Sociodemographic Factors and Health Care Utilization in Pediatric Chronic Suppurative Otitis Media.

OBJECTIVES: Access to and utilization of perioperative healthcare may influence outcomes in patients with chronic suppurative otitis media (CSOM); however, the influencing factors are poorly understood. The objective of this study was to assess the association of sociodemographic factors with perioperative health care utilization for pediatric CSOM patients. METHODS: We conducted a review on pediatric CSOM patients (≤18 years old) who underwent tympanoplasty with/without mastoidectomy between 2010 and 2020. Sociodemographic data and clinical were collected on all participants. Univariate and multivariate logistic regression analysis was conducted to assess the association between these factors and perioperative care utilization. RESULTS: 427 patients were included in the study. The primary factor associated with health care utilization was insurance status. Rural children were more likely to have Medicaid insurance (p = 0.048). For tympanoplasty patients, Medicaid patients have 1.66 higher odds of pre-operative no-shows (p = 0.01), 1.31 higher odds of post-operative no-shows (p = 0.02), and 59% lower odds of having a postoperative audiogram (p = 0.01), and 2.64 higher odds of being from a rural community (p = 0.02). For patients undergoing mastoidectomy, Medicaid patients have 1.25 higher odds of postoperative no-shows (p = 0.01), 39% lower odds of having a revision procedure for ossicular reconstruction (p = 0.045). Appalachian rural mastoidectomy patients had 3.62 higher odds of having cholesteatoma (p = 0.05). CONCLUSION: Pediatric patients with CSOM who have Medicaid insurance, especially those who reside in rural regions, are at risk for lower perioperative hearing health care utilization. As these findings may impact care delivery and clinical outcomes, efforts should be focused on promoting utilization among these populations. LEVEL OF EVIDENCE: 4 Laryngoscope, 133:700-705, 2023.

Effect of 1-week betalain-rich beetroot concentrate supplementation on cycling performance and select physiological parameters.

PURPOSE: Betalains are indole-derived pigments found in beet root, and recent studies suggest that they may exert ergogenic effects. Herein, we examined if supplementation for 7 days with betalain-rich beetroot concentrate (BLN) improved cycling performance or altered hemodynamic and serum analytes prior to, during and following a cycling time trial (TT). METHODS: Twenty-eight trained male cyclists (29 ± 10 years, 77.3 ± 13.3 kg, and 3.03 ± 0.62 W/kg) performed a counterbalanced crossover study whereby BLN (100 mg/day) or placebo (PLA) supplementation occurred over 7 days with a 1-week washout between conditions. On the morning of day seven of each supplementation condition, participants consumed one final serving of BLN or PLA and performed a 30-min cycling TT with concurrent assessment of several physiological variables and blood markers. RESULTS: BLN supplementation improved average absolute power compared to PLA (231.6 ± 36.2 vs. 225.3 ± 35.8 W, p = 0.050, d = 0.02). Average relative power, distance traveled, blood parameters (e.g., pH, lactate, glucose, NOx) and inflammatory markers (e.g., IL-6, IL-8, IL-10, TNFα) were not significantly different between conditions. BLN supplementation significantly improved exercise efficiency (W/ml/kg/min) in the last 5 min of the TT compared to PLA (p = 0.029, d = 0.45). Brachial artery blood flow in the BLN condition, immediately post-exercise, tended to be greater compared to PLA (p = 0.065, d = 0.32). CONCLUSIONS: We report that 7 days of BLN supplementation modestly improves 30-min TT power output, exercise efficiency as well as post-exercise blood flow without increasing plasma NOx levels or altering blood markers of inflammation, oxidative stress, and/or hematopoiesis.