Background Nasopharyngeal swab testing, which has greatly increased in utilization due to the COVID-19 pandemic, is generally safe and well-tolerated, although it may be rarely associated with adverse events. Methods Publicly reported adverse events associated with nasopharyngeal COVID-19 testing within the Manufacturer and User Facility Device Experience (MAUDE) database and the published literature were queried. Results A total of 129 adverse events were reported, including 66 from the MAUDE database and 63 from literature review. The most common complications were swab fracture resulting in retained foreign body (47%), followed by epistaxis (17%), and headache (11%). Seven (12%) of the reported retained foreign body cases required removal under general anesthesia, while 1 (5%) of the epistaxis cases required surgical intervention. The most serious adverse event was meningitis following cerebrospinal fluid leak. Conclusions Patients and healthcare providers should be aware of the potential risks associated with testing, with attention to ensuring proper technique, and be prepared to recognize and manage adverse events.

Background Households are increasingly stockpiling and producing hand sanitizer amid the coronavirus disease 2019 (COVID-19) pandemic, which can pose an increased risk for unintentional toxicity among children. Despite guidelines for hand sanitizer production published by the World Health Organization, many turn to streaming media for instruction. Objective The purpose of this investigation was to evaluate hand sanitizer formulations and safety precautions discussed in popular do-it-yourself (DIY) YouTube videos, and to assess the frequency of calls to poison control centers for pediatric hand sanitizer exposure before and after the arrival of COVID-19 in the United States. Methods The first 100 videos on YouTube with the most views using the search term “DIY hand sanitizer” were evaluated for accuracy compared with the World Health Organization local hand sanitizer production guidelines. The incidence of pediatric hand sanitizer exposure reported to participating U.S. poison control centers from January 2018 through May 2020 was reviewed from the American Association of Poison Control Centers National Poison Data System. The average number of calls between January 2020 and May 2020 was compared, and the average number of calls in March 2020 was compared with March 2019 and March 2018. Results Of the YouTube videos that met inclusion criteria, 27% discussed the use of at least 96% ethanol or 99.8% isopropyl alcohol, 4.1% incorporated 3% hydrogen peroxide, 82% used glycerol or an alternative humectant, and 4.1% specified the need for distilled or previously boiled water. Most of the videos failed to describe labeling storage containers, 69% of videos encouraged the use of oils or perfumes to enhance hand sanitizer scent, and 2% of videos promoted the use of coloring agents to be more attractive for use among children specifically. There was a significantly increased average number of daily calls to poison control centers regarding unsafe pediatric hand sanitizer exposure since the first confirmed COVID-19 patient in the United States. There was a significantly increased average number of daily calls in March 2020 compared with the previous 2 years. Conclusions YouTube may not be an accurate source for effective hand sanitizer concoction. Health care providers and parents should be aware of the increased surge in hand sanitizer exposure among children and should take proper precautionary measures.

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Objectives: Minimally invasive fat sculpting techniques are becoming more widespread with the development of office-based devices and therapies. Electrochemical lipolysis (ECLL) is a needle-based technology that uses direct current (DC) to electrolyze tissue water creating acid and base in situ. In turn, fat is saponified and adipocyte cell membrane lysis occurs. The electrolysis of water can be accomplished using a simple open-loop circuit (V-ECLL) or by incorporating a feedback control circuit using a potentiostat (P-ECLL). A potentiostat utilizes an operational amplifier with negative feedback to allow users to precisely control voltage at specific electrodes. To date, the variation between the two approaches has not been studied. The aim of this study was to assess current and charge transfer variation and lipolytic effect created by the two approaches in an in vivo porcine model. Methods: Charge transfer measurements from ex vivo V-ECLL and P-ECLL treated porcine skin and fat were recorded at −1 V P-ECLL, −2 V P-ECLL, −3 V P-ECLL, and −5 V V-ECLL each for 5 min to guide dosimetry parameters for in vivo studies. In follow-up in vivo studies, a sedated female Yorkshire pig was treated with both V-ECLL and P-ECLL across the dorsal surface over a range of dosimetry parameters, including −1.5 V P-ECLL, −2.5 V P-ECLL, −3.5 V P-ECLL, and 5 V V-ECLL each treated for 5 min. Serial biopsies were performed at baseline before treatment, 1, 2, 7, 14, and 28 days after treatment. Tissue was examined using fluorescence microscopy and histology to compare the effects of the two ECLL approaches. Results: Both V-ECLL and P-ECLL treatments induced in-vivo fat necrosis evident by adipocyte membrane lysis, adipocyte denuclearization, and an acute inflammatory response across a 28-day longitudinal study. However, −1.5 V P-ECLL produced a smaller spatial necrotic effect compared to 5 V V-ECLL. In addition, 5 V V-ECLL produced a comparable necrotic effect to that of −2.5 V and −3.5 V P-ECLL. Conclusions: V-ECLL and P-ECLL at the aforementioned dosimetry parameters both achieved fat necrosis by adipocyte membrane lysis and denuclearization. The −2.5 V and −3.5 V P-ECLL treatments created spatially similar fat necrotic effects when compared to the 5 V V-ECLL treatment. Quantitatively, total charge transfer between dosimetry parameters suggests that −2.5 V P-ECLL and 5 V V-ECLL produce comparable electrochemical reactions. Such findings suggest

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Purpose: To describe the feasibility of an attachment-free iOS-based cobalt blue light application to accurately detect corneal injury. Methods: Corneal epithelium from New Zealand White rabbits was removed by gentle scraping with a dulled scalpel or by using a classic biopsy punch (2 mm in diameter). Each cornea was then examined using a smartphone-enabled blue light after applying a fluorescein sodium ophthalmic strip. Photographs of each cornea before and after using the smartphone-based light were captured with a second smartphone device. Results: The iOS-based (Apple Inc., Cuptertino, CA) cobalt blue light effectively illuminated fluorescein dye in all ex vivo samples. Both circular punch biopsy and linear scalpel-induced corneal injuries were readily identified. Conclusions: The iOS-based cobalt blue light is a portable, low-cost, and effective alternative to commercially available cobalt blue lights.

Objectives/Hypothesis Intraoperative recording devices are being increasingly used to provide video for contemporary surgical training. The objective of this study was to evaluate the use of a smartphone as a low‐cost alternative to obtain high‐resolution video from the surgeon's perspective. Study Design A study evaluating the feasibility of using a head‐mounted smartphone with a telephoto lens for point‐of‐view surgical videography. Methods Video recordings of a rhinoplasty procedure were taken using a head‐mounted smartphone and two handheld cameras, a Canon Powershot SD1400 IS and a Sony HandyCam HDR‐CX160. Video clips were shown to 16 blinded otolaryngology residents (n = 10) and attending physicians (n = 6) for individual video evaluation using a Likert scale (1 being poor quality, 5 being excellent quality). In addition, the study participants were asked to select which video clip they preferred when presented to them side by side. Results The iPhone 7 was given the highest overall mean video quality rating of 3.9 ± 0.57 and was preferred over the two handheld cameras by nearly all surveyed surgeons. The Canon Powershot SD1400 IS was given a mean rating of 3.3 ± 1.0 and preferred over the SonyHandyCam HDR‐CX160 by all surgeons. The Sony HandyCam HDR‐CX160 was given a mean rating of 1.5 ± 0.13. Conclusions A head‐mounted smartphone equipped with a telephoto lens provides a novel method to intraoperative surgical recording. The design is simple, low cost, and allows the surgeon to capture fine anatomical detail from the desirable point‐of‐view perspective. Level of Evidence NA Laryngoscope, 129:578–581, 2019