Motivational Interviewing for Hearing Aid Use: A Systematic Meta-Analysis on Its Potential for Adult Patients with Hearing Loss.

PURPOSE: The aim of the study is to conduct a meta-analysis examining the impact of motivational interviewing (MI) on hearing aid (HA) use compared with standard care. RESEARCH DESIGN: The research design is a systematic review and meta-analysis. Cochrane ENT, Central, Medline, Web of Science, ICTRP, and ClinicalTrials.gov electronic databases were searched. Inclusion criteria consisted of randomized controlled trials (RCTs) published between 1988 and 2018 that compared MI to standard care. STUDY SAMPLE: The study sample consists of four RCTs, investigating a total of 176 patients. DATA COLLECTION AND ANALYSIS: RevMan 5.3 and a random effect model were used for analysis. RESULTS: The standardized mean difference in data-logged hours of HA use was not statistically significant (0.34 [95% confidence interval or CI: -0.10, 0.78; p = 0.13]). The mean difference for user-reported outcomes on the International Outcome Inventory-Hearing Aids of 0.41 [CI: -1.00, 1.82; p = 0.57] was also not significant. CONCLUSION: There is no current evidence that MI significantly improves HA use or user-reported outcomes. However, there were limited studies included in this review and further research is indicated.

Vocal Cord Paralysis After Thoracic Aortic Surgery: Incidence and Impact on Clinical Outcomes.

BACKGROUND: Vocal cord paralysis (VCP) is a serious complication associated with thoracic aortic surgery; however, there is a paucity of literature regarding the incidence and impact of VCP on postoperative outcomes. We sought to determine the incidence of VCP and its impact on clinical outcomes in patients who underwent thoracic aortic repair at our center. METHODS: A retrospective chart review was conducted on all patients who underwent thoracic aortic surgery between January 2009 and September 2012. RESULTS: A total of 259 patients underwent a thoracic aortic procedure during the study period. Vocal cord paralysis was diagnosed in 12 (5%) patients, a median of 6 [3 to 21] days after extubation. The incidence was 1%, 0%, 20%, and 25% in those undergoing an open ascending, hemiarch, total arch, or descending aortic procedure, respectively. Patients with VCP had an increased incidence of pneumonia (58% vs 17%, p = 0.003), readmission to the intensive care unit for respiratory failure (17% vs 2%, p = 0.047), and longer hospital length of stay (18 [11 to 43] days versus 9 [6 to 15] days, p = 0.002). A propensity-matched analysis confirmed a higher incidence of pneumonia (58% vs 17%, p = 0.020) and longer hospital length of stay (18 [11 to 43] vs 10 [7 to 14] days, p = 0.015) in patients suffering VCP. CONCLUSIONS: Vocal cord paralysis is a common complication in patients undergoing open surgery of the aortic arch and descending aorta, and is associated with significant morbidity. Further research may be warranted to determine if early fiberoptic examination and consideration of a vocal cord medialization procedure may mitigate the morbidity associated with VCP.

Laryngeal candidiasis in the outpatient setting.

OBJECTIVES: We present the largest case series on laryngeal candidiasis and review the literature on the diagnosis and management of laryngeal candidiasis. SUBJECTS AND METHODS: Fifty-four patients were included in a retrospective chart review of all cases seen at the Pacific Voice Clinic, University of British Columbia, Vancouver, from 1995 to 2005. RESULTS: The most common presenting symptom was dysphonia (37 patients; 69%). Forty-eight patients (89%) were on steroid inhalers, and four patients (7%) were on oral prednisone. In terms of anatomic involvement, 18 patients (33%) showed Candida involvement in all three anatomic locations: the hypopharynx, the supraglottis, and the glottis. In 15 patients (28%), the Candida was isolated to the glottis. The remaining patients showed subglottic and glottic involvement. Fifty-two patients (96%) were successfully treated with a single course of an oral antifungal. CONCLUSION: The most common risk factor identified was inhaled steroids. Most often, laryngeal candidiasis is effectively treated with oral antifungal medications.

Global analysis of yeast endosomal transport identifies the vps55/68 sorting complex.

Endosomal transport is critical for cellular processes ranging from receptor down-regulation and retroviral budding to the immune response. A full understanding of endosome sorting requires a comprehensive picture of the multiprotein complexes that orchestrate vesicle formation and fusion. Here, we use unsupervised, large-scale phenotypic analysis and a novel computational approach for the global identification of endosomal transport factors. This technique effectively identifies components of known and novel protein assemblies. We report the characterization of a previously undescribed endosome sorting complex that contains two well-conserved proteins with four predicted membrane-spanning domains. Vps55p and Vps68p form a complex that acts with or downstream of ESCRT function to regulate endosomal trafficking. Loss of Vps68p disrupts recycling to the TGN as well as onward trafficking to the vacuole without preventing the formation of lumenal vesicles within the MVB. Our results suggest the Vps55/68 complex mediates a novel, conserved step in the endosomal maturation process.