of sedation was not achieved. RESULTS: There were 116 patients who underwent 136 ablation procedures; 71 patients underwent RF ablation, and 65 patients underwent cryoablation. RF ablation was associated with a significantly higher mean dose of fentanyl (mean dose for RF ablation, 236.43 µg; mean dose for cryoablation, 172.27 µg; P<.001). RF ablation was also associated with a higher mean dose of midazolam (mean dose for RF ablation, 4.5 mg; mean dose for cryoablation, 3.27 mg; P<.001). In the RF ablation group, two patients required additional sedation with droperidol. As a result of oversedation, two patients in the RF ablation cohort required sedation reversal with naloxone and flumazenil. None of the patients who underwent cryoablation required sedation reversal. No other sedation-related complications occurred. CONCLUSIONS: Cryoablation of small renal masses was performed with less sedation medication than RF ablation. This finding suggests renal cryoablation is less painful than RF ablation; however, prospective studies with validated pain scales are needed to confirm these results.


Asunto(s)
Ablación por Catéter , Criocirugía , Hipnóticos y Sedantes/administración & dosificación , Neoplasias Renales/cirugía , Dolor Postoperatorio/prevención & control , Cirugía Asistida por Computador , Tomografía Computarizada por Rayos X , Adulto , Anciano , Anciano de 80 o más Años , Ablación por Catéter/efectos adversos , Criocirugía/efectos adversos , Droperidol/administración & dosificación , Femenino , Fentanilo/administración & dosificación , Humanos , Hipnóticos y Sedantes/efectos adversos , Neoplasias Renales/diagnóstico por imagen , Neoplasias Renales/patología , Masculino , Midazolam/administración & dosificación , Persona de Mediana Edad , Dimensión del Dolor , Dolor Postoperatorio/diagnóstico , Dolor Postoperatorio/etiología , Estudios Retrospectivos , Cirugía Asistida por Computador/efectos adversos , Resultado del Tratamiento , Carga Tumoral
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