JAMA otolaryngology-- head & neck surgery
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JAMA Otolaryngol Head Neck Surg · Oct 2020
Randomized Controlled TrialPredictors of Behavioral Changes After Adenotonsillectomy in Pediatric Obstructive Sleep Apnea: A Secondary Analysis of a Randomized Clinical Trial.
Adenotonsillectomy (AT) is associated with improved behavior in children with obstructive sleep apnea (OSA). However, it is unknown whether polysomnographic parameters are superior to the parent-reported severity of sleep-disordered breathing (SDB) in predicting behavioral changes after AT. ⋯ This secondary analysis of a national randomized clinical trial found that most treatment-related behavioral changes in children with OSA were mediated by the changes in parent-reported SDB severity alone. These findings suggest that polysomnographic parameters provide clinicians with limited means to predict the improvement in neurobehavioral morbidity in OSA.
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JAMA Otolaryngol Head Neck Surg · Sep 2020
ReviewMolecular Profiling of Thyroid Nodules-Are These Findings Meaningful, or Merely Measurable?: A Review.
Advances in genomic technologies have facilitated the development of sophisticated molecular diagnostic tests for thyroid nodules, in the hopes of better risk stratifying nodules with indeterminate cytopathologic diagnosis. It is unclear whether the widespread, or reflexive, use of these tests will improve outcomes for patients with thyroid nodules. ⋯ Because of variable performance, unclear benefit to patients, and questionable cost-effectiveness, clinical practice guidelines in the US and Europe currently do not recommend the universal, reflexive use of molecular assays for cytologically indeterminate thyroid nodules. These tests might offer value when used in selected scenarios, although this is not well understood. Future research should address whether the routine use of these molecular diagnostic tests leads to superior patient survival or quality-of-life outcomes compared with management based on clinical and radiographic criteria.
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JAMA Otolaryngol Head Neck Surg · Sep 2020
Meta AnalysisAssociation of Central Noninvasive Brain Stimulation Interventions With Efficacy and Safety in Tinnitus Management: A Meta-analysis.
Tinnitus has a prevalence of 10% to 25% and is frequently associated with numerous complications, such as neuropsychiatric disease. Traditional treatments have failed to meet the needs of patients with tinnitus. Noninvasive brain stimulation (NIBS) can focally modify cortical functioning and has been proposed as a strategy for reducing tinnitus severity. However, the results have been inconclusive. ⋯ This network meta-analysis suggests a potential role of NIBS interventions in tinnitus management. Future large-scale RCTs focusing on longer follow-up and different priming procedure NIBS are warranted to confirm these findings.
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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 · Apr 2021
Exposure to Spoken Communication in Children With Cochlear Implants During the COVID-19 Lockdown.
The coronavirus disease 2019 (COVID-19) lockdowns in Ontario, Canada in the spring of 2020 created unprecedented changes in the lives of all children, including children with hearing loss. ⋯ The findings of this cohort study indicate a clear association of COVID-19 lockdowns with a reduction in children's access to spoken communication.