Prevalence and clinical profile of fungal rhinosinusitis.

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Prevalence and clinical profile of fungal rhinosinusitis.

Allergy Rhinol (Providence). 2016 Jun 21;

Authors: Suresh S, Arumugam D, Zacharias G, Palaninathan S, Vishwanathan R, Venkatraman V

Abstract
BACKGROUND: There are only a few landmark studies from the Indian subcontinent on fungal rhinosinusitis. The lack of awareness among clinicians regarding the varying clinical presentations of fungal rhinosinusitis prompted us to undertake this study.
OBJECTIVE: To determine the prevalence, etiologic basis, clinical features, radiologic features, and microscopic features of fungal rhinosinusitis, and to evaluate the various treatment modalities available.
METHODS: This was a prospective study in which evaluation of 100 patients with chronic rhinosinusitis was done. Specimens collected were subjected to both microbiology and pathologic examination; data collected, including clinical and radiologic features, were analyzed by the Pearson X squared test and Fisher's exact test.
RESULTS: The prevalence of fungal rhinosinusitis in our study was 30% (n = 30). Mucor was the most commonly isolated species (n = 15 [50%]) of fungus. Pathologic examination had a higher sensitivity (76.67%) compared with microbiology tests (50%) in the diagnosis of fungal rhinosinusitis. Fungus ball (n=14 [46.6%]) was the most prevalent entity in the spectrum of fungal rhinosinusitis. Forty percent of cases (n = 12) were of invasive fungal rhinosinusitis. The prevalence of fungal rhinosinusitis was higher among individuals who were immunocompetent (n = 17 [56.6%]). Of patients who were immunocompromised, 84.6% (n = 11) had mucormycosis.
CONCLUSIONS: Unilateral involvement of paranasal sinuses was more in favor of fungal etiology. Complications were more common in fungal rhinosinusitis caused by Mucor species. Mucormycosis, a rare clinical entity, in subjects who were immunocompetent, had a high prevalence in our study.

PMID: 27349695 [PubMed - as supplied by publisher]

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Brief communication: A 61-year-old woman with vesicular eruption after varicella zoster vaccination.

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Brief communication: A 61-year-old woman with vesicular eruption after varicella zoster vaccination.

Allergy Rhinol (Providence). 2016 Jun 21;

Authors: Ganacias K, Spriet S, Banks TA

Abstract
BACKGROUND: Vesicular rashes are associated with a variety of infectious and noninfectious causes.
OBJECTIVE: To discuss the differential diagnoses of vesicular rashes.
METHODS: We present the clinical case of an adult woman who was immunocompetent and who developed several clear fluid-filled vesicles on her upper extremity within days of receiving the varicella zoster vaccine. Over the next several days, the skin eruption generalized, and she developed new lesions in various stages of healing.
RESULTS: After a detailed history and further studies were obtained, a final diagnosis was made.
CONCLUSION: In patients who have recently been vaccinated, a high index of suspicion for an adverse vaccine reaction should be maintained.

PMID: 27349562 [PubMed - as supplied by publisher]

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Prevalence and clinical profile of fungal rhinosinusitis.

Related Articles

Prevalence and clinical profile of fungal rhinosinusitis.

Allergy Rhinol (Providence). 2016 Jun 21;

Authors: Suresh S, Arumugam D, Zacharias G, Palaninathan S, Vishwanathan R, Venkatraman V

Abstract
BACKGROUND: There are only a few landmark studies from the Indian subcontinent on fungal rhinosinusitis. The lack of awareness among clinicians regarding the varying clinical presentations of fungal rhinosinusitis prompted us to undertake this study.
OBJECTIVE: To determine the prevalence, etiologic basis, clinical features, radiologic features, and microscopic features of fungal rhinosinusitis, and to evaluate the various treatment modalities available.
METHODS: This was a prospective study in which evaluation of 100 patients with chronic rhinosinusitis was done. Specimens collected were subjected to both microbiology and pathologic examination; data collected, including clinical and radiologic features, were analyzed by the Pearson X squared test and Fisher's exact test.
RESULTS: The prevalence of fungal rhinosinusitis in our study was 30% (n = 30). Mucor was the most commonly isolated species (n = 15 [50%]) of fungus. Pathologic examination had a higher sensitivity (76.67%) compared with microbiology tests (50%) in the diagnosis of fungal rhinosinusitis. Fungus ball (n=14 [46.6%]) was the most prevalent entity in the spectrum of fungal rhinosinusitis. Forty percent of cases (n = 12) were of invasive fungal rhinosinusitis. The prevalence of fungal rhinosinusitis was higher among individuals who were immunocompetent (n = 17 [56.6%]). Of patients who were immunocompromised, 84.6% (n = 11) had mucormycosis.
CONCLUSIONS: Unilateral involvement of paranasal sinuses was more in favor of fungal etiology. Complications were more common in fungal rhinosinusitis caused by Mucor species. Mucormycosis, a rare clinical entity, in subjects who were immunocompetent, had a high prevalence in our study.

PMID: 27349695 [PubMed - as supplied by publisher]

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Brief communication: A 61-year-old woman with vesicular eruption after varicella zoster vaccination.

Related Articles

Brief communication: A 61-year-old woman with vesicular eruption after varicella zoster vaccination.

Allergy Rhinol (Providence). 2016 Jun 21;

Authors: Ganacias K, Spriet S, Banks TA

Abstract
BACKGROUND: Vesicular rashes are associated with a variety of infectious and noninfectious causes.
OBJECTIVE: To discuss the differential diagnoses of vesicular rashes.
METHODS: We present the clinical case of an adult woman who was immunocompetent and who developed several clear fluid-filled vesicles on her upper extremity within days of receiving the varicella zoster vaccine. Over the next several days, the skin eruption generalized, and she developed new lesions in various stages of healing.
RESULTS: After a detailed history and further studies were obtained, a final diagnosis was made.
CONCLUSION: In patients who have recently been vaccinated, a high index of suspicion for an adverse vaccine reaction should be maintained.

PMID: 27349562 [PubMed - as supplied by publisher]

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Odontogenic abscess complicated by descending necrotizing mediastinitis: evidence of medical and dental malpractice.

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Odontogenic abscess complicated by descending necrotizing mediastinitis: evidence of medical and dental malpractice.

Minerva Stomatol. 2016 Jun 28;

Authors: Ventura Spagnolo E, Mondello C, Cardia L, Ventura Spagnolo O, Bartoloni G

PMID: 27351109 [PubMed - as supplied by publisher]

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[The place of otorhinolaryngology in modern medicine].

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[The place of otorhinolaryngology in modern medicine].

Vestn Otorinolaringol. 2016;81(2):4-6

Authors: Pal'chun VT

Abstract
This publication is devoted to the peculiar features of the development of otorhinolaryngology as an integral component of modern medical science and practice and the place it now occupies among other disciplines. Much attention is given to the formation of the scientific views of focal infections with special reference to tonsillitis, the role of immune pathology an allergic reactions in etiology and pathogenesis of ENT diseases. Also considered is the problem of the elaboration of the new surgical methods and their application for the treatment of ENT pathology.

PMID: 27351043 [PubMed - in process]

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[The functional conditions of nasal cavity mucosa and paranasal sinuses following radical and minimally invasive surgical interventions].

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[The functional conditions of nasal cavity mucosa and paranasal sinuses following radical and minimally invasive surgical interventions].

Vestn Otorinolaringol. 2016;81(2):88-92

Authors: Magomedov MM, Zeinalova DF, Magomedova NM, Starostina AE

Abstract
The data of the literature are presented concerning the state of the mucous membrane of the nasal cavity, nasal turbinates, and maxillary sinus during the postoperative period following various surgical procedures.

PMID: 27351042 [PubMed - in process]

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[Intrauterine infections as a risk factor of the development of sensorineural impairment of hearing ].

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[Intrauterine infections as a risk factor of the development of sensorineural impairment of hearing ].

Vestn Otorinolaringol. 2016;81(2):82-7

Authors: Boboshko MY, Vikhnin SM, Savenko IV

Abstract
Intrauterine infections are a crucial pathogenic factor exerting an appreciable influence on the development of the fetus. They can provoke intrauterine death, cause multiple lesions in the organs and tissues as well as long-term complications that manifest themselves at the later stages of the growth and development of the child. One of such complications is the sensorineural loss of hearing. The importance of hearing impairment arises from the high prevalence of tis condition and frequent incapacitation it causes in the patients. The present publication is focused on various mechanisms underlying the development of hearing impairment depending on the primary infection. Special attention is given to the methods of diagnostics and treatment of intrauterine infections.

PMID: 27351041 [PubMed - in process]

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Pre-Treatment Objective Diagnosis and Post-Treatment Outcome Evaluation in Patients with Vascular Pulsatile Tinnitus Using Transcanal Recording and Spectro-Temporal Analysis.

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Pre-Treatment Objective Diagnosis and Post-Treatment Outcome Evaluation in Patients with Vascular Pulsatile Tinnitus Using Transcanal Recording and Spectro-Temporal Analysis.

PLoS One. 2016;11(6):e0157722

Authors: Kim SH, An GS, Choi I, Koo JW, Lee K, Song JJ

Abstract
OBJECTIVE: Although vascular pulsatile tinnitus (VPT) has been classified as "objective", VPT is not easily recognizable or documentable in most cases. In response to this, we have developed transcanal sound recording (TSR) and spectro-temporal analysis (STA) for the objective diagnosis of VPT. By refining our initial method, we were able to apply TSR/STA to post-treatment outcome evaluation, as well as pre-treatment objective diagnosis.
METHODS: TSR was performed on seven VPT patients and five normal controls before and after surgical or interventional treatment. VPT was recorded using an inserted microphone with the subjects placed in both upright and supine positions with 1) a neutral head position, 2) head rotated to the tinnitus side, 3) head rotated to the non-tinnitus side, and 4) a neutral position with ipsi-lesional manual cervical compression. The recorded signals were analyzed in both time and time-frequency domains by performing a short-time Fourier transformation.
RESULTS: The pre-treatment ear canal signals of all VPT patients demonstrated pulse-synchronous periodic structures and acoustic characteristics that were representative of their presumptive vascular pathologies, whereas those the controls exhibited smaller peaks and weak periodicities. Compared with the pre-treatment signals, the post-treatment signals exhibited significantly reduced peak- and root mean square amplitudes upon time domain analysis. Additionally, further sub-band analysis confirmed that the pulse-synchronous signal of all subjects was not identifiable after treatment and, in particular, that the signal decrement was statistically significant at low frequencies. Moreover, the post-treatment signals of the VPT subjects revealed no significant differences when compared to those of the control group.
CONCLUSION: We reconfirmed that the TSR/STA method is an effective modality to objectify VPT. In addition, the potential role of the TSR/STA method in the objective evaluation of treatment outcomes in patients with VPT was proven. Further studies incorporating a larger sample size and more refined recording techniques are warranted.

PMID: 27351198 [PubMed - as supplied by publisher]

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A Systematic Review of Unmet Information and Psychosocial Support Needs of Adults Diagnosed with Thyroid Cancer.

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A Systematic Review of Unmet Information and Psychosocial Support Needs of Adults Diagnosed with Thyroid Cancer.

Thyroid. 2016 Jun 27;

Authors: Hyun YG, Alhashemi A, Fazelzad R, Goldberg AS, Goldstein DP, Sawka AM

Abstract
BACKGROUND: Patient education and psychosocial support to patients are important elements of comprehensive cancer care but the needs of thyroid cancer survivors are not well understood.
METHODS: We systematically reviewed the published English-language, quantitative literature on: a) unmet medical information and, b) psychosocial support needs of thyroid cancer survivors. A librarian information specialist searched 7 electronic databases and a hand search was conducted. Two reviewers independently screened citations from the electronic search and reviewed relevant full-text papers. There was consensus between reviewers on the included papers and duplicate independent abstraction was performed. The results were summarized descriptively.
RESULTS: We screened 1984 unique electronic citations and reviewed 51 full-text papers (3 from the hand search). We included 7 cross-sectional, single-arm, survey studies, including data from 6215 thyroid cancer survivor respondents. The respective study sizes ranged from 57 to 2398 subjects. All of the studies had some methodologic limitations. Unmet information needs were variable relating to the disease, diagnostic tests, treatments, and co-ordination of medical care. There were relatively high unmet information needs related to aftercare (especially long-term effects of the disease or its treatment and its management) and psychosocial concerns (including practical and financial matters). Psychosocial support needs were incompletely met. Patient information on complementary and alternative medicine was very limited.
CONCLUSIONS: In conclusion, thyroid cancer survivors perceive many unmet information needs and these needs extend to aftercare. Psychosocial information and supportive care needs may be insufficiently met in this population. More work is needed to improve knowledge translation and psychosocial support for thyroid cancer survivors.

PMID: 27350421 [PubMed - as supplied by publisher]

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Single-photon emission computed tomography for preclinical assessment of thyroid radioiodide uptake following various combinations of preparative measures.

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Single-photon emission computed tomography for preclinical assessment of thyroid radioiodide uptake following various combinations of preparative measures.

Thyroid. 2016 Jun 27;

Authors: Zwarthoed C, Chatti K, Guglielmi J, Hichri M, Compin C, Darcourt J, Vassaux G, Benisvy D, Pourcher T, Cambien B

Abstract
BACKGROUND: MicroSPECT/CT imaging was used to quantitatively evaluate how iodide uptake in the mouse thyroid is influenced by i) route of iodine administration; ii) injection of recombinant human TSH (rhTSH); and iii) low iodide diet in euthyroid and T3-treated mice.
METHODS: 99mTcO4- and 123I thyroid uptake in euthyroid and T3-treated animals fed either a normal-iodine diet (NID) or a low-iodide diet (LID), treated or not with rhTSH, and radiotracer administered intravenously, subcutaneously, intraperitoneally or by gavage, were assessed using microSPECT/CT imaging. Western blotting was performed to measure Na/I symporter (NIS) expression levels in the thyroid.
RESULTS: Systemic administration of radioiodide resulted in a higher (2.35-fold in NID mice) accumulation of iodide in the thyroid than oral administration. Mice fed LID with systemic radioiodide administration showed a further two-fold increase in thyroid iodide uptake to yield a ~5-fold increase in uptake compared to the standard NID/oral route. Although rhTSH injections stimulated thyroid activity in both euthyroid and T3-treated mice fed the NID, uptake levels for T3-treated mice remained low compared with those for the euthyroid mice. Combining LID and rhTSH in T3-treated mice resulted in a 2.8-fold higher uptake compared with NID/T3/rhTSH mice and helped restore thyroid activity to levels equivalent to those of euthyroid animals.
CONCLUSIONS: Systemic radioiodide administration results in higher thyroidal iodide levels than oral administration, particularly in LID-fed mice. These data highlight the importance of LID, both in euthyroid and T3-treated, rhTSH-injected mice. Extrapolated to human patients, and in the context of clinical guidelines for the preparation of differentiated thyroid cancer patients, our data indicate that LID can potentiate the efficacy of rhTSH treatment in T3-treated patients.

PMID: 27349131 [PubMed - as supplied by publisher]

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Spontaneous Intracranial Hypotension Associated with Kinetic Tremor and Ataxia.

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Spontaneous Intracranial Hypotension Associated with Kinetic Tremor and Ataxia.

Tremor Other Hyperkinet Mov (N Y). 2016;6:366

Authors: Salazar R

Abstract
BACKGROUND: Spontaneous intracranial hypotension (SIH) is a clinically variable syndrome caused by low cerebrospinal fluid (CSF) pressure due to a non-traumatic CSF leak.
PHENOMENOLOGY SHOWN: This case describes a 68-year-old gentleman who presents with chronic and slightly progressive kinetic tremor of bilateral hands associated with gait ataxia and gait start hesitation.
EDUCATIONAL VALUE: This case underscores the importance of having a high index of suspicion for the diagnosis of SIH when encountering a patient presenting with late-onset progressive kinetic tremor and gait ataxia syndrome.

PMID: 27351232 [PubMed - as supplied by publisher]

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Recurrent Streptococcus Pneumoniae 23 F meningitis due to cerebrospinal fluid leakage from the ear cannel: a case report.

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Recurrent Streptococcus Pneumoniae 23 F meningitis due to cerebrospinal fluid leakage from the ear cannel: a case report.

BMC Pediatr. 2015;15:195

Authors: Li YC, Chen CY, Wu KH, Kuo HT, Wu HP

Abstract
BACKGROUND: Bacterial meningitis is a medical emergency, and immediate diagnostic steps must be taken to establish the specific cause. Recurrence of bacterial meningitis in children is not only potentially life-threatening, but also involves or induces psychological trauma to the patients through repeated hospitalization with many invasive investigations.
CASE PRESENTATION: A 6-year-old boy was diagnosed with recurrent bacterial meningitis caused by Streptococcus Pneumonia 23 F. He had received serial imaging studies for identifying the cause. The initial sinus computed tomography (CT) also showed sinusitis without bony defect of sinus. However, after performing nuclear scan, the results showed cerebrospinal fluid (CSF) leaked originating from the right petrooccpital region into the middle ear. Subsequent high resolution CT (HRCT) reports showed focal enlargement of the right facial nerve canal, erosion of the bony canal at geniculate ganglion and tympanic segment with tiny high-density spots. The reconstruction HRCT showed multiple bony defects at temporal bone. The magnetic resonance imaging revealed multifocal bony destruction with CSF collection in the right petrous ridge, carotid canal and jugular foramen. Eventually, CSF leakage to the right middle ear was confirmed and this could be the cause of the recurrent bacteria meningitis in this patient.
CONCLUSION: Although recurrent bacterial meningitis in childhood is not common, this case report illustrates that recurrence of meningitis within a short period should be considered as cause of underline immunologic or anatomic defect.

PMID: 26603622 [PubMed - indexed for MEDLINE]

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Electrophysiological detection of scalar changing perimodiolar cochlear electrode arrays: a long term follow-up study.

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Electrophysiological detection of scalar changing perimodiolar cochlear electrode arrays: a long term follow-up study.

Eur Arch Otorhinolaryngol. 2016 Jun 28;

Authors: Mittmann P, Todt I, Ernst A, Rademacher G, Mutze S, Göricke S, Schlamann M, Ramalingam R, Lang S, Christov F, Arweiler-Harbeck D

Abstract
The position of the cochlear electrode array within the scala tympani is essential for an optimal hearing benefit. An intraoperative NRT-ratio was established, which can provide information about the intraoperative intracochlear electrode array position for perimodiolar electrodes. The aims of this study were to verify the longterm reliability for the NRT-ratio in perimodiolar electrodes. In a retrospective controlled study in a Tertiary Referral Center the electrophysiological data sets of 123 patients with implanted Nucleus Contour Advance electrodes were enclosed. Intraoperative and up to 1 year follow-up Auto-NRTs were evaluated. A NRT-ratio was calculated by dividing the average Auto-NRT data from electrode 16 to 18 with the average from electrode 5 to 7. Using a flat panel tomography system, the position of the electrode array was certified radiological. 31 patients with perimodiolar electrodes with 1 year follow-up data were included in the study. Eleven patients showed regular follow-up NRT-ratio with a correlated and radiologically confirmed electrode position. 20 patients showed mismatches between the NRT-ratio and the radiological position. These patients were highly variable in terms of duration of deafness and neural spectrum disorders. The NRT-ratio can be used to determine the intracochlear position of the electrode array for perimodiolar electrodes. Intraoperatively the NRT-ratio predicts the array position within the cochlea highly reliable for perimodiolar electrodes. We showed that after 6 months and a year, the NRT-ratio remains unchanged in most of the cases and shows a good correlation to the radiological determined position of the array. Nevertheless, the condition of the neural structures is highly important for reproducible responses. Limited validity is given in patients with degenerative and structural neural disorders.

PMID: 27351885 [PubMed - as supplied by publisher]

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Routine preoperative colour Doppler duplex ultrasound scanning in anterior lateral thigh flaps.

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Routine preoperative colour Doppler duplex ultrasound scanning in anterior lateral thigh flaps.

Br J Oral Maxillofac Surg. 2016 Jun 24;

Authors: Lichte J, Teichmann J, Loberg C, Kloss-Brandstätter A, Bartella A, Steiner T, Modabber A, Hölzle F, Lethaus B

Abstract
The anterior lateral thigh flap (ALT) is often used to reconstruct the head and neck and depends on one or more skin perforators, which often present with variable anatomy. The aim of this study was to localise and evaluate the precise position of these perforators preoperatively with colour Doppler duplex ultrasound scanning (US). We detected 74 perforators in 30 patients. The mean duration of examination with colour Doppler was 29 (range 13-51) minutes. Adequate perforators and their anatomical course could be detected preoperatively extremely accurately (p<0.001). The mean difference between the preoperatively marked, and the real, positions was 6.3 (range 0-16) mm. There was a highly significant correlation between the accuracy of the prediction and the body mass index of the patient (0.75; p<0.001). Neither the age nor the sex of the patient correlated with the accuracy of the prediction. Colour Doppler duplex US used preoperatively to localise perforators in ALT flaps is reliable and could be adopted as standard procedure.

PMID: 27349963 [PubMed - as supplied by publisher]

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Stop, Drop and Talk – The Importance of Talking to Your Child; Contributions by Dr. Sonja Pruitt-Lord

“In a world where emoji’s are beginning to replace words and expressions — conveying a message to someone has taken on a new meaning. Public settings have become a little less chatty and it’s not uncommon to find rows of people in the bent-neck, plugged-in posture. Very little human-to-human communication, no eye-contact, minimal speech.”

• See the full article on Huffington Post!

 

 

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Odontogenic abscess complicated by descending necrotizing mediastinitis: evidence of medical and dental malpractice.

Related Articles

Odontogenic abscess complicated by descending necrotizing mediastinitis: evidence of medical and dental malpractice.

Minerva Stomatol. 2016 Jun 28;

Authors: Ventura Spagnolo E, Mondello C, Cardia L, Ventura Spagnolo O, Bartoloni G

PMID: 27351109 [PubMed - as supplied by publisher]

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The American Thyroid Association Guidelines on Voice Assessment-Have We Done Enough?

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The American Thyroid Association Guidelines on Voice Assessment-Have We Done Enough?

JAMA Otolaryngol Head Neck Surg. 2016 Feb;142(2):115-6

Authors: Shonka DC, Terris DJ

PMID: 26767318 [PubMed - indexed for MEDLINE]

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