Incorporating Virtual Reality to Improve Otolaryngology Resident Wellness: One Institution's Experience

xlomafota13 shared this article with you from Inoreader Incorporating Virtual Reality to Improve Otolaryngology Resident Wellness: One Institution's Experience Via The Laryngoscope Objective Burnout is defined as work‐related emotional exhaustion, depersonalization, and decreased sense of accomplishment. Virtual reality (VR) has emerged as an effective treatment modality for various conditions related to anxiety, however, few studies have assessed its role for stress management in residents. We hypothesize that VR‐based mindfulness meditation can reduce resident burnout in real‐world settings. Study Design Prospective randomized crossover trial. Methods Resident participants completed the validated Maslach Burnout Inventory (MBI). One group used a VR‐based meditation app; the second group received no intervention. After a 2‐month rotation, all subjects completed an MBI and crossed over to the other arm. Wilcoxon rank‐sum tests were used to compare MBI scores before and after intervention, and to compare results by gender and postgraduate year. Mann‐Whitney U tests were used to assess qualitative differences between participants. Results Eighteen residents completed the study. Five participants were female and 13 were male. Weekly use of VR‐guided meditation and paced breathing was associated with a significant decrease in emotional exhaustion (P = .009), and on subgroup analysis, male gender specifically was associated with a decrease in emotional exhaustion (P = .027). In the post‐intervention survey, 42.9% subjects reported that VR encouraged them to employ paced breathing techniques, 71.4% reported that they would use the technology if regularly available, and 21.4% reported they would use paced breathing in the future. Conclusion VR‐based therapy may serve as a successful tool in stress management and reduce the rate of burnout among otolaryngology residents. Level of Evidence N/A Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Obstructive Sleep Apnea in Children Under 3 Years of Age

xlomafota13 shared this article with you from Inoreader Obstructive Sleep Apnea in Children Under 3 Years of Age Via The Laryngoscope Objective To identify predictors of severe obstructive sleep apnea (OSA) in children under 3 years of age and to compare demographics, comorbidities, and polysomnographic characteristics of infants and toddlers with OSA. Study Design Retrospective case series Methods We examined children under 3 years of age who had polysomnogram between August 2012 and March 2020. Demographics, clinical, and polysomnographic parameters were compared in children age 0–1 versus 1–3 years and 0–2 versus 2–3 years and severe versus mild–moderate OSA. Univariate analysis was used to compare age groups; multiple logistic regression for predictors of severe OSA. Significance was set at P < .05. Results Of the 413 children, 267 (65%) were male and 131 (32%) obese. The population included Hispanic (41%), African American (28%), and Caucasian (25%) children. A total of 98.5% had OSA and 35% had severe OSA. Children under 1 year of age more commonly had gastroesophageal reflux disease (GERD) (38% vs. 23%; P = .014); tonsillar hypertrophy was more common in children over 2 years of age (56% vs. 34%, P = .001). Down syndrome (odds ratio (OR): 3.16, 95% confidence interval (CI) = 1.14–8.68, P = .026) and tonsillar hypertrophy (OR: 1.97, 95% CI = 1.28–3.02, P = .002) were predictors of severe OSA. Conclusion Children under 3 years of age with OSA are more likely to be male and have GERD. Down syndrome and tonsillar hypertrophy are predictors of severe OSA, and children with these conditions should be prioritized for polysomnography. Level of Evidence 4. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comprehensive Analysis of Factors Affecting Cochlear Size: A Systematic Review and Meta‐analysis

xlomafota13 shared this article with you from Inoreader Comprehensive Analysis of Factors Affecting Cochlear Size: A Systematic Review and Meta‐analysis Via The Laryngoscope Objectives To determine the cochlea's average size in humans and evaluate the relationships between certain covariates and cochlear size. Methods A systematic search on articles on cochlear size and published in English was conducted using Cochrane, PubMed, Web of Science, and Scopus databases up to September 15, 2020. Data were pooled using random‐effects with three models. The effect of demographic, clinical, and measurement‐related parameters was specifically analyzed. Meta‐regression and subgroup analyses were conducted. The overall effect estimation was made for outcomes. Results The meta‐analysis included 4,708 cochleae from 56 studies. The overall length of the organ of Corti was 32.94 mm (95% confidence interval [CI]: 32.51–33.38). The first and second models revealed that age, gender, country, continent, measurement method (direct, indirect), measured structure ("A" value, cochlear lateral wall), origin (in vivo, in vitro), and type (histology specimens, plastic casts, imaging) of the cochlear material did not affect the cochlear size. However, study populations (general population, patients with a cochlear implant, and patients with congenital sensorineural hearing loss [CSNHL]) were found to affect the outcomes. Compared to the other populations, patients with CSNHL had shorter cochleae. Therefore, we developed a third model and found that the general population and patients with cochlear implants did not differ in cochlear size. Conclusion This meta‐analysis investigated the factors that could affect the cochlear size and found that patients with CSNHL had significantly shorter cochleae, whereas other covariates had no significant effect. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessment of Visual and Brainstem Auditory Evoked Potentials in Patients with Hashimoto's Thyroiditis

xlomafota13 shared this article with you from Inoreader Assessment of Visual and Brainstem Auditory Evoked Potentials in Patients with Hashimoto's Thyroiditis Via cortical auditory J Immunol Res. 2021 Mar 3;2021:3258942. doi: 10.1155/2021/3258942. eCollection 2021. ABSTRACT BACKGROUND: The present study was aimed to evaluate parameters of visual and brainstem auditory evoked potentials (VEP, BAEP) in euthyreotic Hashimoto's thyroiditis (HT) patients without central nervous system involvement. METHODS: 100 HT patients (92 women, 8 men), mean age 46.9 years, and 50 healthy controls. They underwent a neurological examination, thyroid hormone levels, thyroid autoantibody titers, and brain imaging. Latencies and amplitudes of the N75, P100, and N145 component of VEP and the I-V components of BAEP were analyzed. RESULTS: The neurological examination revealed in 31 patients signs of increased neurovegetative excitability. Brain resonance imaging showed no abnormalities in HT patients. The mean P100, relative P100, and N145 VEP latencies were significantly longer, and P100 amplitude significantly higher in HT patien ts than the controls. HT patients also had a longer mean wave BAEP V latency and mean wave III-V and I-V interpeak latencies, and significantly lower mean wave I and V amplitudes. Abnormal VEP and BAEP were recorded in 34% of the patients. There were no statistically significant correlations between the mean VEP parameters and thyroid profile and the applied dose of L-thyroxine. There was a relationship between the level of TSH and the wave BAEP III-V interpeak latency. CONCLUSIONS: There were changes in the brain's bioelectrical activity in one-third of the patients with HT without nervous system involvement. The increased amplitude of the VEP may indicate increased cerebral cortex activity. Disorders of the brain's bioelectrical activity in the course of HT may be associated with an autoimmune process. PMID:33763490 | PMC:PMC7946475 | DOI:10.1155/2021/3258942 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Identification of miR-145 as a regulator of the cardiomyocyte inflammatory response and oxidative stress under hyperglycemia

xlomafota13 shared this article with you from Inoreader Identification of miR-145 as a regulator of the cardiomyocyte inflammatory response and oxidative stress under hyperglycemia Via Experimental and therapeutic medicine Exp Ther Med. 2021 May;21(5):467. doi: 10.3892/etm.2021.9898. Epub 2021 Mar 8. ABSTRACT The current study aimed to explore the effects of microRNA (miR)-145 on the inflammatory response and oxidative stress (OS) in high glucose (HG)-induced cardiomyocytes, as well as the specific mechanism underlying this action. H9c2 cells were treated with 33 mmol/l glucose (HG group) or cotreated with 24.5 mmol/l mannitol and 5.5 mmol/l glucose (hypertonic group), and the expression levels of miR-145 and ADP ribosylation factor 6 (ARF6) were detected. The cells were transfected with pcDNA3.1-ARF6, miR-145 mimics or corresponding negative controls prior to the assessment of cell survival rate. Levels of lactate dehydrogenase (LDH), reactive oxygen species (ROS) and malondialdehyde (MDA), as well as the activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx), and the levels of IL-6, TNF-α and monocyte chemoattractant protein-1 (MCP-1) were subsequently determined. The apoptotic rate of H9c2 cells was examined by flow cytometry. The interaction between miR-145-ARF6 was predicted and confirmed by luciferase reporter assays. In the HG group, miR-145 expression was significantly decreased and ARF6 expression significantly increased compared with controls. Furthermore, the levels of inflammatory factors (IL-6, TNF-α and MCP-1), LDH, ROS and MDA were significantly elevated in the HG group compared with controls. Significantly decreased SOD, CAT and GPx activities and significantly increased numbers of apoptotic cells were observed in the HG group compared with controls. The cells transfected with miR-145 mimics exhibited significantly decreased LDH, ROS and MDA levels, significantly increased antioxidant enzyme activities and significantly decreased apoptotic rates compared with controls, while the opposite results were observed in cells transfected with pcDNA3.1-ARF6. Moreover, co-transfection with miR-145 mimics and pcDNA3.1-ARF6 exacerbated the inflammatory response and OS injury in HG-induced cardiomyocytes compared with cells transfected with miR-145 mimics alone. Furthermore, miR-145 negatively targeted ARF6. miR-145 attenuated the HG-induced inflammatory response and OS injury in cardiomyocytes by negatively regulating ARF6, which may contribute to providing a theoretical basis for the treatment of diabetic cardiomyopathy. PMID:33763154 | PMC:PMC7983182 | DOI:10.3892/etm.2021.9898 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Regulatory effect of mitoQ on the mtROS-NLRP3 inflammasome pathway in leptin-pretreated BEAS-2 cells

xlomafota13 shared this article with you from Inoreader Regulatory effect of mitoQ on the mtROS-NLRP3 inflammasome pathway in leptin-pretreated BEAS-2 cells Via Experimental and therapeutic medicine Exp Ther Med. 2021 May;21(5):466. doi: 10.3892/etm.2021.9897. Epub 2021 Mar 8. ABSTRACT Obese asthma is a phenotype of asthma whose occurrence is gradually increasing in both adults and children. The majority of studies have demonstrated that obesity is a major risk factor for asthma and the effect of obesity on the lungs is considerable. NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome has been previously demonstrated to serve a role in obese asthma mediated by mitochondrial reactive oxygen species (mtROS). The aim of the present in vitro study was to investigate the effect of leptin on airway epithelial cells and the protective effect of the mitochondrial-targeted antioxidant mitoquinone (mitoQ). Human normal bronchial epithelial cell lines BEAS-2 cells were used and divided into 6 groups: Control group (negative control), DMSO group (solvent control), lipopolysaccharide (LPS) group (positive control), LPS + mitoQ group, Leptin group and Leptin + mitoQ group. CCK8 assay was used to establish the optimal concentration and incubation time of the drugs. mitoTracker probe and mitoSOX reagent were used to detect the integrity of mitochondrial membranes and the content of mtROS. mRNA expression levels were detected by reverse transcription-quantitative PCR analysis. It was revealed that the mitochondrial membrane was disrupted in the Leptin group, which recovered after treatment with mitoQ. As a result, the production of mitochondrial reactive oxygen species (mtROS) in the Leptin group was significantly increased (P<0.01), but following treatment with mitoQ, this overproduction of mtROS was significantly decreased to normal levels (P<0.01). Furthermore, the expression levels of NOD-, LRR- and pyrin domain-containing protein 3 NLRP3 and caspase-1 mRNA in the leptin-pretreated BEAS-2 cells were significantly increased compared with those in the control group (P<0.01), while they wer e decreased following mitoQ treatment (P<0.01). Taken together, these data suggested that leptin may promote airway inflammation partially through upregulating the mtROS-NLRP3 inflammasome signaling pathway in airway epithelial cells and mitoQ may be a potential treatment for obese asthma. PMID:33763153 | PMC:PMC7983181 | DOI:10.3892/etm.2021.9897 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management of primary ciliary dyskinesia

xlomafota13 shared this article with you from Inoreader Management of primary ciliary dyskinesia Via hno HNO. 2021 Mar 24. doi: 10.1007/s00106-021-01037-w. Online ahead of print. NO ABSTRACT PMID:33763740 | DOI:10.1007/s00106-021-01037-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.