Thermal Characteristics of Different Types of Cochlear Implants in Pediatric Cochlear Implant Users: AComparative Digital-Infrared Thermal Imaging Analysis.

BACKGROUND: This study aimed to evaluate thermal characteristics of different types of pediatric cochlear implants METHODS: A total of 39 pediatric patients using Med-El (Synchrony®), Cochlear (Nucleus®), or Advanced Bionics (HiRes 90K®) type of cochlear implants were included. A digital infrared thermal imaging analysis was performed to measure the heating over the implant and the tissue heat- ing of the skin below and around the device, while skin thickness and visual analog scale scores were also recorded. RESULTS: Over the implant, heating values were significantly higher in the on-mode vs. off-mode of device for each type of implant (P ranged from <.05 to <.001). The implants groups were similar in terms of skin thickness, visual analog scale scores, on-mode values for heating over the implant, and the heating of the skin (below or around the device; <36°C for each), while the off-mode values for heating over the implant were significantly higher in the Med-El (Synchrony®) implants compared to other implants (median 31.75 vs. 31.30 and 30.20°C, P = .001). Skin thick- ness was negatively correlated with the heating over the implant (off-mode, r=-0.708, P < .001) and heating of the skin (around the device, r = -0.479, P = .028) in Advanced Bionics (HiRes 90K®) implants. CONCLUSION: Our findings emphasize that there is no hazard or discomfort from a cochlear implant in terms of heating of skin and no significant difference between 3 implant types in terms of skin thickness or tissue heating, whereas indicate the increased likelihood of thermal characteris- tics of implant to differ with respect to skin thickness in Advanced Bionics (HiRes 90K®) users.

The Impact of Isotretinoin Therapy on the Nasal Skin Thickness and Elasticity: An Ultrasonography and Elastography Based Assessment in Relation to Dose and Duration of Therapy.

BACKGROUND: This study aimed to evaluate the impact of isotretinoin therapy on the nasal skin thickness and elasticity with regard to implications for rhinoplasty METHODS: A total of 40 acne vulgaris patients (mean±SD age: 20.9 ± 3.0 years, 65.0% were females) initiating oral isotretinoin treatment (0.25 mg/kg/day, n = 16 or 0.5 mg/kg/day, n = 24) were included in this prospective 4-month isotretinoin follow-up study. Ultrasonography assessments regarding nasal skin thickness (dermis and soft tissue) and elastography were repeated at second and fourth months of treatment. RESULTS: No significant difference was noted between isotretinoin dose groups in terms of second month and fourth month nasal skin thickness (dermis and soft tissue) values measured at any region. Each dose revealed significant decrease in dermis and soft tissue thickness from baseline at any region (p ranged < 0.001 to < 0.001), while only fourth month values at nasal tip and second month values at rhinion for dermis and only fourth month values at rhinion and glabella for subcutaneous tissue significantly differed from baseline (p < 0.01 for each) in the 0.25 mg and 0.50 mg dose groups, respectively. Elastography values at fourth month of isotretinoin treatment were significantly higher than pre-treatment and second month values in both 0.25 mg (90.4 ± 20.6 vs. 59.5 ± 21.8 and 76.4 ± 22.9, p < 0.01 for each) and 0.5 mg (86.7 ± 20.6 vs. 61.8 ± 23.2 and 76.9±24, p < 0.01 for each) dose groups. CONCLUSIONS: In conclusion, our findings revealed the association of isotretinoin treatment with a significant decrease in dermis and subcutaneous soft tissue thickness measured at each anatomical landmark, regardless of the treatment dose. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Objective evaluation of odor loss in COVID-19 and other suspected cases.

INTRODUCTION: COVID-19 is a pandemic disease known with one of the symptoms is sudden onset anosmia. This symptom sometimes may be the only sign of the disease, therefore it must be research widely. OBJECTIVE: We aim to evaluate odor dysfunction in COVID-19 patients objectively and safely without any risk of transmitting the disease. METHODS: The odor threshold test was performed on 105 patients hospitalized at the XXXX Training and Research Hospital on the COVID-19 pandemic service before any treatment began. Odor threshold was tested using a modification of the Connecticut Chemosensory Clinical Research Center olfactory function test. COVID-19 signs and symptoms, PCR test results, thorax computed tomography (CT) findings, and length of hospital stay were recorded. Odor tests were scored between 0-8, 0-1 anosmia, 2-3 severely hyposmia, 4 moderate hyposmia, 5 mild hyposmia, 6 and above normosmia. RESULTS: Forty-one (39%) of the 105 patients were diagnosed with COVID-19 after the PCR results. Patients with an odor threshold score < 5 were classified as "Smell-Impaired Group", patients with an odor threshold score ≥ 5 were placed in "Smell Intact Group". The incidence of female patients in smell-impaired group was significantly higher (p ˂ 0.05). The proportion of patients who were PCR-positive for COVID-19 in smell-impaired group was significantly higher (p ˂ 0.05) than in smell intact group. Among patients with an odor threshold score from 0 to 1 (anosmic; n = 15), 12 (80%) demonstrated PCR positivity (p < 0.0001). CONCLUSION: Anosmia can be predictive for coronavirus disease. Odor threshold test can be helpful for diagnosis.

The predictive value of dominant nodules and the management of indeterminate group in multinodular goiter.

The objectives of this study were to determine the predictive value of dominant nodules (DNs) in multinodular goiters (MNGs), and to stratify the risk of malignancy within the indeterminate category. The study design was retrospective study of patients with MNG. A total of 140 patients were reviewed. Fine needle aspiration biopsy (FNAB) findings for all DNs were categorized into four groups: (1) benign, (2) positive or suspicious for malignancy, (3) indeterminate, and (4) non-diagnostic. All FNAB specimens of the indeterminate group were also evaluated for the presence of Hurthle cell metaplasia and were categorized according to the presence of cytological atypia. Cytohistological comparison was then performed. Mean number and diameter of the DNs were 1.45 and 25.6 mm, respectively. Based on final histopathology, 22.14% of the patients had thyroid malignancy and 74.2% of thyroid carcinomas were located in DNs. The number of DNs was significantly larger in malignant thyroid glands than in benign ones. In total, 22.6% of the indeterminate FNABs were malignant. FNABs of the indeterminate group that included atypical cells had a statistically significant higher incidence of malignancy. The presence of Hurthle cells was not statistically different in malignant and benign nodules upon final histological diagnosis. In conclusion, FNAB of only DNs in MNG could determine thyroid malignancy in 75% of patients. The DN number might be required for the predictive value of malignancy. A subclassification of the indeterminate group, based on the presence or absence of cytological atypia, is necessary to better assess the risk of malignancy.