Phase Transition inside Changed Newtonian Dynamics MONDian SelfGravitating Programs

To analyze the impact of steroids on postoperative tonsillectomy recovery and implement findings for improvement in postoperative management.
Institutional review board approved prospective study with retrospective analysis of private practice setting tonsillectomy patients (November 2015 to January 2017). A questionnaire was provided postoperatively to patients undergoing tonsillectomy with or without adenoidectomy. The study population was separated into 2 groups patients who received steroids (3 days of either dexamethasone or prednisolone), postoperative steroid (POS), versus patients who did not receive steroids (PONS).
The questionnaire had a return rate of 27.3% (254/931). Nine of the 254 responses were disqualified for lack of information; therefore, the total number of responses was 245. Of these, 115 were POS and 130 were PONS. The groups were similar in mean age (POS 13.2 ± 10.4 years, PONS 14.7 ± 12.1 years,
= .32) and sex (POS Male 40.0%, PONS Male 40.0%,
= .97). There was an overall decrease of pain and nausea/vomiting (N/V) in the steroid group (
= .0007). There was reduction in pain (
< .05) from postoperative day (POD) 2, 3, 4, and 6 in the POS group. Otherwise, there was no significant reduction in pain from POD 7 to 14, day-by-day rate of N/V, bleeding, or rate of emergency department (ED) or clinic visit (
> .05).
Postoperative steroid reduced overall pain and N/V, as well as daily pain on POD 2, 3, 4, and 6. Pain from POD 7 to 14, rate of ED or clinic visit, or daily N/V and bleeding rate were not significantly different between cohorts.
Postoperative steroid reduced overall pain and N/V, as well as daily pain on POD 2, 3, 4, and 6. Pain from POD 7 to 14, rate of ED or clinic visit, or daily N/V and bleeding rate were not significantly different between cohorts.Hodgkin lymphoma (HL) is an uncommon B-cell malignant disease. It usually presents with mediastinal and/or laterocervical lymph node localization, while primary extranodal HL is a rare entity giving rise to diagnostic and therapeutic challenges. It rarely presents as just extranodal localization, so its presence within the maxillary sinus without any lymphadenopathy is exceptional. Given the rarity of this localization, there is no standard treatment for maxillary sinus HL. We present a case of a patient with extranodal HL of the right maxillary sinus treated with primary surgery followed by adjuvant sequential chemoradiation therapy.Hearing loss in older people can cause communication impairments, decreased quality of life, social isolation, depression, and dementia. Cochlear implant surgery is an effective treatment for older patients with hearing loss who cannot achieve satisfactory audiologic outcomes with hearing aids. However, older people have an increased risk of heart disease and often take medications that affect heart rhythm. Herein, we report a case of an 80-year-old woman who underwent cardioversion at 50J after cochlear implant surgery. Electrical impedance before and after cardioversion showed only minor changes without abnormality, and the cochlear implant functioned well. We believe that the electronic circuits of the cochlear implant may have been relatively tolerant to the electrical shock from the external defibrillator. Typically, cardioversion should be avoided in cochlear implant recipients because it may damage the implant. If cardioversion cannot be avoided, we strongly recommend starting cardioversion at the lowest energy level (50 J) and removing the sound processor of the implant during the procedure.
The aim of this study was to assess the predictive value of the Vandenberg and Kuse Mental Rotation Test (MRT) on performance of novice medical students for manipulation of a nasal endoscope on a cadaveric model.
We randomly selected 39 medical students who had never handled a nasal endoscope and subjected them to the MRT. click here General information including experience in manual, technical, or surgical activities and testing of anatomical knowledge were collected to exclude possible confounding factors. They were then asked to perform series of cadaveric model exercises using a nasal endoscope. Their cadaver performance was evaluated by 2 blinded observers, using a standardized scale.
We found that medical students with higher mental rotation skills had significantly increased endoscopic sinus performance (
= .0002 using multivariate regression adjusted for specialty choice, previous surgical exposure, and anatomy knowledge). Higher anatomy knowledge was also associated with better endoscopic sinus performance (
= .0141). Other parameters had no impact on endoscopic sinus performance measured by the endoscopic scale (
> .05).
The score obtained on the MRT was correlated with the practical performance of manipulating the nasal endoscope in cadaver. It could therefore be a useful spatial ability tool for directing targeted training in rhinology.
The score obtained on the MRT was correlated with the practical performance of manipulating the nasal endoscope in cadaver. It could therefore be a useful spatial ability tool for directing targeted training in rhinology.
Endoscopic percutaneous tracheostomy (PT) is a safe technique that is performed frequently by otolaryngologists and intensivists. New challenges have been identified in order to maintain the safety of this procedure during the COVID-19 pandemic. A novel approach, using a modified demistifier canopy, was developed during the first wave of the pandemic and implemented for 17 consecutive percutaneous tracheostomies in order to enhance procedural safety.
A protocol was developed after performing a literature review of tracheostomy in COVID-19 patients. A multidisciplinary tracheostomy team was established, including the departments of otolaryngology, critical care, and respiratory therapy. Simulation was performed prior to each PT, and postoperative debriefings were done.
A protocol and technical description of PT using a modified demistifier canopy covering was written and video documented. Data were collected on 17 patients who underwent this procedure safely in our tertiary care hospital. There were no procedure-related complications, and no evidence of COVID-19 transmission to any member of the health care team during the study period.