Physicians-in-training in the United States work long hours for relatively low wages. In response to increased economic burden, the popularity of unionization in residency training programs has increased dramatically. In this study, we conducted a cross-sectional investigation of the association between unionization status and Internal Medicine PGY-1 compensation and benefits.
<p>Supplementary Table S6 shows saliva, serum, and their combined (saliva/serum) miRNA levels in early-stage and late-stage OSCC, and their relative expression compared to healthy controls (HC), in total patients, non-smokers and smokers.</p>
<p>Supplementary Table S5 shows saliva, serum, and their combined miRNA levels from OSCC patients and healthy individuals (HC), and their fold-changes (OSCC/HC), in total patients, smokers, and non-smokers.</p>
PURPOSE: Current evidence has not linked breast implants to autoimmune or other systemic diseases; however, women continue to pursue explantation due to a heterogenous constellation of symptoms referred to as "breast implant illness" (BII). Although BII has no clear medical definition, pathophysiological explanation or diagnostic testing, a subset of patients report symptomatic improvement after explantation. Although several studies have attempted to clarify and better define this phenomenon, none have considered patient satisfaction and quality of life following implant removal. This study aims to assess patient reported satisfaction with the removal of implants through the use of the BREAST-Q. METHODS: Patients who underwent breast implant removal due to concerns for BII were asked to complete the augmentation BREAST-Q. Additionally, a survey was administered that queried 35 different BII-related symptoms and their response to implant removal. Questions specifically referencing the implants were removed because they were not applicable to this cohort. Consistent with scoring guidelines, missing data were replaced with the mean of remaining scores as long as 50% of questions were still completed. Outcomes in this cohort were compared with normative data for all modules this information was available for. Furthermore, satisfaction for patients who underwent explantation alone was compared with those who pursued explantation with cosmetic reconstruction. RESULTS: Of the 29 patients who underwent implant removal for BII, 16 patients (55.2%) completed the BREAST-Q and symptom survey. Mean age was 49.1 ± 10.8, and mean BMI was 25.1 ± 8. Interestingly, all patients were Whites. En bloc capsulectomy was requested by patients and performed in 100% of cases. The average time between augmentation and implant removal was 11.3 ± 6.2 months. Only 11 patients (68.8%) underwent implant removal and the other five underwent a cosmetic procedure (either autologous reconstruction or mastopexy) in addition to implant removal. Subjects report on average a total of 13.1 symptoms with brain fog, fatigue, chest discomfort, and anxiety being the most common. On average, symptoms of 14.9% of patients did not improve, those of 48.1% partially improved, and those of 37.0% were completely resolved. Compared with normative data, BII patients with implant removal alone had scores comparable to those of normative BREAST-Q data in the psychosocial well-being (P = 0.928), sexual well-being (P = 0.819), and satisfaction with breast modules (P = 0.529). They had lower scores for physical well-being (17 versus 86, P < 0.001). Upon subgroup analysis, implant removal with cosmetic procedures had a higher score in the satisfaction with breast module when compared with implant removal alone (76 versus 48, P = 0.022), though no other differences were seen. CONCLUSIONS: Concurrent with previous literature, patients with BII report some degree of symptomatic improvement after removal of implants. Patient-reported outcomes are similar to normative data in recently augmented patients. However, despite reported improvement of symptoms, physical well-being remains lower for patients with breast implant illness even after implant removal. Implant removal may be combined with cosmetic procedures to improve satisfaction with breasts. These results may aid in preoperative patient counseling.
The aim of this study was to assess recent trends in financial compensation in the field of academic otolaryngology, and distribution based on rank, sex, race/ethnicity, and geographical regions in academic medical centers.
Objectives Off‐label use of Ciprodex® (ciprofloxacin‐dexamethasone: CPD), an antibiotic‐steroid combination solution, in the airway has been reported by pediatric otolaryngologists with anecdotal success. We examined national trends regarding off‐label CPD use including prevalence, common indications, prescriber patterns, adverse events, and accessibility. Methods 15‐item cross‐sectional survey was distributed to American Society of Pediatric Otolaryngology members from January–April 2022. Univariate analyses were performed to compare responses for users of off‐label CPD versus non‐users. Ease of access was compared across geographies and practice types using multivariate logistic regressions. Results Of the 163 complete responses (26.6% response rate), 156 (95.7%) reported using off‐label CPD. Most common indications for off‐label CPD were tracheal granulation (87.8%, n = 137) and choanal atresia (82.1%, n = 128). Ease of access was significantly increased in the Midwest (OR:18.79, 95%CI:3.63–1.24, p = 0.001) and West (OR:29.92, 95%CI:3.55–682.00, p = 0.006). Ease of access was significantly lower at tertiary referral centers (OR:0.11, 95%CI:0.01–0.64, p = 0.041) and private practices (OR:0.04, 95%CI:0.002–0.33, p = 0.009) compared to academic free‐standing children's hospitals. Two‐thirds of respondents reported feeling “Very Comfortable” with the safety profile of off‐label CPD; 99.4% ( n = 156) felt that the benefits outweighed the risks of off‐label use. Seven respondents (4.5%) reported adverse events (e.g., local allergic reaction, cushingoid symptoms) from off‐label use. Conclusions Our findings (26.6% response rate) suggest that off‐label CPD is commonly used by pediatric otolaryngologists, many of whom reported feeling that the benefits of off‐label CPD outweigh the risks. Our results establish a baseline for future efforts to assess the efficacy and safety of off‐label CPD and to improve its accessibility. Level of Evidence V Laryngoscope , 134:2922–2930, 2024
<p>Supplementary Table S2 shows healthy individuals’ characteristics, social history for risk factors and histology of oral lesion that saliva and blood (serum) were collected.</p>
