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Πέμπτη 13 Μαΐου 2021

Differential cardiopulmonary monitoring system for artifact-canceled physiological tracking of athletes, workers, and COVID-19 patients

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Sci Adv. 2021 May 12;7(20):eabg3092. doi: 10.1126/sciadv.abg3092. Print 2021 May.

ABSTRACT

Soft, skin-integrated electronic sensors can provide continuous measurements of diverse physiological parameters, with broad relevance to the future of human health care. Motion artifacts can, however, corrupt the recorded signals, particularly those associated with mechanical signatures of cardiopulmonary processes. Design strategies introduced here address this limitation through differenti al operation of a matched, time-synchronized pair of high-bandwidth accelerometers located on parts of the anatomy that exhibit strong spatial gradients in motion characteristics. When mounted at a location that spans the suprasternal notch and the sternal manubrium, these dual-sensing devices allow measurements of heart rate and sounds, respiratory activities, body temperature, body orientation, and activity level, along with swallowing, coughing, talking, and related processes, without sensitivity to ambient conditions during routine daily activities, vigorous exercises, intense manual labor, and even swimming. Deployments on patients with COVID-19 allow clinical-grade ambulatory monitoring of the key symptoms of the disease even during rehabilitation protocols.

PMID:33980495 | DOI:10.1126/sciadv.abg3092

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Risk and Clinical Factors of Late Lower Cranial Neuropathy in Oropharyngeal Squamous Cell Carcinoma

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This cohort study assesses the cumulative incidence of an d clinical factors associated with late lower cranial neuropathy among patients with long-term survival of oropharyngeal squamous cell carcinoma.
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Validation of a 3-Dimensionally Printed Nasopharyngeal Swab for SARS-CoV-2 Testing

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This diagnostic study examines the accuracy and acceptabi lity of a 3-dimensionally printed swab for identifying SARS-CoV-2.
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Otolaryngologic Manifestations in Pediatric Inflammatory Multisystem Syndrome Temporally Associated With COVID-19

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This cohort study describes the various otolaryngologic m anifestations in and rates among patients 18 years or younger with pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2.
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Oral Corticosteroids Following Endoscopic Sinus Surgery for Chronic Rhinosinusitis Without Nasal Polyposis

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This randomized clinical trial assesses the efficacy of p ostoperative oral corticosteroids in patients with chronic rhinosinusitis without polyps.
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Test-Retest Reliability of Audiometric Assessment in Individuals With Mild Dementia

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This cross-sectional study obtains quantitative measures of reliability to evaluate the degree to which audiologic testing can be accurately conducted for older adults with mild dementia.
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Early vs Late Tracheotomy for Pneumonia and Ventilator Days

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This meta-analysis compares clinical outcomes of early vs late tracheotomy among patients undergoing ventilator support for critical illness.
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A Mysterious Odor After Nose Blowing

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A 15-year-old male patient presented with several years o f bilateral congestion and hyposmia; medical history and nasal endoscopy findings were unremarkable, but a foul smell emanated when blowing his nose. What is your diagnosis?
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Laryngeal and Tracheal Pressure Injuries in Patients With COVID-19

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To the Editor The important study by Fiacchini and colleagues of laryngotracheal complications in ventilated patients with coronavirus disease 2019 (COVID-19) reported a staggering 47% incidence of full-thickness tracheal erosion (FTTE) and tracheoesophageal fistulae (TEF). These findings raise critical questions about ensuring safe, high-quality care for intubated patients. Although intense research has focused on the molecular basis of COVID-19, pathogenesis of pneumonitis, and novel therapeutics; far less work has addressed the prevalence and pathogenesis of iatrogenic injury—particularly with respect to airway device-related pressure injuries. Injury at the level of the tracheal cuff likely accounts for the preponderance of FTTE and TEF reported, and tissue injury may occur at any site where there is contact between a device and the aerodigestive tract. Risk is highest in patients with overzealous cuff inflation, high-dose steroids, prone ventilation, prolonged intubation, feeding tubes, or impaired wound healing from diabetes or radiation—a perfect storm for patients with COVID-19.
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Considerations for Integrating Cognitive Testing Into Adult Cochlear Implant Evaluations

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This Viewpoint proposes integrating cognitive testing with adult cochlear implant evaluations and discusses anticipated challenges.
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Association Between Habitual Snoring and Cognitive Performance in Preadolescent Children

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This cross-sectional study uses a baseline data set from the ongoing Adolescent Brain and Cognitive Development study to examine the extent to which potential confounding factors modify the association between parent-reported habitual snoring and cognitive outcomes among preadolescent children.
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Outpatient Parotidectomy, a Safety and Financial Review

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Ann Otol Rhinol Laryngol. 2021 May 12:34894211016714. doi: 10.1177/00034894211016714. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study is to investigate the safety, efficacy, and potential cost-savings of the outpatient parotidectomy procedure.

METHODS: This is a retrospective chart review of all patients who underwent a parotidectomy at a large academic center from 2015 through 2019 including demographic data, postoperative complications, drain p lacement, readmission, and financial cost. A comparison was performed between patients who underwent an outpatient vs inpatient parotidectomy.

RESULTS: A total of 335 patients underwent parotidectomy (136 outpatient; 199 inpatient). Comparison of patient demographics, common comorbidities, tumor size, tumor type, postoperative complications, and readmission rate was similar between the inpatient and outpatient cohorts. The overall mean cost difference between inpatient parotidectomy and outpatient parotidectomy for all years was $1528.58 (95%CI: $1139-$1916).

CONCLUSION: The outpatient parotidectomy procedure has a comparable safety profile to the inpatient procedure while providing a significant cost-savings benefit.

PMID:33980056 | DOI:10.1177/00034894211016714

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