Factors associated with poor controller medication use in children with high asthma emergency department use

Understanding health and social factors associated with controller medication use in children with high-risk asthma may inform disease management in the home and community. Objective: To examine health and social factors associated with the Asthma Medication Ratio (AMR), a measure of guideline-based care and controller medication use, in children with persistent asthma and frequent emergency department (ED) use.

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Predictors of granulomatous lymphocytic interstitial lung disease in common variable immunodeficiency

A subset of patients with common variable immunodeficiency (CVID) develop granulomatous lymphocytic interstitial lung disease (GLILD), which is associated with early mortality.

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Reliable mite-specific IgE testing in nasal secretions by means of allergen microarray

Because there is evidence for local production of IgE in the nasal mucosa,1-3 methods to measure allergen-specific IgE (sIgE) at nasal level in patients with allergic rhinitis (AR) are of great interest. Nasal secretions (NasSec) are easily collected with various noninvasive methods4 and are suitable for IgE measurements.5-7 Nevertheless, IgE "classic" assays, based on immunoenzymatic methods and allergen extracts, require large volumes and are inefficient in detecting the low amounts of IgE in NasSec.

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Corrigendum to ‘“Hidden scar” submandibular gland excision using an endoscope-assisted hairline approach’ [Oral Oncol. 65 (2017) 83–88]

The authors regret that Seung Hoon Woo's name appeared incorrectly in the original article. It appears correctly above.

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Clinical implications of microscopic extrathyroidal extension in patients with papillary thyroid carcinoma

Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy, accounting for ∼90% of all thyroid carcinomas [1]. It is a differentiated carcinoma with a relatively good prognosis and a low mortality rate. However, PTC frequently spreads to the cervical lymph nodes (LN), which is associated with a higher locoregional recurrence. Various clinicopathological factors, including age, gender, tumor size, extrathyroidal extension (ETE), and distant metastasis, are associated with the prognosis of PTC [2–4].

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Pharyngeal swallowing pressures in the base-of-tongue and hypopharynx regions identified with three-dimensional manometry

Objectives

This study aims to use three-dimensional (3D) high-resolution manometry to identify circumferential pressure patterns generated within the asymmetrical base-of-tongue and hypopharynx regions of the pharynx during deglutition.

Study Design

Case series.

Methods

Radial pressures in the regions of interest were evaluated during swallowing events in 12 healthy subjects using 3D high-resolution manometry.

Results

Repeated measures analysis of variance revealed asymmetrical pharyngeal clearance pressures in the base-of-tongue and hypopharynx regions during swallowing. A significant main effect of direction on pressure was found at the time point of average maximum pressure (P < 0.001) and for pressure integral (P < 0.001), with pressure primarily generated from the posterior direction. An interaction was noted between direction and location when comparing maximum directional pressures, regardless of time (P =0.045), highlighting the differences in anterior pressure production between regions. In contrast to the high posterior pressures produced in the base-of-tongue region, an anteroposterior dominant pressure pattern was observed in the hypopharynx. Pressure waveform complexity in the hypopharynx also is likely attributed to activity in the anterior and posterior directions. Symmetrical pressure generation was observed during intrabolus flow within the hypopharynx.

Conclusion

This study shows that pressure is asymmetrically generated in the base-of-tongue and hypopharynx regions during swallowing of a 10-mL bolus, reflecting the complex anatomy within the pharynx. Understanding of these complex pressure patterns aids in the interpretation of high-resolution manometry and can help guide further study in the clinical assessment and treatment of pharyngeal pathology.

Level of Evidence

4. Laryngoscope, 2016

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Racial disparities in preventable risk factors for head and neck cancer

Objectives/Hypothesis

To demonstrate racial differences in preventable risk behaviors/practices that contribute to head and neck cancer (HNCA).

Study Design

Cross-sectional analysis of large national risk factor survey.

Methods

The Behavioral Risk Factor Surveillance System for 2013 was analyzed. Demographic data were extracted, including age, sex, and race. Social habits considered risk factors for HNCA were also extracted, including alcohol consumption, smoking, and human papillomavirus (HPV) vaccination status. Statistical comparisons were conducted according to race for each risk factor, and additional comparisons were conducted within the American Indian population subgroup for risk factors according to sex.

Results

A total of 238.6 million Americans were surveyed. American Indians reported higher rates of binge drinking (19.0%) than whites (17.3%), blacks (12.4%), and Asian Americans (13.1%; P < .001). This rate was significantly higher for American Indian males (23.5%) versus females (13.7%; P < .001). Mean total drinks per month was higher for whites and American Indians (13.5 and 13.5; P < .001). American Indians reported the highest rates of current smoking (28.1%), followed by blacks (20.1%), whites (18.3%), and Asians (10.2%; P < .001). American Indians also reported the highest rates of every day smoking (18.2%), versus whites (13.3%), blacks (13.1%), and Asians (6.1%; P < .001). Rates of HPV vaccination were lowest for American Indians (11.7%), compared to whites (14.6%), blacks (13.6%), and Asians (12%; P = 0.618).

Conclusions

There are striking racial disparities in the prevalence of preventable risk factors for HNCA. These data highlight the need for targeted education and prevention programs in particular racial groups.

Level of Evidence

4. Laryngoscope, 2017

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