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1.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2009570

ABSTRACT

Background: Oral mucositis (OM) is a debilitating side effect of concomitant chemoradiotherapy (CRT) for head and neck cancer (HNC). EC-18 may effectively mitigate OM by minimizing the CRT-induced innate immune response. This Phase II, 2-stage trial evaluated safety, tolerability, and efficacy of EC- 18 in reducing the duration, incidence, and trajectory of severe OM (SOM) in HNC patients. Methods: Patients (n = 105) with pathologically confirmed oral cavity, oropharynx, hypopharynx, or nasopharynx squamous cell cancers who received intensity-modulated radiation therapy (IMRT;with ≥ 55 Gy on ≥ 2 oral sites) and weekly or tri-weekly cisplatin were studied. In Stage 1, 24 patients were randomized (n = 6 per arm) to receive 500, 1000, or 2000 mg of EC-18, or placebo. Following independent Data Safety Monitoring Board review, 81 patients in Stage 2 received EC-18 2000 mg (n = 41) or placebo (n = 40) throughout CRT. WHO OM grade was assessed twice weekly during IMRT and then once weekly for up to 6 weeks post-IMRT. The primary efficacy endpoint was duration of SOM during the active and short-term follow-up (STFU) periods in the compliant per-protocol population (PP). Much of Stage 2 was conducted during peak periods of the COVID-19 pandemic which measurably impacted patient compliance relative to test medication dosing and planned radiation. Consequently, to assess efficacy most accurately, the PP population was analyzed (with at least 4 weeks of study drug dosing, minimum cumulative radiation of 55 Gy, 80% study drug compliance in the first 28 days of dosing, and without using not-allowed-therapy). Results: Patient demographics and baseline characteristics were balanced between groups. Adverse events (AEs) were comparable amongst cohorts without drug-related severe AEs. In the PP, the median duration of SOM from baseline through STFU was 0 day in the EC-18 group (n = 22) v 13.5 days in the placebo group (n = 20). SOM incidence through STFU (45.5% v 70%) and opioid use (time to onset: 32.3 v 26.0 days;and duration: 32.8 v 37.5 days) favored EC-18 v placebo. Results of the covariates analyses suggested that EC-18 favorably impacted SOM incidence in patients who experienced SOM treated with weekly low-dose cisplatin (n = 26;37.5% v placebo 70.0%) and HPV+ tumors (n = 29;35.3% v placebo 66.7%;Table). One-year long-term follow-up for tumor outcomes is ongoing. Conclusions: EC-18 safely mitigated the development and the time course of SOM in CRT-treated HNC patients. In addition, EC-18 may provide substantial benefits to subpopulations of HPV+ HNC patients treated with low dose cisplatin.

2.
Stigma and Health ; 2022.
Article in English | Web of Science | ID: covidwho-2004754

ABSTRACT

The onset of COVID-19 has resulted in higher rates of racial discrimination toward Asian American and Pacific Islanders, including Korean Americans. This study used moderated mediation analyses to examine the relationship between COVID-19-related racial discrimination and anxiety, depression, and life satisfaction among Korean Americans (KA;N = 270) and explored the buffering effect of ethnic identity and coping strategies. Experiences of pandemic-related racial discrimination were linked to the severity of anxiety and depression levels among KA, which resulted in lower levels of life satisfaction. Coping strategies moderated the link between depression and life satisfaction but not between anxiety and life satisfaction. Ethnic identity exacerbated the relationship between racial discrimination and levels of anxiety and depression. The significance of these findings highlights the important role of coping strategy and ethnic identity in mental health among KA during the pandemic. Based on these findings, implications for professional counselors are outlined.

3.
Cytotherapy ; 24(5):S147, 2022.
Article in English | EMBASE | ID: covidwho-1996729

ABSTRACT

Background & Aim: Blood is one of the most vital resources in modern medicine. Blood transfusions have become an essential and often lifesaving procedure for accidents, during surgery, for patients with chronic disorders such as anemia, sickle cell disease, cancer, and myriad other circumstances. However, despite the rapidly growing world population, the availability of healthy blood donors is declining with aging populations. Furthermore, natural and man- made calamities often produce sudden and concentrated shocks in demand, which strains global supply chains. The COVID-19 pandemic has demonstrated this issue on a global scale by reducing the number of blood drives and donations, resulting in 39% of blood centers in the United States being left with only one- to two-day supplies, and a 50% drop of blood units collected in countries such as Zambia. Additionally, storage limitations of 42 days for donor blood limits stock availability during peak demand. Large-scale generation of universal red blood cells (RBCs) from O-ve human induced pluripotent stem cells (hiPSCs) offers the potential to alleviate blood shortages and provide a secure year-round supply. Mature iPSC-derived RBCs and reticulocytes could also find important applications in research in malaria and COVID-19 studies. (Figure Presented) Fig. 1 ( 700). Methods, Results & Conclusion: In this study, we have reprogrammed hiPSC from CD34+ O-ve cells and demonstrated the smallscale generation of high-density cultures of erythroblasts in a stirred perfusion bioreactor system. Twenty O-ve iPSC lines were derived, screened, and characterized for their ability to differentiate towards the erythroid lineage, showing high expression of mesoderm (KDR+, 64.9%), hematopoietic (CD34+/CD45+, 68.4%;CD34+/CD43+, 84.9%), and erythroid markers (CD235a+, 83,5%), and were able to undergo enucleation in vitro. Using the best clones, we were able to achieve erythroblast peak cell density of 34.7 million cells/mL with 92.2% viability in an Applikon perfusion bioreactor using an ultrasound system (Sonosep) to concentrate cells while removing waste media. This resulted in a cumulative-fold expansion of over 1,500 after 29 days of culture. Cells carried O2 effectively as demonstrated by hemoglobin dissociation curves. The perfusion culture platform paves the way for controlled high-density bioreactor culture for the generation of RBCs.

4.
IEEE Robotics and Automation Letters ; : 1-8, 2022.
Article in English | Scopus | ID: covidwho-1961414

ABSTRACT

We design a central controller system (CCS) and a tele-controlled system (TCS) with an aim of developing the integrated tele-monitoring/operation system that can enable the medical staff to tele-monitor the state of therapeutic devices utilized in the isolation intensive care unit (ICU) and to tele-operate its user interfaces. To achieve this aim, we survey the medical staff for medical requirements first and define the design guideline for tele-monitoring/operation functionality and field applicability. In designing the CCS, we focus on realizing the device having intuitive and user-friendly interfaces so that the medical staff can use the device conveniently without pre-training. Further, we attempt to implement the TCS capable of manipulating various types of user interfaces of the therapeutic device (e.g., touch screen, buttons, and knobs) without failure. As two core components of the TCS, the precision XY-positioner having a maximum positioning error of about 0.695 mm and the end-effector having three-degrees-of-freedom motion (i.e., pressing, gripping, and rotating) are applied to the system. In the experiment conducted for assessing functionality, it is investigated that the time taken to complete the tele-operation after logging into the CCS is less than 1 minute. Furthermore, the result of field demonstration for focus group shows that the proposed system could be applied practically to the medical fields when the functional reliability is improved. IEEE

5.
Online Information Review ; 2022.
Article in English | Scopus | ID: covidwho-1948707

ABSTRACT

Purpose: This study investigated information needs on COVID-19 by identifying topics discussed on social questions and answers (Q&A) about daily routines, problems, and health issues for survival. A layered model of contexts for everyday life information seeking (ELIS) was adapted for interpreting topics to better understand the contexts in which users could relate information needs. Design/methodology/approach: Questions and answers posted on Naver Knowledge-iN were collected and analyzed during the first nine months following the outbreak. Time distribution, topic modeling, and association rule mining were applied to examine the topics on COVID-19 and their temporal variation. Findings: Numerous topics related to the cognitive context (symptoms and masks) and situational contexts (international affairs, financial support, study, and work) were discovered. Topics related to social context were discussed moderately, but the number of questions on this topic increased with time. Strong associations were observed between terms related to symptoms, indicating their importance as a COVID-19 topic in health. Originality/value: This study investigated topics of information needs using social Q&A data in which not only information inquiry but also information sharing coexist. The findings can help bridge the theory of ELIS to topic modeling in practice. The insights gained from this study can be used by information service providers for developing guidance and programs about how to survive during a pandemic. Peer review: The peer review history for this article is available at: https://publons.com/publon/10.1108/OIR-10-2021-0547. © 2022, Emerald Publishing Limited.

6.
Alcoholism-Clinical and Experimental Research ; 46:233A-233A, 2022.
Article in English | Web of Science | ID: covidwho-1894215
7.
37th ACM/SIGAPP Symposium on Applied Computing, SAC 2022 ; : 1771-1778, 2022.
Article in English | Scopus | ID: covidwho-1874700

ABSTRACT

The social confusion caused by the recent pandemic of COVID-19 has been further facilitated by fake news diffused via social media on the Internet. For this reason, many studies have been proposed to detect fake news as early as possible. The content-based detection methods consider the difference between the contents of true and fake news articles. However, they suffer from the two serious limitations: (1) the publisher can manipulate the content of a news article easily, and (2) the content depends upon the language, with which the article is written. To overcome these limitations, the diffusion-based fake news detection methods have been proposed. The diffusion-based methods consider the difference among the diffusion patterns of true and fake news articles on social media. Despite its success, however, the lack of the diffusion information regarding to the COVID-19 related fake news prevents from studying the diffusion-based fake news detection methods. Therefore, for overcoming the limitation, we propose a diffusion-based fake news detection framework (D-FEND), which consists of four components: (C1) diffusion data collection, (C2) analysis of the data and feature extraction, (C3) model training, and (C4) inference. Our work contributes to the effort to mitigate the risk of infodemics during a pandemic by (1) building a new diffusion dataset, named CoAID+, (2) identifying and addressing the class imbalance problem of CoAID+, and (3) demonstrating that D-FEND successfully detects fake news articles with 88.89% model accuracy on average. © 2022 ACM.

8.
12th International Conference on ICT Convergence (ICTC) - Beyond the Pandemic Era with ICT Convergence Innovation ; : 673-677, 2021.
Article in English | Web of Science | ID: covidwho-1853468

ABSTRACT

Combining the current era background of the rapid development of related industries in metaverse and the social environment brought about by the COVID-19. As a result, there are more and more cases of receiving treatment for mental illness in the metaverse space. Therefore, in the current actual situation, the main body of this article is to use a game engine to build a high-realistic virtual diagnosis and treatment stage based on the metaverse. This project has two components: This project has two components: 1. Design a metaverse space scene. Designed to improve the discomfort of elderly users in the metaverse environment. 2. The PBR (Physically Based Rendering) rendering material processing method in the metaverse stage. This article aims to establish a digital diagnosis and treatment space based on the metaverse, which can help patients reduce the unfamiliarity of online diagnosis and treatment, provide a more active psychotherapy atmosphere, and reduce the discomfort of patients during the treatment process. Furthermore, based on metaverse, this article aims to build a more intelligent, realistic, and visualized digital therapy stage and the highly realistic performance of the digital therapy treatment content in the future under visualization.

9.
Asian American Journal of Psychology ; : 14, 2022.
Article in English | Web of Science | ID: covidwho-1821569

ABSTRACT

What is the public significance of this article? This study suggests that greater use of coping may be helpful for reducing the harmful effect of racial discrimination on mental health of AAPIs. Additionally, it highlights that a strong sense of ethnic identity may reduce the impact of depression on life satisfaction but worsen the impact of anxiety on life satisfaction. The coronavirus disease (COVID-19) pandemic has contributed to higher rates of racial discrimination and xenophobia toward Asian Americans and Pacific Islanders (AAPIs). The present study examined a moderated mediation model with a national sample of AAPI individuals (N = 725) to determine how experiences of COVID-19 related racial discrimination impacted scores of depression, anxiety, and life satisfaction. Results indicated that experiences of COVID-19 related racial discrimination significantly and negatively impacted life satisfaction among AAPI participants via increased levels of depression and anxiety. Findings also indicated that coping strategies attenuated the link between discrimination and anxiety and discrimination and depression. High levels of ethnic identity exploration exacerbated the association between anxiety and life satisfaction but attenuated the relationship between depression and life satisfaction. Implications for mental health clinicians, educators, and researchers are provided.

10.
J Occup Environ Hyg ; 19(4): 223-233, 2022 04.
Article in English | MEDLINE | ID: covidwho-1684399

ABSTRACT

In 2020, the Centers for Disease Control and Prevention recommended the use of the National Institute for Occupational Safety and Health-certified Elastomeric Half Mask Respirators equipped with N95 or P100 respirator filter cartridges for protection against the SARS-CoV-2 viral agent, as a viable alternative to N95 filtering facepiece respirators. Additionally, the Centers for Disease Control and Prevention recommendations stated that based on current practice, it was acceptable to repeatedly use these filter cartridges for up to 12 months as a contingency capacity strategy during anticipated respirator shortages. To validate this recommendation, an investigation was undertaken in which Elastomeric Half Mask Respirators equipped with P100 respirator filter cartridges were deployed and used by healthcare professionals in clinical settings (i.e., inpatient nursing units, operating rooms) for extended periods. These filter cartridges were subsequently tested to accurately quantify their filtration efficiency and breathing resistance to determine if they continued to meet National Institute for Occupational Safety and Health's performance requirements. Findings from this investigation confirmed that an Elastomeric Half Mask Respirator when equipped with a P100 filter cartridge continues to provide a high level of aerosol filtration performance (≥99.97%) and exhibits little change in breathing resistance even after 12 months of repeated use (i.e., wear, cleaning, and disinfection between patient use and at the end of work shift) in healthcare settings.


Subject(s)
COVID-19 , Occupational Exposure , Respiratory Protective Devices , COVID-19/prevention & control , Delivery of Health Care , Filtration , Humans , Occupational Exposure/prevention & control , SARS-CoV-2 , United States , Ventilators, Mechanical
11.
Korean Journal of English Language and Linguistics ; 2021(21):298-323, 2021.
Article in Korean | Scopus | ID: covidwho-1643992

ABSTRACT

Due to the COVID-19 pandemic, domestic universities have been forced to become a vast experimental ground for using technology for online classes. Despite the decades’ research on the use of technology in the field of English education, these online classes, which were suddenly and involuntarily administered to both teachers and learners, puzzled everyone. Considering a crisis can work as an opportunity, this unfamiliar non-face-to-face situation can be an opportunity to look at the teachers’ response to the crisis more clearly than the usual face-to-face situation. This study explored the experience of the college instructors, facing unprecedented challenges. In-depth interviews were conducted for four university professors who managed on-line-only English classes during the pandemic in 2020, asking the difficulties, emotions, solutions, and any changes while they were facing challenges this time. All interviews were recorded and transcribed to generate initial codes for each participant. The concepts with similar attributes were categorized through the process of integrating and reducing the codes. As a result, the challenges experienced by the participants were broadly categorized into two levels—individual and institutional. Participants’ emotions along with the obstacles they perceived;the ways they dealt with those obstacles;and any internal or external changes were further explored. The implications are discussed based on these results. © 2021 KASELL All rights reserved.

12.
12th International Conference on Information and Communication Technology Convergence, ICTC 2021 ; 2021-October:673-677, 2021.
Article in English | Scopus | ID: covidwho-1642561

ABSTRACT

Combining the current era background of the rapid development of related industries in metaverse and the social environment brought about by the COVID-19. As a result, there are more and more cases of receiving treatment for mental illness in the metaverse space. Therefore, in the current actual situation, the main body of this article is to use a game engine to build a high-realistic virtual diagnosis and treatment stage based on the metaverse. This project has two components: This project has two components: 1. Design a metaverse space scene. Designed to improve the discomfort of elderly users in the metaverse environment. 2. The PBR (Physically Based Rendering) rendering material processing method in the metaverse stage. This article aims to establish a digital diagnosis and treatment space based on the metaverse, which can help patients reduce the unfamiliarity of online diagnosis and treatment, provide a more active psychotherapy atmosphere, and reduce the discomfort of patients during the treatment process. Furthermore, based on metaverse, this article aims to build a more intelligent, realistic, and visualized digital therapy stage and the highly realistic performance of the digital therapy treatment content in the future under visualization. © 2021 IEEE.

13.
IEEE Access ; 2021.
Article in English | Scopus | ID: covidwho-1594852

ABSTRACT

Given its low dose and compactness, chest radiography has been widely used as the first-line test to determine the presence of lung anomalies. Nevertheless, a high-performance diagnosis for initial screening to detect shadows in lungs due to general lung diseases is not available. During initial screening, chest radiography can be used to distinguish any diseased lung shadowing caused by lung diseases. Thus, chest radiography can contribute to the early diagnosis and prevention of novel lung infectious diseases if training for a specific disease is not required. Accordingly, we propose a deep-learning-based diagnostic system called contrast-shifted instances via patch-based percentile (CSIP) to automatically detect diseased lung shadowing via training only on chest X-ray data from healthy subjects. CSIP is the first application of a patch-based percentile approach to state-of-the-art one-class classifiers (OCCs). This application improves the sensitivity of the network to recognize shadowing density differences in each local area of the lung, thereby considerably improving the diagnostic performance of average area under the curve (AUC) by more than 20% and achieving a sufficiently high diagnostic performance (average AUC of 0.96 for various lung diseases), compared to the existing OCC case without applying our patch-based approach (average AUC of 0.74). Therefore, CSIP may contribute to the early detection of anomalies caused by novel infectious diseases such as variants of the coronavirus disease, for whom training data are scarce. The code is available at https://github.com/kskim-phd/CSIP. Author

15.
Audiology and Speech Research ; 17(4):352-363, 2021.
Article in Korean | Scopus | ID: covidwho-1529072

ABSTRACT

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has severely affected public health and people’s lifestyle. The purpose of this survey study is to investigate audiology services during COVID-19 pandemic to understand the current audiology service situations in Korea and to improve audiology services. Methods: A total of 120 participants (60 audiologists and 60 clients visiting audiologists) were surveyed in this study using online or face-to-face methods. The participants answered 24~25 questions including current status of audiology service, communication difficulties with wearing masks, and the provision of tele-audiology services during COVID-19. Results: The results showed that both audiologists and clients with hearing loss still preferred face-to-face audiology services in COVID-19 situation in spite of 56% of visiting schedule delay and cancellation. The primary audiology services they considered in COVID-19 were hearing aid fitting and maintenance & repair services. Wearing masks has led communication difficulties in both audiologists and clients with hearing loss due to speech level reduction, frequency filtering of sounds, and insufficient visual cues during the conversation. Only 30% of audiologists have provided tele-audiology services, and 4.4% of clients received tele-audiology services during COVID-19. Conclusion: The impacts of COVID-19 in audiology services in South Korea are still progressing. The technical and administrative systems and educational support to improve audiology services in South Korea are necessary. Copyright © 2021 Korean Academy of Audiology

16.
5th International Virtual Conference on Human Interaction and Emerging Technologies, IHIET 2021 and 6th International Conference on Human Interaction and Emerging Technologies: Future Systems, IHIET-FS 2021 ; 319:240-245, 2022.
Article in English | Scopus | ID: covidwho-1446022

ABSTRACT

The fashion world is trying various changes due to the development of technology, the non-face-to-face environment caused by Covid-19, and the lifestyle change of the digital generation. It is a world where luxury brands promote and sell their products in a metaverse environment. Fashion influencers also use YouTube to give advice on styling and short content, and lead lifestyle changes. As a result, the values and sensibility of digital-based fashion are also changing. Therefore, this thesis researched related contents through Fashion YouTube. Fashion YouTube, which has the top 5 domestic subscribers and videos as of May 2021, was selected. I crawled their youtube data reviews with python. As a result of the analysis of the collected data with text-mining, past fashion discovered fashion and trends, but modern fashion further emphasized the philosophy and values of life based on their own lifestyles. Rather than changing fashion based on trends, fashion is a means of expressing individual values, emphasizing emotional details and expressing fashion changes. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

17.
Journal of General Internal Medicine ; 36(SUPPL 1):S402-S402, 2021.
Article in English | Web of Science | ID: covidwho-1349089
18.
Journal of Clinical Oncology ; 39(15 SUPPL), 2021.
Article in English | EMBASE | ID: covidwho-1339323

ABSTRACT

Background: Since the COVID-19 pandemic began in early 2020, there have been many reports that it has had a significant impact on screening, case identification and referral in cancer diagnosis. We investigated the diagnostic and therapeutic status of breast malignancy before and after the COVID-19 pandemic at the multi-institution level. Methods: We have reviewed the records of patients with breast cancer from February 2019 to July 2020 in six university hospitals in Korea. The patients were divided into two groups according to the initial date of cancer diagnosis: Period A, from February to April and Period B, from May to July in 2020. The two groups were compared for the same periods in 2019. The goals were to determine whether breast cancer screening and diagnosis have been delayed and thus resulted in stage migration. We also examined the difference in the number of surgeries in patients diagnosed with breast cancer during those periods. Results: The total of 1,669 breast malignancy diagnosis was made in the grouped periods of 2019, and 1,369 diagnoses in 2020. All patients were screened by PCR test for COVID-19 prior to hospitalization, and none of them tested positive. Overall, there was a 9.9% reduction in the number of diagnoses than in 2019 and the decrease was more significant in Period A (11.1% vs. 8.7%). According to the age, there was no difference until the 30s but decreased from those in their 40s and above. The decline was more pronounced in the elderly. The COVID-19 pandemic has affected breast cancer screening (decreased by 27.4%) and more diminished in Period A (41.0% vs. 19.0%). Invasive breast cancer stage was not statistically different in Period A compare with 2019 (p = 0.170). But the stage in Period B was different (p = 0.032), and more patients were observed in advanced stages in 2020. The decrease in surgery was noticeably observed in Period A (4.6%, from 480 to 438 surgeries) and not in Period B. The analysis of reconstruction surgery was similar. Conclusions: Patients with COVID-19 increased exponentially from late February in Korea. However, the number of patients per day decreased to less than 100 on March 15 and then flattened. The health care system for cancer was not overloaded and restrictions on visiting hospital were minimal. Analysis in the pandemic period of the 6-month showed that the number of breast cancer screening, diagnosis and surgeries decreased compared with the previous year. Those decreases were prominent in Period A when the COVID-19 patient surged. The upstage migration of breast cancer was generally insignificant but slightly occurred in Period B. The outbreak of infectious disease makes patients reluctant to come to the hospital, especially in the elderly. We need to discuss the potential long-lasting deleterious effect of the COVID-19 pandemic on cancer diagnosis and management. And we should prepare for how to deal with the backlog caused by the COVID-19 pandemic.

19.
American Journal of Respiratory and Critical Care Medicine ; 203(9), 2021.
Article in English | EMBASE | ID: covidwho-1277473

ABSTRACT

The medicinal use of leeches (hirudotherapy) is intimately connected to the history and practice of medicine. Here we describe a novel case of hirudotherapy in an intubated patient with macroglossia related to oral trauma and venous congestion. The patient was a 23-year-old woman with a history of morbid obesity initially admitted to an outside hospital with acute hypoxic respiratory failure secondary to COVID-19 pneumonia. She received early treatment with supplemental oxygen, dexamethasone, remdesivir, and tocilizumab but developed worsening respiratory failure requiring intubation on hospital day 13. Despite neuromuscular blockade and proning, she remained difficult to oxygenate and was transferred to our hospital 24 days after admission. Weaning of pharmacologic paralysis was complicated by ongoing ventilator dyssynchrony, and she continued to require deep sedation with multiple agents, including phenobarbital. Her respiratory status gradually improved, but weaning of sedation was marked by agitation and tongue biting. On day 50, significant isolated tongue edema was noted. Further trauma was observed on the ventral aspect of the swollen tongue where it came into contact with the teeth. High-level ventilatory support precluded tracheostomy, and conservative management with repositioning of the endotracheal tube and insertion of a bite block did not resolve the edema. The otolaryngology service was consulted, and the decision was made to trial an application of medicinal leeches. The patient received two courses of hirudotherapy with packing of the oropharynx to prevent leech migration, resulting in significant improvement of her edema. Among already mechanically ventilated patients, macroglossia remains a rare but documented complication. Endotracheal tube position and proning are the most frequently implicated etiologies. In this instance, oral trauma from tongue-biting coupled with impaired lymphovascular return from extrinsic impingement on the swollen tongue were thought to be the cause. Therapeutic options are limited and include ice, elevation, bite block placement, intravenous steroids, manual reduction and compression wrapping. In extreme cases, tracheostomy and even partial glossectomy have been performed. Hirudotherapy is well described in modern clinical practice among facial reconstructive surgeons for the management of venous congestion and resultant compromise of pedicle or microvascular tissue-free transfer flaps. Few case reports in the trauma literature have described its use with macroglossia on presentation, but its use in cases of post-intubation trauma appears novel. Given the frequent contribution of venous congestion in intubated patients with macroglossia, hirudotherapy should be considered a logical treatment modality in cases where conservative measures are unsuccessful.

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