Perspectives on the Impact of the COVID-19 Pandemic on Research: A Cross-Sectional Survey of Pediatric Otolaryngologists.

OBJECTIVE: To investigate the perspectives of pediatric otolaryngologists on the impact of the coronavirus disease 2019 (COVID-19) pandemic on their research. METHODS: Two surveys were sent to members of the American Society of Pediatric Otolaryngology (ASPO) in 2019 and 2021 to assess research perspectives before and during the COVID-19 pandemic. The surveys contained questions about research engagement, barriers, time allocation, and shifts in research focus. RESULTS: The COVID-19 pandemic reshaped research within pediatric otolaryngology, with a mixed impact on the amount of time allocated to research endeavors. Almost half of respondents reported a change in research focus to COVID-19-related studies. Protected time and funding were significant pre-pandemic barriers, whereas reduced staff, collaboration opportunities, and enrollment limitations emerged as key pandemic-related obstacles. A personal commitment to research was most strongly correlated with time spent on this endeavor. During the pandemic, women were less likely to report an increase in research activity when compared to men, possibly due to a disproportionate burden of caregiving on women during school closures and stay-at-home orders. CONCLUSION: Overall, the pandemic prompted both increases and decreases in research time allocation, depending on individual circumstances and priorities. Despite new challenges, pediatric otolaryngologists remain committed to research and have continued to remain productive.

Rethinking Data Collection Methods During the Pandemic: Development and Implementation of CATI for the All of Us Research Program.

The All of Us Research Program is a longitudinal cohort study aiming to build a diverse database to advance precision medicine. The COVID-19 pandemic hindered the ability of participants to receive in-person assistance at enrollment sites to complete digital surveys. Therefore, the program implemented Computer-Assisted Telephone Interviewing (CATI) to facilitate survey completion remotely to combat the disrupted data collection procedures. In January 2021, All of Us implemented a 1-year CATI Pilot supporting 9399 participants and resulting in 16 337 submitted surveys. The pilot showed that CATI was successful in increasing survey completion and retention activities for the All of Us Research Program, given the additional remote support offered to participants. Given the success of the CATI Pilot, multimodal survey administration will continue.

Cutaneous head and neck angiosarcoma: The 30-year UCLA experience.

Background: Cutaneous angiosarcoma is an aggressive tumor commonly found in the head and neck region. There is no consensus regarding the definitive treatment for angiosarcoma. Methods: This was a retrospective chart review that evaluated 64 patients from 1983 to 2019. Demographic and clinical variables were examined for impact on recurrence using the time to recurrence and the overall survival in Kaplan-Meier curves. Results: Average age at diagnosis was 71 (32-95) years, with a 2.8 male: female ratio. Surgery was utilized in 62% of patients, with mean defect size of 11.4 ± 8.1 cm. Recurrence was found in 70% of patients, and mean time to recurrence was 15.3 ± 12.3 months. Decreased recurrence was associated with use of intraoperative frozen section analysis (p = .036) and negative margins (p = .086). Two-year overall survival was 80%, and recurrence free survival was 30%. Conclusions: Negative margins are associated with decreased recurrence, and intraoperative frozen section analysis may be considered to obtain preliminary surgical margins.Level of Evidence: 4.

Feasibility of Instituting a Clinical Otolaryngology Human Papillomavirus (HPV) Vaccination Program.

OBJECTIVES: To measure baseline human papillomavirus (HPV) vaccination rates among tertiary and community-based Otolaryngology - Head and Neck Surgery (Oto-HNS) clinic patients and to determine risk factors for under-vaccination. METHODS: Retrospective chart review of patients aged 9 to 26 years presenting to an Oto-HNS clinic from 2017 to 2019. Patients were considered complete for HPV vaccination if they received two doses of HPV vaccine with the first dose received before age 15 years or three doses of HPV vaccine otherwise. RESULTS: 8,532 unique patients met the criteria. At the index visit, 3,110 (36.5%) had completed the HPV series, 5,422 (63.5%) were due for one or more doses, with 4,981 (58.4%) eligible for vaccination at the time of their appointment. Of those dues, most (3,148/5,422 or 58%) were past due by age (≥13 years old). Of the 3,148 patients past due, 745 (23.7%) were partially vaccinated and 2,403 (76.3%) were vaccine naïve. Male sex and younger age were both independently associated with incomplete vaccination (p < 0.0001). CONCLUSION: This study demonstrates that the implementation of on-site HPV vaccination has the potential to increase the opportunities for vaccination among vaccine-eligible patients, especially among young males. Otolaryngologists have the potential to provide meaningful preventive services in the fight against HPV-mediated disease. LEVEL OF EVIDENCE: 3 Laryngoscope, 133:116-123, 2023.

Management of a salivary fistula following removal of mandibular distractors in a neonate.

There are multiple management options for treatment of iatrogenic salivary fistulas including reduced oral intake, pressure dressings, total parotidectomy, tympanic neurectomy, surgical repair, radiation therapy, and pharmacotherapy. However, the optimal management of salivary fistulas is unclear due to uncertain efficacy and adverse outcomes. We present a case of a neonate that developed a submandibular fistula following removal of mandibular distractors and was ultimately successfully managed using intralesional botulinum toxin injection. The purpose of this communication is to summarize the management of this complication in the context of the current literature.

Society of Interventional Radiology Foundation Funding to National Institutes of Health Funding: Report from the Society of Interventional Radiology Foundation/National Institutes of Health Task Force.

The Society of Interventional Radiology Foundation (SIRF) aims to support interventional radiology (IR) investigators by awarding numerous grants to promote the advancement of scientific knowledge in IR. Over the last 19 years, SIRF has awarded 227 research grants, amounting to more than $4.7 million. To increase the engagement of interventional radiologists and IR scientists with the National Institutes of Health (NIH), SIRF created a SIRF/NIH taskforce in 2020. Over the past couple of years, the task force has been working to assess the return on investment of SIRF grants in terms of NIH funding because this metric is an effective measure of assessing the early success of foundation funding. The objectives of this report are to assess SIRF funding from 2002 to 2020 and investigate the conversion of this funding into NIH grants by the same investigators. During the study period, more than $37.6 million in NIH funds were awarded to SIRF awardees, which shows a return of 8 NIH dollars for every 1 SIRF dollar invested.

Unconventional Obturator Artery Nutrient Branch: Image of an Anatomical Variation.

Variations in vascular anatomy are of great concern to surgeons, as proper identification of aberrant arteries can reduce the risk of iatrogenic injury and improve patient outcomes. Several studies have highlighted the irregular branching pattern of pelvic arteries, with a recent focus on the obturator artery (OA). The OA has an inconstant origin from the internal iliac artery, external iliac artery, or inferior epigastric artery. Within the pelvis, the OA can give off muscular branches and nutrient vessels to the ilium and pubis. Though occasionally described in text, few resources employ images of human donors that depict branches arising from the OAs. Out of the 34 hemisected pelves studied, we identified 1 individual with a substantial nutrient vessel branching unilaterally from the OA. Herein, we present the first image of this unconventional nutrient artery. This vessel should be highlighted given that its size and course make it particularly vulnerable during intrapelvic surgeries such as pelvic lymph node dissection or in procedures requiring arterial embolization of the OA.

Manejo del dolor postoperatorio en pacientes de cirugía cardiotorácica / Management of postoperative pain in patients with cardio surgery

El efecto beneficioso principal de un control eficaz del dolor es la satisfacción del paciente. La importancia de una correcta analgesia perioperatoria obliga a un profundo conocimiento de las características del dolor, de las armas terapeúticas de las que se dispone y de la técnica utilizada. Si bien la analgesia intravenosa pautada es la forma más extendida de control del dolor postoperatorio, el desarrollo de técnicas de analgesia controlada por el paciente (PCA) y las ventajas que ofrece la analgesia epidural obliga a plantear cuál sería el tratamiento ideal. Por tanto, las ventajas que ofrece un estricto control del dolor postoperatorio tras la cirugía cardiotorácica obliga a tenerlo cada vez más en cuenta y perseguirlo como uno de los objetivos primordiales del período postoperatorio.

Fisiopatología del dolor en intervenciones cardiotorácicas / Physiopathology of pain interventions cardio

Las cirugías que implican esternotomía o toracotomía son unas de las que más dolor postoperatorio producen, razón por la cual el objetivo del tratamiento no solo se dirige a calmar el dolor sino también a evitar los efectos adversos fisiopatológicos que pueden llegar a ser muy nocivos en el paciente sometido a cirugía cardiotorácica. Para que la analgesia postoperatoria sea eficiente es necesario que el anestesiólogo conozca profundamente la fisiopatología del dolor. Así se podrá enfrentar adecuadamente los cambios hemodinámicos, respiratorios, endócrinos, metabólicos e inmunitarios. Se presenta este primer artículo relacionado con la fisiopatología del dolor en intervenciones cardiotorácicas y un segundo en donde se analizan 10/ diferentes tratamientos que se pueden aplicar.

Estándares de monitorización anestésica básica en cinco hospitales de Quito

El presente estudio operativo no experimental post-evaluatorio, tuvo el propósito de determinar el cumplimiento de los estándares de monitorización anestésica básica aporbado en 1986 por la ASA (Asociación Americana de Anestesiólogos), considerando que su uso podría prevenir y evitar la morbilidad y mortalidad asociados a la anestesia. Se observaron en forma aleatoria 351 procedimientos anestésicos en cinco hospitales de la ciudad de Quito (Carlos Andrade Marín, General de las Fuerzas Armadas, Pediátrico Baca Ortíz, Gineco Obstétrico Isidro Ayora y Pablo Arturo Suárez); además, se realizó una encuesta que evaluó el conocimiento de los estándares a 69 profesionales de los servicios de anestesiología de los mencionados centros hospitalarios...

Complicaciones de la anestesia peridural en el Hospital Pablo Arturo Suarez 1995

Se trata de un estudio prospectivo longuitudinal en el que se analizaron las complicaciones de la práctica de la anestesia peridural en el Hospital Pablo Arturo Suarez de la ciudad de Quito. Se analizaron un total de 100 pacientes quirurgicos sometidos a anestesia peridural entre enero y marzo de 1995. Se encuentran los siguientes hallazgos: 1). sexo: femenino 63 por ciento, masculino 37 por ciento. 2). Tipo de cirugía: cesárea 26 por ciento, hernia inguinal 25 por ciento y salpingectomia 10 por ciento. 3). Altura de punción: L3-L4 62 por ciento, L2-L3 35 por ciento, L1-L2 3 por ciento, 4). Efectos colaterales: a) escalofrios 20.3 por ciento. b) Hipotension arterial 15.62 por ciento, c) técnica insuficiente 14.06 por ciento, d) dolor tipo "corrientazo" 12.5 por ciento e) dolor lumbar post punción 7.81 por ciento f) vómito 7.81 por ciento g) cefálea 6.25 por ciento h) prurito 6.25 por ciento i) precordialgia 1,56 por ciento. 5). Combinaciones farmacológicas: a) lidocaina con epinefrina + epinefrina+fentanyl+bicarbonato: 10 por ciento; b) lidocaína+epinefrina+bicarbonato: 15 por ciento; c) lidocaína+bupivacaina+epinefrina: 20 por ciento d) lidocaina+epinefrina (1:400.000)+bicarbonato: 25.5 por ciento.