JAMA otolaryngology-- head & neck surgery
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JAMA Otolaryngol Head Neck Surg · Mar 2021
Early Outcomes From Early Tracheostomy for Patients With COVID-19.
Decision-making in the timing of tracheostomy in patients with coronavirus disease 2019 (COVID-19) has centered on the intersection of long-standing debates on the benefits of early vs late tracheostomy, assumptions about timelines of infectivity of the novel coronavirus, and concern over risk to surgeons performing tracheostomy. Multiple consensus guidelines recommend avoiding or delaying tracheostomy, without evidence to indicate anticipated improvement in outcomes as a result. ⋯ This cohort study from the first 2 months of the pandemic in New York City provides an opportunity to reconsider guidelines for tracheostomy for patients with COVID-19. Findings demonstrated noninferiority of early tracheostomy and challenges recommendations to categorically delay or avoid tracheostomy in this patient population. When aligned with emerging evidence about the timeline of infectivity of the novel coronavirus, this approach may optimize outcomes from tracheostomy while keeping clinicians safe.
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JAMA Otolaryngol Head Neck Surg · Dec 2020
Characteristics and Outcomes of Research Funded by the American Head and Neck Society Foundation.
For decades, the American Head and Neck Society (AHNS) has been providing funding for meritorious research to investigators for studies on head and neck cancer. Recently, the AHNS Foundation sought to evaluate the impact of its funds for investigators and research. ⋯ The findings of this study suggest that, over the past 20 years, the AHNS funding mechanism has resulted in 80% of awards generating publications and 63% resulting in future funding. The additional benefits of AHNS grant awards on the culture of research is also substantial. Continued analysis of these data may help guide future AHNS funding and award decisions.
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JAMA Otolaryngol Head Neck Surg · Nov 2020
In Vitro Efficacy of a Povidone-Iodine Nasal Antiseptic for Rapid Inactivation of SARS-CoV-2.
Research is needed to demonstrate the efficacy of nasal povidone-iodine (PVP-I) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). ⋯ Povidone-iodine nasal antiseptic solutions at concentrations as low as 0.5% rapidly inactivate SARS-CoV-2 at contact times as short as 15 seconds. Intranasal use of PVP-I has demonstrated safety at concentrations of 1.25% and below and may play an adjunctive role in mitigating viral transmission beyond personal protective equipment.
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JAMA Otolaryngol Head Neck Surg · Nov 2020
Multicenter StudyNovel Risk Loci in Tinnitus and Causal Inference With Neuropsychiatric Disorders Among Adults of European Ancestry.
Tinnitus affects at least 16 million US adults, but its pathophysiology is complicated, and treatment options remain limited. A heritable component has been identified in family and twin studies; however, no large-scale genome-wide association studies (GWAS) have been accomplished. ⋯ This large GWAS characterizes the genetic architecture of tinnitus, demonstrating modest but significant heritability and a polygenic profile with multiple significant risk loci and genes. Genetic correlation and inferred causation between tinnitus and major depressive disorder, educational level, and hearing impairment were identified, consistent with clinical and neuroimaging evidence. These findings may guide gene-based diagnostic and therapeutic approaches to this pervasive disorder.
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JAMA Otolaryngol Head Neck Surg · Oct 2020
Swallowing and Communication Management of Tracheostomy and Laryngectomy in the Context of COVID-19: A Review.
The care of patients with a surgically modified airway, such as tracheostomy or laryngectomy, represents a challenge for speech-language pathologists (SLPs) in the context of the coronavirus disease 2019 (COVID-19) pandemic. The objective was to review available publications and practice guidelines on management of tracheostomy and laryngectomy in the context of COVID-19. This study performed a review and synthesis of information available in the PubMed database and from national SLP organizations across 6 countries. ⋯ Frequent guideline updates for SLPs are necessary to inform best practice and ensure patient and health care worker protection and safety while providing high-quality care and rehabilitation.