bluuebunny/crossref_metadata_2025_split huggingface dataset:
MRI assessment of excess cardiac iron in thalassemia major: When to initiate?
Authors: Chen Xiaodong , Zhang Zuoquan , Zhong Jinglian , Yang Qihua , Yu Taihui , Cheng Ziliang , Chan Queenie , Guo Hua , Liang Biling 
Published: July 2015

BackgroundTo determine optimal initial age of cardiac iron screening with magnetic resonance imaging (MRI) T2* in patients with thalassemia major (TM).MethodsWe retrospectively reviewed black blood cardiac T2* assessments from 102 TM patients from the ages of 3 to 32 years. Cases of patients under and above 7 years old with detectable cardiac iron overload were analyzed separately. Associations between cardiac T2* and various factors, such as serum ferritin (SF), patient age and hepatic T2*, were assessed using either scatterplots or regression. Images were evaluated by two independent radiologists.ResultsWith a T2* cut‐off value of 20 ms, no patient under 5 years old showed cardiac iron overload. Three of 19 (15.8%) patients under 7 years of age had a cardiac T2* ≤ 20 ms (5.5 to 7 years) but none had ≤10 ms, while 35 of 83 (42.2%) patients above 7 years old had a cardiac T2* ≤ 20 ms (8 to 32 years) and 18 of them ≤10 ms. Cardiac T2* correlated weakly with serum ferritin and liver T2* (r = −0.39 and 0.41, respectively, both P < 0.001), but not with patient age (P > 0.05).ConclusionCardiac iron overload can occur in young TM patients, even as young as 5.5 years old. Assessment of cardiac iron with T2* might need to begin as early as 5 years old if suboptimal chelation therapy is administered. J. Magn. Reson. Imaging 2015;42:737–745.
Stakeholder Influence on the Implementation of Environmental Management Practices in the Hotel Industry
Authors: Sánchez‐Medina Patricia S. , Díaz‐Pichardo René , Cruz‐Bautista Maricela 
Published: July 2015

AbstractBased on the stakeholder theory, this research aims to analyze the relationship between hoteliers' perceptions of stakeholders' interests and the implementation of environmental management practices in Oaxaca, Mexico, incorporating the effect of three hotel characteristics: size, age and economic capacity. Empirical evidence, obtained from hotel owners and/or managers, reveals a direct and positive relationship between the hoteliers' perceptions of stakeholders' interests and the implementation of environmental management practices, with hotel age and size having a moderating effect. Economic capacity, as an independent variable, is also an important factor in the implementation of environmental management practices. Copyright © 2015 John Wiley & Sons, Ltd.
Clinical factor for successful nonsurgical treatment of pediatric peritonsillar abscess
Authors: Kim Dong‐Kyu , Lee Jung Woo , Na Yoon Sung , Kim Myung Jin , Lee Jun Ho , Park Chan Hum 
Published: July 2015

Objectives/HypothesisCurrent management for peritonsillar abscess in pediatric patients includes intensive medical therapy using antibiotics with or without surgical drainage. However, attaining proper surgical drainage is difficult in young children because they have narrow oral cavities and are less cooperative than adults. The aim of this study was to investigate which factors are associated with a good response to nonsurgical treatment of a pediatric peritonsillar abscess.Study DesignA retrospective analysis.MethodsThis study included consecutive children who visited our pediatric clinic for the treatment of peritonsillar abscess. All patients initially received medical treatment, and additional surgical treatment was provided if the patient appeared unlikely to recover. Multivariate logistic regression models were constructed to identify factors associated with a good response to nonsurgical treatment. In addition, a receiver operating characteristic curve was used to identify the age cutoff for predicting good treatment response.ResultsA total of 88 children were included the study. Patient age, recurrent tonsillitis, and abscess size were significantly associated with response to nonsurgical treatment (adjusted odds ratios = 1.485, 2.403, and 1.325, respectively) after adjusting for sex, body mass index, season, serum C‐reactive protein levels, and tonsil grade. The age cutoff associated with good response to nonsurgical treatment was 7.5 years (80.0% sensitivity, 51.5% specificity).ConclusionOur findings suggest that a younger age, fewer episodes of acute tonsillitis, and smaller abscess size predict a successful response to nonsurgical treatment in children with peritonsillar abscess.Level of Evidence4. Laryngoscope, 125:2608–2611, 2015
Comparison of intraoral and extraoral approaches to mandibular angle fracture repair with cost implications
Authors: Hsueh Wayne D. , Schechter Clyde B. , Tien Shaw I , Stupak Howard D. 
Published: July 2015

Objectives/HypothesisThe objective of this study was to analyze outcomes of intraoral and extraoral approaches to mandibular angle fractures and provide cost estimates for comparison.Study DesignA retrospective review from January 2005 to June 2013 was performed of patients who underwent open reduction internal fixation of mandibular angle fractures at a level I trauma center.MethodsPatients were treated by three surgical specialties: otolaryngology–head and neck surgery, oral and maxillofacial surgery, and plastic and reconstructive surgery. Inpatient and outpatient medical records were reviewed for pertinent data including age, gender, duration of follow‐up, presence of other mandible fractures, surgical approach, surgical team, operative time, and postoperative complications.ResultsOf the 155 patients with mandibular angle fractures, 74% underwent open reduction internal fixation through an intraoral approach, whereas 26% of patients were treated with an extraoral approach. The occurrence of any complication was 69.6% in the extraoral group and 39% in the intraoral group (P = 0.009). In propensity‐weighted analysis, however, the occurrence of any complication was less frequent in intraoral cases but no longer statistically significant (odd ratio 0.28; 95% confidence interval, 0.08 to 1.02; P = 0.053). Operating room time was significantly shorter with the intraoral approach. We estimate that the intraoral approach directly saves at least $2,900 per case.ConclusionWe recommend the use of an intraoral approach for the repair of mandibular angle fractures when clinically appropriate. This can result in a comparable rate of success, however, with significant cost savings to the health care system.Level of Evidence4. Laryngoscope, 126:591–595, 2016
Evaluation of the prevalence of and factors associated with laryngeal diseases among the general population
Authors: Hah J. Hun , Sim Songyong , An Soo‐Youn , Sung Myung‐Whun , Choi Hyo Geun 
Published: July 2015

Objectives/HypothesisDespite the high prevalence of voice disorders, the prevalence of laryngeal disease in the general population has not been determined using laryngoscopy. Factors considered associated with laryngeal disease have mostly been assessed using patient data or highly specific populations. We evaluated the prevalence of and associated factors with laryngeal diseases in the general Korean population.Study DesignCross‐sectional study.MethodsWe analyzed data from the Korea National Health and Nutrition Examination Survey for 19,039 participants assessed between 2008 and 2011. The prevalence, subjective discomforts rates of, and odd ratios (demographics, life‐style factors, and diseases factors) for laryngeal disease were analyzed using simple and multiple logistic regression analyses, taking into account the complex sampling structure of the data.ResultsThe top five laryngeal diseases in prevalence were laryngitis (3,513/100,000), vocal nodules (1,487/100,000), vocal polyp (404/100,000), Reinke's edema (347/100,000), and epiglottic cyst (296/100,000). Prevalence of laryngeal disease was higher in males, whereas the rate of subjective voice complaints was higher in females. In the logistic regression analysis, gender was not associated with laryngeal diseases after adjusting for other factors. We observed a positive association between low body mass index (BMI) and vocal nodules, and between high BMI and laryngitis, smoking and epiglottic cyst/hyperkeratosis/laryngeal cancer, higher education level and vocal nodules, and allergic rhinitis and vocal nodules/laryngitis/epiglottic cyst.ConclusionsThe rate of subjective voice complaints and laryngeal disease co‐occurrence was low. This study provides more reliable information of laryngeal disease because it includes participants without subjective complaints.Level of Evidence2b. Laryngoscope, 125:2536–2542, 2015
Recurrent laryngeal nerve alterations in developing spontaneously hypertensive rats
Authors: da Silva Greice Anne Rodrigues , de Aguiar Mendes Vania Alice , Genari Adriana Borges , Castania Jaci Ayrton , Salgado Hélio Cesar , Fazan Valéria Paula Sassoli 
Published: July 2015

Objectives/HypothesisIt is well known that the recurrent laryngeal nerve not only innervates the larynx but also contains baroreceptor fibers, as demonstrated by physiological studies. Because hypertension has a negative impact on both peripheral nerve morphology and the baroreflex, we investigated the recurrent laryngeal nerve morphological alterations related to the development of hypertension.MethodsWe compared morphological and morphometric aspects of different segments of the recurrent laryngeal nerve in male and female spontaneously hypertensive rats in different ages: 5, 8, and 20 weeks (n = 6 per group). Blood pressure and heart rate were recorded in anesthetized animals, followed by removal of the right and left recurrent laryngeal nerves for epoxy resin embedding and light microscopy analysis. Computer software was used for morphometric analysis.ResultsThe blood pressure was significantly higher in 20‐week‐old animals compared to those at 5 weeks. Body weight increased significantly with age, as did the nerve fascicles. For the myelinated fibers and respective axons, there was a reduction of fiber size, more evident on the axon, associated with a reduction of the small myelinated fibers percentage in animals with high blood pressure. Also, 20‐week‐old animals showed a significant reduction of the blood vessel percentage of occupancy compared to younger ages. No differences were observed between genders.ConclusionHypertension development impaired axon growth, affecting mainly the small myelinated fibers. Males and females were affected equally. The alterations of the endoneural blood vessels probably played an important role on the small fibers alterations.Level of EvidenceN/A. Laryngoscope, 126:E40–E47, 2016
Laryngeal adenoid cystic carcinoma: A population‐based perspective
Authors: Dubal Pariket M. , Svider Peter F. , Folbe Adam J. , Lin Ho‐Sheng , Park Richard C. , Baredes Soly , Eloy Jean Anderson 
Published: July 2015

Objectives/HypothesisAdenoid cystic carcinoma (ACC) occurs infrequently in the larynx. Consequently, no large samples describing its clinical behavior are available in the literature. Our objective was to use a nationally representative population‐based resource to evaluate clinical behavior, patient demographics, and outcomes among patients diagnosed with laryngeal ACC (LACC).Study DesignRetrospective database analysis.MethodsThe National Cancer Institute's Surveillance, Epidemiology, and End Results database was analyzed for patients diagnosed with LACC between 1973 and 2011. Patient demographics, incidence, treatment, and survival between LACC and other laryngeal malignancies were compared.ResultsOf 69 LACC patients, 63.8% were female, 78.2% Caucasian, and the median age was 54 years. LACC patients were much more likely to have subglottic lesions (44.9%) than individuals with other malignancies (1.6%). The incidence of LACC was 0.005/100,000 individuals. The majority of patients with LACC harbored T4 lesions at initial diagnosis, although 87.9% had N0 disease, and only 6.1% had distant metastasis at diagnosis. Disease‐specific survival (DSS) was greater at 1 year for LACC compared to other laryngeal malignancies, but not at 5 or 10 years. Five‐year DSS was greater for LACC patients who underwent surgery versus those who did not undergo surgery.ConclusionsThis analysis notes that LACC has a low incidence with no significant change in incidence over the study period. Compared to other laryngeal malignancies, LACC has a female preponderance, is much more common in the subglottis, presents at a younger age, and more often presents with T4 disease. Surgery was noted to confer a survival advantage in LACC.Level of Evidence4. Laryngoscope, 125:2485–2490, 2015
A systematic review and meta‐analysis on acoustic voice parameters after uncomplicated thyroidectomy
Authors: Lang Brian H. H. , Wong Carlos K. H. , Ma Estella P. M. 
Published: July 2015

BackgroundPostthyroidectomy voice changes are common even without apparent laryngeal nerve injury. Our study evaluated the impact of open cervical thyroidectomy on five acoustic voice parameters in the early (< 3 months) and late (≥ 3 months) postoperative periods.MethodsA systematic review was performed to identify studies that quantitatively assessed voice quality by acoustic voice analysis before and after thyroidectomy. Parameters included average fundamental frequency (F0, Hz), jitter (%), shimmer (%), noise‐to‐harmonic ratio (NHR), and maximum phonation time (MPT) (in secs). Meta‐analysis was performed using both fixed‐ and random‐effects models.ResultsA total of 896 patients were analyzed. Relative to baseline, F0 significantly worsened in the early period (from 194.9 ± 34.9 Hz to 188.0 ± 34.0 Hz, P = 0.001). This was equivalent to a quarter‐tone loss (P = 0.004). Shimmer (from 3.15 ± 1.59% to 3.19 ± 1.70%, P = 0.040) and MPT (from 17.9 secs to 16.7 secs, P = 0.046) also worsened in the early period, whereas jitter and NHR remained unchanged in the early and late periods. Males suffered greater deterioration in F0 (from 120.6 ± 18.8 Hz to 111.0 ± 18.5 Hz, P = 0.048) and in NHR (from 0.12 ± 0.02 to 0.16 ± 0.03, P = 0.019) than females in the early period. Four of the five acoustic parameters (F0, jitter, shimmer, and NHR) significantly worsened after total thyroidectomy (TT) and not after lesser resection.ConclusionF0, shimmer, and MPT significantly worsened in the early and not in the late postoperative period. F0 impairment was perceptually significant. Males and those undergoing TT suffered greater voice impairment than their counterparts during the early period. Laryngoscope, 126:528–537, 2016
Faculty diversity and inclusion program outcomes at an academic otolaryngology department
Authors: Lin Sandra Y. , Francis Howard W. , Minor Lloyd B. , Eisele David W. 
Published: July 2015

Objectives/HypothesisTo describe a 10‐year diversity initiative to increase the number of women and underrepresented minorities in an academic department of otolaryngology–head and neck surgery.Study DesignRetrospective review.MethodsA multifaceted approach was undertaken to recruit and retain women and underrepresented minority (URM) faculty: creation of a climate of diversity, aggressive recruitment, achievement of parity of salary at rank regardless of gender or minority status, provision of mentorship to women and URM faculty, and increasing the pipeline of qualified candidates. Primary outcomes measures included number of women and URM faculty, academic rank, and salary.ResultsFrom 2004 to 2014, the percentage of women clinical faculty increased from 5.8% to 23.7%; women basic science faculty increased from 11.1% to 37.5%. The number of women at associate professor rank increased from 0 to eight. During this period, underrepresented minority faculty increased in number from two to four; URM full professors increased in number from 0 to 1. In 2004, women earned 4% to 12% less than their male counterparts; there were no salary differences for URM. In 2014, salary was equal by rank and subspecialty training independent of gender or minority status.ConclusionA comprehensive diversity and inclusion initiative has increased representation of women and URM faculty in an academic department of otolaryngology–head and neck surgery. However, there continue to be opportunities to further increase diversity.Level of EvidenceN/A. Laryngoscope, 126:352–356, 2016
Post‐sinus surgery insertion of steroid‐eluting bioabsorbable intranasal devices: A systematic review
Authors: Rizan Chantelle , Elhassan Hassan A. 
Published: July 2015

Objectives/HypothesisPostendoscopic sinus surgery corticosteroid administration reduces polyp formation, inflammation, and adhesions. Steroid‐eluting bioabsorbable intranasal devices (SEBID) are novel interventions thought to improve local drug delivery while minimizing systemic side effects. The primary aim of this systematic review is to evaluate the efficacy and safety of bioabsorbable SEBIDs. The secondary aim is to inform clinical recommendations and to introduce clinicians to this novel technology.Study DesignMEDLINE, PubMed, Embase, and Cochrane Database were searched according to Preferred Reporting Items for Systematic Review and Meta‐Analyses guidelines.MethodsOriginal articles assessing the efficacy of SEBIDs inserted after endoscopic sinus surgery. For each study, we recorded the efficacy endpoints and safety outcomes.ResultsSeven studies met the inclusion criteria from 737 initial articles identified, including five prospective randomized controlled trials and two prospective single‐cohort studies involving 394 sinuses within treatment arms. Patients were followed up for 2 to 6 months. Six studies demonstrated SEBID efficacy with statistical significance (P < 0.05). Steroid‐eluting bioabsorbable intranasal devices were effective in reducing adhesion formation, polyp formation, inflammation, Lund‐Kennedy scores, and perioperative sinus endoscopy scores. The devices improved patient‐reported outcomes and olfaction while reducing postoperative interventions. They were not associated with adverse events and pose no ocular safety risk. Complications in three SEBID applications were reported.ConclusionThere is limited data available on SEBIDS; further studies are required to determine whether they are safe and effective adjuncts postendoscopic sinus surgery. Future studies are needed to optimize the dosing regimen, compare devices, and provide long‐term outcomes. Steroid‐eluting bioabsorbable intranasal devices may tentatively be incorporated into future evidence‐based practice. Laryngoscope, 126:86–92, 2016
Shape of the Osseous External Auditory Canal and Its Relationship to Troublesome Cavities
Authors: van Spronsen Erik , van Waegeningh Huibert F. , Geerse Simon , Fokkens Wytske J. , Ebbens Fenna A. 
Published: July 2015

Objectives/HypothesisOn the basis of clinical observations, the shape of the osseous external auditory canal (OEAC) has often been seen as an etiological factor in troublesome cavities after modified radical mastoidectomy.Study DesignRetrospective analysis of CT scans.MethodsTo assess the role of the shape of the OEAC in troublesome modified radical cavities using computed tomographic scans of three groups of patients (without pathology and with or without draining cavities), we determined the depth of the pretympanic recess (DPTR) and its anterior curvature (ACPTR). In addition to looking at the shape of the OEAC, we also studied the role of any remaining mastoid air cells in relation to troublesome radical cavities, as well as the consultation frequency.ResultsThe DPTR was significantly deeper in draining cavities than in ears without pathology and dry cavities. No difference in the ACPTR was observed. The presence of remaining mastoid air cells is significantly associated with the presence of a troublesome radical cavity.ConclusionsThe shape of the OEAC (i.e., the DPTR) is a contributory factor to the drainage of modified radical cavities.Level of Evidence4. Laryngoscope, 126:693–698, 2016
MicroRNA‐34c‐5p is related to recurrence in laryngeal squamous cell carcinoma
Authors: Re Massimo , Çeka Artan , Rubini Corrado , Ferrante Luigi , Zizzi Antonio , Gioacchini Federico M. , Tulli Michele , Spazzafumo Liana , Sellari‐Franceschini Stefano , Procopio Antonio D. , Olivieri Fabiola 
Published: July 2015

Objectives/HypothesisAltered microRNA expression has been found in many cancer types, including laryngeal squamous cell carcinoma (LSCC). We investigated the association of LSCC‐related miR‐34c‐5p with disease‐free survival and overall survival.Study DesignRetrospective cohort study.MethodsExpression levels of miR‐34c‐5p were detected in 90 LSCC formalin‐fixed paraffin‐embedded tissues by reverse‐transcription quantitative polymerase chain reaction. Overall survival and disease‐free survival were evaluated using the Kaplan‐Meier method, and multivariate analysis was performed using Cox proportional hazard analysis.ResultsA downregulation of miR‐34c‐5p expression significantly correlated with worse disease‐free and overall survival. In the multivariate analysis, low miR‐34c‐5p expression was associated with an increased risk of recurrence.ConclusionsA downregulation of miR‐34c‐5p in LSCC is independently associated with unfavorable disease‐free survival, suggesting that miR‐34c‐5p might be a promising marker for evaluating the risk of recurrences.Level of EvidenceNA Laryngoscope, 125:E306–E312, 2015
Voice‐ and swallow‐related quality of life in idiopathic Parkinson's disease
Authors: van Hooren Michel R. A. , Baijens Laura W. J. , Vos Rein , Pilz Walmari , Kuijpers Laura M. F. , Kremer Bernd , Michou Emilia 
Published: July 2015

Objectives/HypothesisThis study explores whether changes in voice‐ and swallow‐related QoL are associated with progression of idiopathic Parkinson's disease (IPD). Furthermore, it examines the relationship between patients' perception of both voice and swallowing disorders in IPD.Study DesignProspective clinical study, quality of life (QoL).MethodsOne‐hundred mentally competent IPD patients with voice and swallowing complaints were asked to answer four QoL questionnaires (Voice Handicap Index, MD Anderson Dysphagia Inventory, Visual Analog Scale [VAS] voice, and Dysphagia Severity Scale [DSS]). Differences in means for the QoL questionnaires and their subscales within Hoehn and Yahr stage groups were calculated using one‐way analysis of variance. The relationship between voice‐ and swallow‐related QoL questionnaires was determined with the Spearman correlation coefficient.ResultsScores on both voice and swallow questionnaires suggest an overall decrease in QoL with progression of IPD. A plateau in QoL for VAS voice and the DSS was seen in the early Hoehn and Yahr stages. Finally, scores on voice‐related QoL questionnaires were significantly correlated with swallow‐related QoL outcomes.ConclusionsVoice‐ and swallow‐related QoL decreases with progression of IPD. A significant association was found between voice‐ and swallow‐related QoL questionnaires. Healthcare professionals can benefit from voice‐ and swallow‐related QoL questionnaires in a multidimensional voice‐ or swallow‐assessment protocol. The patient's perception of his/her voice and swallowing disorders and its impact on QoL in IPD should not be disregarded.Level of Evidence2b Laryngoscope, 126:408–414, 2016