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The virtuality of organizational teams have gained interest and popularity in recent years, and have become more prevalent amidst the COVID-19 pandemic. Organizational productivity and team relationship-building may suffer certain pitfalls in virtual communication and support without the understanding of the dynamics of short-term, project-based virtual teams. The manuscript aimed to expand what is currently known about short-term virtual team dynamics related to types of effective leadership behaviors. The present study employed a mixed method approach to understanding the dynamics of these teams at both the individual and team level. Small teams were formed and instructed to collaborate on a virtual survival task. Team-related outcomes were measured at the individual level, such as team coordination, team support, and team success. Additionally, distinct latent profiles of leadership behaviors were developed and analyzed at the team level. Team support, more so than team coordination, significantly predicted team success at the individual level, with instrumental support having the strongest effect. Distinct leadership behaviors emerged in teams and were classified through a latent profile analysis, but none of the profiles were significantly related to team performance scores. Demonstrating instrumental support in short-term virtual teams may improve team success. It is important to understand that distinct leadership behaviors exist and future research should explore the impact of these leadership behaviors on other team-related outcomes. © 2023 by the authors.
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INTRODUCTION AND OBJECTIVE: Infection control practices and public policy in response to the COVID-19 pandemic shifted healthcare practices towards a telemedicine format. Even two years after peak onset of the pandemic, many clinics, including our own institution, maintain a working telehealth option for patient visits, with some patients even preferring this modality of care delivery. Our objective was to evaluate patient utilization of telehealth visits versus inperson visits at our institution and whether this was impacted by demographics, medical history, and socioeconomic factors. METHOD(S): Medical Record Numbers for all patients with bladder cancer were pulled via accessible billing-level data from the period 7/1/2019-2/28/2022. Chart review was conducted to pull clinical data on patients including telehealth versus in person visits, demographic data, clinical stage, comorbidities (diabetes, smoking status, BMI), rural/urban status by zip code (>50,000, <50,000 individuals) and income levels by zip code (25K-49.9K, 50K-99.9K, <100K), payor status, patient distance, and gas savings/carbon footprint. RESULT(S): 430 patients completed in person visits while 268 completed telehealth visits. There was no statistically significant difference for in person visits vs. telehealth visits regarding patients' race (p=0.541), ethnicity (p=0.394) age (p=0.862), urban/rural status (p=0.507), payor status (p=0.127), mean zip code income (p=0.175), and comorbidities (p=0.626 for diabetes, p=0.706 for smoking, p=0.459 for BMI), and clinical stage (p=0.07). There was a statistically significant difference in mean distance (14.85 miles versus 26.86 miles, p<0.01). CONCLUSION(S): Post-pandemic, telehealth usage and acceptability among patients with bladder cancer remains high. Patients' with bladder cancer receive care from their urologist via in person visits versus telehealth at similar rates irrespective of their urban/rural status, demographics, payor status, relevant comorbidities, or relative income. Patients are more likely to engage in care with their urologist via telehealth if they live farther from a large urban academic center, which produces an economical and environmental impact via gas/time savings and reduced carbon footprint.
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Background: In March 2020, the state of alarm was declared in Spain due to the health crisis caused by SARS-COV-2. The rapid spread of the virus generated uncertainty and concern about the impact it could have on patients with severe asthma (SA) and boosted for the first time the use of teleconsultation for the management of these patients. For this reason, it was necessary to facilitate the transition to a hybrid model that combines face-to-face and digital consultations. Objective(s): Development of the first document designed for SA patients, aimed to support the preparation of the telematic follow-up consultations with their specialist. Method(s): Nine experts in SA from different specialties: 4 allergists, 3 pulmonologists and 2 asthma unit nurses contributed to the conceptualization and development of the document. In a first phase of conceptualization, the profile of patients to which the material is addressed was defined and the minimum content needed to be useful to both patients and healthcare professionals (HCPs) was established. A first draft was prepared and refined after evaluation by adult patients and parents of pediatric patients through cognitive interviews. Result(s): Onasm@ is the first document intended for SA patients to prepare the telematic follow-up consultation with their specialist. It consists of three blocks: A first one with general considerations to be applied on the telematic consultation, a second one to collect all the information that might be requested by the healthcare professional (HCP) during the off-site visit (asthma medications, dosage, adherence, asthma crisis events, emergency visits and oral corticosteroid use) and the third block with tips for achieving and maintaining asthma control. The asthma control test (ACTTM) for adults and the children's version (cACTTM) is also incorporated. Conclusion(s): The transition to a hybrid healthcare model due to the pandemic situation makes it essential to support SA patients to face the telematic follow-up consultation with their specialist. Onasm@ is the first document designed to help patients to appreciate the information needed to face this type of visit, with the aim to promote a fluid communication with their HCP and more efficient visits. This type of document could be applied to the management of other conditions and as such have broader impact on the future of healthcare, which is currently immersed in far-reaching change and transformation.
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Quality of life is a construct of significant relevance for the general population and must be studied in a multidimensional way particularly during a pandemic or endemic. The objective of this study was to assess quality of life levels and its relationship with anxiety, depression, and stress for a population living through the Covid-19 endemic. Methodologically, this is a descriptive and cross-sectional study evaluating 384 people over 18 years old. The study applied the WHOQOL-BREF and the abbreviated DASS-21 tests to assess quality of life and emotional symptoms. Result(s): participants reported an adequate perception of quality of life and mild emotional systems. Likewise, the study observed correlation between the variables analyzed (-0.72 and-0.95).Copyright © 2022, Venezuelan Society of Pharmacology and Clinical and Therapeutic Pharmacology. All rights reserved.
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Introduction: The management of the obstetric patient is a matter of great importance, since it is necessary to guarantee the termination of the pregnancy with satisfactory results for the mother and the child, thus avoiding possible maternal or infant deaths. The general objective of our study was to describe obstetric morbidity and mortality in the emergency department of the Ambato Regional Teaching Hospital during the peak of the COVID-19 pandemic. Methodology: Hospital emergency care records were studied in the period January-September 2020, through an observational, retrospective, descriptive study. In this work, emphasis is placed on the obstetric patient in the period during pregnancy and around childbirth, including the immediate puerperium. Results and Conclusion(s): it was evidenced that in the emergency service of the Ambato Regional Teaching Hospital of a total of 1082 patients treated in the emergency room, 92 of these corre-sponded to obstetric patients. The highest morbidity corre-sponded to eutocic deliveries with 39 patients. In the emergency department, 126 Reverse Transcription Polymerase Chain Reaction (RT-PCR) tests were performed, 92 of them on all the obstetric patients seen in the emergency department, resulting in the virus being identified in 46 patients. The most affected age group in COVID patients was 18 to 33 years old, with overall age of 27 years. COVID morbidity predominated in obstetric patients, in the third trimester of pregnancy, 11 of them with fetal distress. Copyright © 2022, Venezuelan Society of Pharmacology and Clinical and Therapeutic Pharmacology. All rights reserved.
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BACKGROUND: At present, several active ingredients have been investigated in mouthwashes having certain virucidal properties, which could reduce the viral load of SARS-CoV-2 to avoid contamination in medical or dental practice. AIM: The objective of this review is to analyze the available evidence regarding mouthwashes and their effect on the salivary viral load of SARS-CoV-2. METHOD(S): Records were retrieved from databases such as PubMed, Scopus, Web of Science, and Virtual Health Library up to June 21, 2022. Randomized or non-randomized clinical trials were included where saliva samples and laboratory or in vitro studies were used in the presence of saliva. RESULT(S): After a systematic selection process, 11 clinical studies that evaluated at least one mouthwash within clinical protocols and three laboratory studies that evaluated the virucidal efficacy against SARS-CoV-2 in the presence of saliva were finally included. CONCLUSION(S): There are oral disinfectants with virucidal action in saliva samples, under clinical and laboratory conditions, capable of reducing the viral load of SARS-CoV-2. Cetylpyridinium chloride, chlorhexidine, and povidone-iodine present the best results so far. However, it was also possible to find active principles of recent appearance that, based on favorable exploratory results, needs further investigation on their efficacy and possible adverse events. Copyright © 2022 Mariano Ortiz Pizarro, Christian R. Mejia, David R. Rodriguez-Diaz, Ygnacio Moreno Herrera, Alexander Bustamante Cabrejo, Victor Serna-Alarcon.
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Background: Age, atrial fibrillation (AF), and COVID-19 infection predispose patients to hypercoagulability and poor outcomes. It is unclear if older adults with AF and COVID-19 infection would benefit from oral anticoagulants (OACs). Methods: A retrospective study was conducted using the PearlDiver database (PearlDiver Technologies, Fort Wayne, IN). Using ICD-10 codes, adults aged 65–75 and Elixhauser Comorbidity index(ECI) >4 with a history of AF admitted for COVID-19 were identified. The use of OACs for 6 months before the index event was used to split the cohort into two propensity score-matched groups considering age, gender, and ECI. Records from both groups were reviewed for multiple outcomes during the same admission. Pearson's chi-squared test was used to compare groups. The strength of association was reported using Risk Ratios (RR). A p-value < 0.05 was deemed significant. Results: We compared 16,967 individuals in both anticoagulated and non-anticoagulated groups. Anticoagulated patients had a lower risk of mortality (RR=0.11, p=0.026), and a higher risk of 30-day all-cause readmission(RR=1.12, p < 0.0001). However, there were no differences in ICU admission, gastrointestinal bleeding, intracranial hemorrhage, thromboembolic events, or length of hospitalization. Conclusion: Compared to non-anticoagulated patients, older adults with a history AF on chronic oral anticoagulants had a lower risk of all-cause mortality, and higher risk of 30-day all-cause readmission. This information would help clinicians decide whether to prescribe OACs to this population of patients.
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Background: Data suggest an increased incidence of myocarditis (MC) associated with the COVID-19 virus. However, the risk factors for COVID-19-related MC remains poorly understood and debated. Therefore, we sought to evaluate the correlation of a history of coronary artery disease (CAD) with MC in older adults admitted for COVID-19. Methods: Data were obtained from the PearlDiver database (PearlDiver Technologies, Fort Wayne, IN). The study included patients aged 65–75, hospitalized with a primary diagnosis of COVID-19, and Elixhauser Comorbidity index(ECI) >4. History of CAD upon admission was used to split the cohort into two propensity score-matched groups considering age, gender, other cardiovascular diseases, and ECI. Records from both groups were reviewed to identify patients diagnosed with MC during and up to one month after admission. Pearson's chi-squared test was used to compare groups. The strength of association was reported using Risk Ratios (RR). A p-value < 0.05 was deemed significant. Results: 182,556 patients with and 218,729 without a history of CAD admitted for COVID-19 were identified. Patients with a history of CAD were more likely to be male(54.7% vs. 42% p < 0.0001), older(mean age 70.62 vs. 70.30, p < 0.001), and had more comorbidities(ECI=11 vs. 8, p < 0.0001). After propensity score matching, 0.13% of patients with CAD and 0.12% without CAD developed MC within one month of admission(RR= 1.05, CI95%=0.87–1.26, p=0.61). Conclusion: One month following admission for COVID-19, the risk of MC was not significantly higher in older persons with a history of CAD.
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Introduction: Collection media of clinical samples with the capacity to denature viruses reduce the risk of contagion during transportation and processing. Objective(s): To use the nucleic acids transport media (NATM) in nasopharyngeal swab samples collected for the diagnosis of SARS-CoV-2. Method(s): An experimental study was conducted to demonstrate the medium capacity to inactivate viral infectivity. Zika virus (ZIKV), of biosafety level 2, was used as an enveloped virus model. The clinical performance of the NATM for the diagnosis of SARS-CoV-2 was evaluated. A ZIKV strain propagated in the Vero cell line was used and, prior to cells infection, ZIKV was in contact at different intervals (2;15, and 30 min) with pure NATM;subsequently, serial dilutions (10-1-10-4) were performed. Viral inactivation was evaluated by RT-PCR in the supernatant and the collected cells when the propagation period was completed. CITOSWAB VTM was used as reference to estimate the clinical performance of the NATM in 30 nasopharyngeal swabs collected for the diagnosis of SARS-CoV-2 infection. Result(s): ZIKV remained infectious at inoculum dilutions of >= 10-2, regardless of contact time. Clinical specificity and sensitivity of the NATM for the diagnosis of SARS-CoV-2 were 100%, respectively. Conclusion(s): Results suggest that ZIKV positive clinical samples at dilutions <= 10-1 of the NATM can be safely handled, which could potentially be applied to the molecular diagnosis of SARS-CoV-2. Copyright © 2022, Editorial Ciencias Medicas. All rights reserved.
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Background: For many malignancies, hypofractionated radiation therapy (HFRT) is a safe and effective standard of care offering significant benefits to patients including decreased treatment time and costs. Yet, rates of usage of HFRT in the United States (US) trail those seen in other developed nations. In other countries, prior work suggests that provider beliefs regarding the risks, benefits, and perceived barriers to implementation impact the adoption of HFRT. However, these attitudes are poorly studied in the US, where patient/provider populations and reimbursement models differ from other nations. Objective(s): We surveyed radiation oncologists (ROs) practicing in the US to measure rates of utilization of HFRT for prostate (PC), breast (BC), and rectal cancer (RC) of varying stages, characterize the beliefs governing these decisions, and assess the impact of the COVID-19 pandemic. (Table Presented) Methods: From July to October 2021, an anonymized, online survey was electronically distributed to ROs. Only ROs practicing in the US were included. Information regarding demographic and practice characteristics was collected. Questions assessing utilization of HFRT for PC, BC, and RC of various disease stages;perceived limitations towards using HFRT;and the effect of the COVID-19 pandemic on practice patterns were queried. Descriptive statistics including frequency counts and proportions as well as medians with interquartile range were performed. These analyses used SAS version 9.4 (SAS Institute, Cary, NC;http://www.sas.com). Result(s): Of the 203 survey respondents (72% male, 72% white, 53% non-academic practice, 69% > 10 years in practice), 77%, 78%, and 60% reported treating PC, BC, and RC, respectively (Table 1). Approximately 50% and 85% of ROs offered stereotactic body radiation therapy (SBRT) and HFRT, respectively, for early/favorable intermediate risk PC (Fig. 1). Although > 90% of ROs offered whole breast HFRT for early-stage BC, only 33% offered accelerated partial breast irradiation (APBI). 41% of ROs offered short course neoadjuvant (5 Gy x 5 fractions) radiation therapy for RC. The main factors ROs cited that limited use of HFRT were a lack of data (13% PC and 64% BC) and concerns by referring providers (52% RC) (Fig. 2). 25%, 36%, and 17% of ROs reported greater use of HFRT for PC, BC, and RC, respectively, due to the COVID-19 pandemic. Conclusion(s): HFRT is safe, effective, and offers significant quality of life benefits for patients, yet it is inconsistently utilized in the US. Prostate SBRT, APBI for BC, and short course RT for RC are particularly underutilized. Hesitancy to offer HFRT appears primarily driven by provider concerns regarding lack of supporting data (PC and BC) or concerns by referring providers (RC). The COVID-19 pandemic minimally affected practice patterns, particularly for RC. Education of both ROs and referring physicians regarding the data supporting HFRT and potential benefits to patients may be one potential way to increase utilization rates. (Table Presented).
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Introduction: Since the first report in Wuhan (China) in 2019, the SARS-CoV 2 virus has spread throughout the world, with a significant impact in public health. To contain the spread of SARS-CoV-2, the WHO has encouraged the development of rapid, simple, sensitive and specific tests that complement the gold standard RT-qPCR. Loop-mediated isothermal amplification (LAMP) has shown a good yield to detect SARS-CoV2 in different fluids. Objective: To validate the colorimetric RT-LAMP technique using two sets of oligonucleotides aimed at identifying the N gene of SARS-CoV-2 in 117 nasopharyngeal swab samples, previously confirmed by RT-qPCR using the Charite/Berlin protocol. Material and methods: 153 nasopharyngeal swab samples from individuals with suspected Covid-19 were subjected to qRT-PCR and RT-LAMP using a commercial colorimetric kit (NEB, Germany). RT-LAMP was run using both extracted RNA samples and raw samples without prior RNA extraction, and the result was assessed by a simple color change in the reaction. Results: RT-LAMP sensibility and specificity for gen N SARS-CoV-2 detection using one primers set previosly reported got values 0.97 (0.85, 1.00) and 0.81 (0.65, 0.92) respectively, for CI 95%. The other set primer used in this paper also reported previosly had 0.96 (0.78,1.00) sensibility and 0.77 (0.55,0.92) specificity to RT-LAMP. Without RNA extraction we found sensibility value of 0.95 (0.74, 1.00) and specificity 0.88 (0.64, 0.99). Conclusion: Taking together, the obtained results show RT-LAMP technique could be considered a rapid diagnostic test, easy to perform, free of sophisticated equipment, sensitive and specific to diagnose SARS-CoV-2 in nasopharyngeal swabs with and without prior RNA extraction, which that allows scaling its portability to places with scarce sources of resources.
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Introduction: Coronavirus disease 2019 (COVID-19) causes a multisystem disease with predominantly respiratory involvement such as pneumonia and respiratory distress syndrome. The lethal behavior of the disease is related to comorbidities that worsen its progno-sis. In this study, they evaluated several of the factors that increase the risk of mortality among hospitalized COVID-19 patients and the quantitative analysis of cases with mortality at the local level of the Ambato canton in the province of Tungurahua. Methodology: A study with a retrospective and descriptive design was carried out in 1080 patients with COVID-19 from the Hospital General Docente Ambato database during the period March 25 to August 22, 2020, in these data estimated response variables to identify the impact of the epidemic, incidence, mortality and lethality rates. Results: Of 1080 patients evaluated, the main groups affected in our population were males (56.6%;n=611), subjects >50 years old (60.9%;n=657), the presence of comorbidity (90 .9%;n=982) and mortality of 34.5% (n=372). The mortality rate was higher in those with co-morbidities (without comorbidity: 8.1% vs with comor-bidity: 33.5%). Conclusion: In the analyzed population, the mortality rate is directly proportional to associated comorbidities, being increased by 25% compared to patients who did not present comorbidities, specifically cardiovascular disease, hypertension, DM and CKD;double the risk of dying from SARS-CoV2 compared to patients without these comorbidities. © 2022, Venezuelan Society of Pharmacology and Clinical and Therapeutic Pharmacology. All rights reserved.
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The Coronavirus disease 2019 (COVID-19) pandemic revealed our need for reliable tools to evaluate patients with skin disease virtually. Thus far, there has not been a study that has attempted to score the Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI), a validated outcome measure of skin activity and damage, from photographs. In this study, patients were prospectively recruited during routine clinic visits and skin regions used in scoring the CDASI were photographed by research staff using two iPhone cameras (an iPhone 8 and iPhone 11). Two dermatologists served as the raters. The in-person CDASI assessment was scored by rater 1 at the clinic visit and the photographs were scored at a later date by both rater 1 and rater 2. Of the 34 patients participating in the study, 82.3% were female, 85.3% were Caucasian with a mean age of 54 years (SD=12). For the total activity score, the intraclass correlation coefficient (ICC) between rater 1’s in-person assessment compared to photograph assessment was 0.806 (95% CI 0.649-0.898 p<0.001) and was 0.822 (95% CI 0.675-0.907 p<0.001) between rater 2 and the in-person assessment. For the total damage score, the ICC between rater 1 and the in-person assessment was 0.54 (95% CI 0.254-0.739 p=0.004) and was 0.601 (95% CI 0.338-0.778 p<0.001) between rater 2 and the in-person assessment. The reliability was interpreted as “excellent” for skin activity, an important measure in clinical trials for dermatomyositis. Photographs may be a useful tool for evaluating clinical trial patients in the future. More research is needed to determine innovations for improving our ability to evaluate skin activity through photographs such as the use of a color checker card or color correction algorithm.
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Introduction: PrecISE is an ongoing Phase II clinical trial sponsored by the National Heart, Lung, and Blood Institute to investigate the efficacy of several treatments for severe asthma. The threat of COVID-19 has raised interest in obtaining reliable spirometry data for asthma research and clinical care in a remote, “no-touch” fashion. Prior studies of the accuracy of remote spirometry have not included real-time coaching. The PrecISE investigators hypothesized that remote spirometry with real-time video coaching could provide an accurate FEV1 for use as a study endpoint in a clinical trial setting. Methods: PrecISE network participants had remote spirometry post-bronchodilator (4 puffs of albuterol) measured with video coaching from trained research coordinators using the ZEPHYRx platform connected to MIR Spirobank Smart handheld spirometers. Remote spirometry measurements occurred within a +/- 3-day window from scheduled in-person PrecISE visits during which in-person spirometry with bronchodilator challenge was measured with standard equipment (Vyaire Medical). All measurements occurred during the screening/run-in period of the PrecISE protocol. Both remote and in-person spirometry was overread by the PrecISE Spirometry Core and only included in analysis if sessions met ATS acceptability and reproducibility criteria. Correlations between remote and in-person FEV1 and FVC were analyzed, and Bland-Altman plots generated. As a comparison, within subject biological variability was measured using data from separate in-person visits during the screening/run-in period. Results: A total of 128 pairs of remote/in-person spirometry data were obtained. The mean FEV1 for remote spirometry was 2.50 L (SD 0.81) and for inperson spirometry was 2.42 L (SD 0.80), with an estimated correlation of 0.95 (95% CI: 0.93, 0.97). The mean difference in FEV1 (in-person - remote) was -0.07 L (95% CI: -0.11, -0.03, SD 0.25). The mean FVC for remote spirometry was 3.72 L (SD 1.01) and for in-person spirometry was 3.53 L (SD 0.93), with an estimated correlation of 0.91 (95% CI: 0.87, 0.93). The mean difference in FVC (in-person - remote) was -0.19 L (95% CI: -0.27, -0.12, SD 0.42). A total of 142 pairs of repeated in-person spirometry measurements were performed (median time between measurements: 43 days), with mean difference in FEV1 of -0.01 L (95% CI: -0.06, 0.03) and FVC of -0.02 L (95% CI: -0.07, 0.03). Bland-Altman plots for FEV1 differences are shown in Figure 1. Conclusions: Remote spirometry with real-time video coaching provides a reliable FEV1 measurement which correlates closely with in-person spirometry and is suitable for use in clinical trials. (Figure Presented).
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Objective. Assessment in distance education provides a safe evaluation environment during the COVID-19 pandemic. The purpose of this study is to explore the extent of knowledge available regarding the challenges of assessment in distance education of health professions during the 2020-2021 COVID-19 pandemic and to discuss a reflection in the Philippine setting. Method. We conducted a rapid review through an electronic search in PubMed, Scopus, CINAHL, ERIC, Web of Science, and PsycINFO databases. Results. Out of 1,519 articles, 9 were included for analysis. Philippine reflection was provided through an unsystematic search of literature. Challenges in assessment included resources, learners’ issues, technical issues of the learning management system, and methodological assessment issues. Distance education allowed instructors to safely continue delivery of instruction and assessment during the pandemic. Conclusion. The Philippine setting is relatable to the current international context of the challenges of assessment in distance education in health professions. © 2022 University of the Philippines Manila. All rights reserved.
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Focused on the field of hypermedia journalism due to its possibilities of monitoring through teleworking, and because of the emphasis that the country is placing on the increasing use of ICTs, a team of researchers with diverse profiles, with representation in all regions of Cuba, identified 35 experiences of hypermedia journalism published in the Cuban public media until June 5th, 2020. From this sample, 20 proposals were selected using the nominal group technique in virtual variant, to which a more detailed analysis was carried out, based on 13 criteria identified among the international recommendations for dealing with the pandemic in the press. Both the analysis of the sample, as well as a discussion forum held with journalists from all over the archipelago from the publication of the report resulting from this research, yielded interesting guidelines about the positive communicative practices detected, potentially applicable in the productive dynamics of Cuban public media. © 2022, Centro Nacional de Informacion de Ciencias Medicas. All rights reserved.
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The agri-food system depends on global variations such as economic changes that generate insecurity or food shortfall, in addition to the current health emergency that mainly affects small producers in rural areas. This work reviews the conditions of rural producers of Xochimilco in Mexico City and proposes a structure that promotes the viability of the agri-food system. The study was carried out in two stages, the ethnographic method was first used and, then from the Systemic Approach, the Soft Systems Methodology (SSM) in complementarity with Viable System Model (VSM) was applied to contextualize the effects of the current health emergency in this area. The results show that these communities are facing the pandemic from their limited capacities, so mechanisms and organizational structures are needed to make food systems robust to meet the challenges that their environment presents. It is proposed that the necessary linkage should be based on systemic models capable of managing the complexity of rural systems, such as the joint use of SSM and VSM, which through its systemic functions process environmental complexity and improve adaptation to the environment to ensure their survival.
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Introduction: A 67 year old man presented dysphagia after a right partial epiglottectomy for a cT1N2bM0 supraglottic squamous cell carcinoma. Immunohistological assessment showed a mixed cellularity: a neuroendocrine (CK-20 +, S100 +, Ki67 90%) and squamous cell carcinoma. Margin ampliation to the right glossoepiglottic fold and a bilateral cervical lymphadenectomy was performed. Tracheostomy was needed after surgery because of laryngeal edema. Materials and Methods: Nasolaryngoscopy showed no glottic closure, saliva retention with aspiration and an absent answer to stimuli in the right supraglottic space. After a 5 ml pudding texture was given, methylene blue remained in the right pyriform sinus, aspiration and an absence of cough reflex. No oxygen desaturation or oral residuewas evidenced during exploration. Fractioned swallowing was needed. Results: A multidisciplinary evaluation of the patient in our Dysphagia Department took place. Logopedic restitutive techniques were a pillar in the rehabilitation of the patient. Sensory stimulation with heat foam, increase in muscular tone with direct stimulation to the tongue/pharynx and compensatory swallowing techniques were taught to the patient. After a 6 month follow up the same test with 5 ml pudding was performed. Glottic closure returned, with no evidence of aspiration to 5 ml pudding texture. Aspiration to nectar texture, fractioned swallowing and a right absence to stimuli remained. Conclusions: Dysphagia after head and neck cancer surgery is a common occurrence, given the most common location of appearance for squamous cell carcinoma is the supraglottis. Multidisciplinary approach to the patient that develops dysphagia remains key in the improvement of their quality of life and reduces the number of comorbidities after treatment. In this case the patient needed a tracheostomy after surgery, increasing their chances of dysphagia. After a closely followed multidisciplinary rehabilitation the patient was able to improve glottic closure and never had an episode of aspiration pneumonia until their death this past March 2021 from COVID-19.