The use of Mepilex Ag after pediatric tracheotomy reduces the occurrence of postoperative peristomal pressure ulcers.

Background Recurrent Respiratory Papillomatosis (RRP) is a rare disease characterized by the growth of papillomas in the airway and especially the larynx. The clinical course is highly variable among individuals and there is poor understanding of the factors that drive an aggressive vs an indolent course. Methods A convenience cohort of 339 affected subjects with papillomas positive for only HPV6 or HPV11 and clinical course data available for 1 year or more, from a large multicenter international study were included. Exploratory data analysis was conducted followed by inferential analyses with frequentist and Bayesian statistics. Results We examined 339 subjects: 82% were diagnosed prior to the age of 18 years, 65% were infected with HPV6, and 69% had an aggressive clinical course. When comparing age at diagnosis with clinical course, the probability of aggressiveness is high for children under five years of age then drops rapidly. For patients diagnosed after the age of 10 years, an indolent course is more common. After accounting for confounding between HPV11 and young age, HPV type was minimally associated with aggressiveness. Fast and Frugal Trees (FFTs) were utilized to determine which algorithms yield the highest accuracy to classify patients as having an indolent or aggressive clinical course and consistently created a branch for diagnostic age at ~5 years old. There was no reliable strong association between clinical course and socioeconomic or parental factors. Conclusion In the largest cohort of its type, we have identified a critical age at diagnosis which demarcates a more aggressive from less aggressive clinical course.

Clinicians should be aware of an elevated prevalence of moyamoya syndrome in Down syndrome and sickle cell disease populations and should consider moyamoya syndrome in the differential diagnosis of postoperative stroke. Stroke risk is magnified in the perioperative setting related to perioperative dehydration and hypotension. Awareness and screening for cerebral vasculopathy in high-risk populations could prompt measures to decrease the occurrence of postoperative strokes after adenotonsillectomies.

Program Description: Unprecedented availability of health-related information on the Internet, television, radio, and print has empowered our patients to play larger roles in medical decision making. Increasingly, to help educate a knowledge-hungry public and to help build their practices, otolaryngologists must interact with journalists. Formal media training is often lacking in residency or fellowship, making this task seem daunting. This miniseminar reveals the multitude of media opportunities, including those on the Academy Web site, and how to best interact with journalists and the public. Speakers include renowned television and print health journalists and otolaryngologists with media experience. Audience participation is encouraged. Educational Objectives: (1) Improve their communication with journalists. (2) Recognize the opportunities within and outside the Academy for print, television, radio, and online media exposure. (3) Increase involvement with the media to enhance your practice and educate your patients.

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