Optimal Insertion Depth for Nasal Mid-Turbinate and Nasopharyngeal Swabs.

Millions of people are tested for COVID-19 daily during the pandemic, and a lack of evidence to guide optimal nasal swab testing can increase the risk of false-negative test results. This study aimed to determine the optimal insertion depth for nasal mid-turbinate and nasopharyngeal swabs. The measurements were made with a flexible endoscope during the collection of clinical specimens with a nasopharyngeal swab at a public COVID-19 test center in Copenhagen, Denmark. Participants were volunteer adults undergoing a nasopharyngeal SARS-CoV-2 rapid antigen test. All 109 participants (100%) completed the endoscopic measurements; 52 (48%) women; 103 (94%) white; mean age 34.39 (SD, 13.2) years; and mean height 176.7 (SD, 9.29) cm. The mean swab length to the posterior nasopharyngeal wall was 9.40 (SD, 0.64) cm. The mean endoscopic distance to the anterior and posterior end of the inferior turbinate was 1.95 (SD, 0.61) cm and 6.39 (SD, 0.62) cm, respectively. The mean depth to nasal mid-turbinate was calculated as 4.17 (SD, 0.48) cm. The optimal depths of insertion for nasal mid-turbinate swabs are underestimated in current guidelines compared with our findings. This study provides clinical evidence to guide the performance of anatomically correct nasal and nasopharyngeal swab specimen collection for virus testing.

[Ultrasound-guided radiofrequency ablation of benign symptomatic thyroid nodules].

Ultrasound-guided radiofrequency ablation is an effective and safe treatment option for solid and cystic, cold, benign symptomatic thyroid nodules of ≥ 2 cm and less-than 20 ml. It is non-invasive, and in this review, we consider it well supported in the current literature for its efficacy, safety, patient satisfaction and cost. In addition, it is also a promising alternative therapy for hyperfunctioning nodules.

Co-morbidity of migraine and Ménière's disease -- is allergy the link?

This study determined the prevalence of migraine and allergy in patients with Ménière's disease (MD) compared with age- and sex-matched controls. We tested the hypothesis that if migraine and MD is linked by allergy, then allergy should be more prevalent in patients with MD and migraine compared with MD patients without migraine. A web-based questionnaire was used to recruit patients with MD (n = 108) while the control group consisted of patients attending the ENT clinic for other problems (n = 100). The prevalence of migraine and allergy was significantly higher in patients with MD compared with age- and sex-matched controls (p > or = 0.005). In addition, the prevalence of allergy was significantly higher in patients who had both MD and migraine (30/42) than MD alone (26/66,p = 0.002). However, there was no link with any specific allergy types. This study suggests that migraine and MD may be linked by an immunological determinant.

Operative training in otolaryngology in the United Kingdom: a specialist registrar survey.

OBJECTIVE: To assess the current status of operative training for otolaryngology specialist registrars in the United Kingdom. DESIGN: Web-based questionnaire survey. PARTICIPANTS: All otolaryngology specialist registrars in the United Kingdom. MAIN OUTCOME MEASURES: The overall satisfaction with operative training was assessed as well as the number of operations performed and level of competency in stage-specific procedures, as defined by the Joint Committee for Higher Specialist Training. RESULTS: Otolaryngology specialist registrars are generally satisfied with the quality of their operative training. The most important predictive factor of satisfaction with operative training was the number of theatre sessions per week. The vast majority of registrars (92 per cent by the end of year one, 73 per cent at the end of years two to four) appear to attain all the stage-appropriate surgical competencies during the first four years. However, with respect to the last two years of registrar training, only 26 per cent can perform all the designated (complex) procedures. There are no significant differences between deaneries or geographic regions in the overall satisfaction rates, number of operative sessions, number of operations performed or operative competencies attained. CONCLUSION: It appears that the Specialist Advisory Committee (SAC) is generally successful in maintaining common operative training standards and providing a homogenous training environment. During the first four years registrars attain an appropriate level of general training while the last two years are mainly devoted to subspecialty interests.