Objectives
To determine the proportion of otolaryngologists with work‐related musculoskeletal discomfort (WRMD) and to review objective ergonomic data that contribute to WRMD.
Study Design
Systematic review and meta‐analysis.
Methods
A comprehensive search of the literature identified 1121 articles for initial review of which 19 (3563 participants) met criteria for qualitative discussion and eight (2192 participants) met criteria for meta‐analysis. Random effects meta‐analyses were used to estimate the proportion of otolaryngologists reporting WRMD.
Results
The overall proportion (95% confidence intervals [CI]) of general otolaryngologists reporting WRMD was 0.79 (0.66, 0.88) for any symptoms; 0.54 (0.40, 0.67) for neck symptoms; 0.33 (0.20, 0.49) for shoulder symptoms; and 0.49 (0.40, 0.59) for back symptoms. Surgeons performing primarily subspecialty cases had a lower estimated overall prevalence of WRMD versus those performing general ENT cases, however the odds ratio (OR) was not statistically significant (OR [95% confidence interval] 0.53 [0.22, 1.25]). 23%–84% of otolaryngologists underwent medical treatment for WRMD. 5%–23% took time off work and 1%–6% stopped operating completely as a result of WRMD. 23%–62.5% of otolaryngologists believed WRMD negatively impacted their quality of life. Objective measures of ergonomic posture indicate moderate to severe risk of injury during the routine clinic and surgical procedures with none found to be low risk.
Conclusions
Ergonomic stressors among otolaryngologists contribute to a high rate of WRMD across all subspecialties with notable impact on productivity, longevity, and quality of life. Laryngoscope, 133:467–475, 2023
Ionic liquids have the potential for being ideal alternatives for organic solvents in chemical warfare agent reactions and demilitarization processes. They are considered to be an excellent substitute, because of their extraordinarily wide liquid range, low melting points, chemical and thermal stability, high conductivity, and nonvolatility. In addition, many have excellent hydrophobic properties and immiscibility with water and offer the opportunity to isolate the chemical agents and reaction products from the environment. In this report, we describe a two-step process in which chemical warfare simulants are reacted with hydrogen peroxide (H 2 O 2 ) followed by basic methanol in a common ion binary ionic liquid that consists of 1,2-dimethyl-3propylimidazolium bis(trifluoromethylsulfonyl)amide and copper(II) bis(trifluoromethylsulfonyl)amide. The chemical agent simulants used in this study are diisopropylfluorophosphate, bis(2-ethylhexyl) phosphite, and 2-chloroethylphenyl sulfide, which simulate agents GB, VX, and HD, respectively. Initially, H 2 O 2 is added to the mixture of simulants and ionic liquid to remove 2-chloroethylphenyl sulfide, followed by the addition of methanolic tetramethylammonium hydroxide hydrate (TMAOH • 5H 2 O) (basic methanol) to eliminate diisopropylfluorophosphate and bis(2-ethylhexyl) phosphite. The reactions were monitored by liquid chromatography/mass spectroscopy time-of-flight (LC/MS-TOF), coupled with ultraviolet (UV) diode array detection. Gas chromatography/mass spectroscopy (GC/MS) was used to aid in product identification.
Herein, we present a unique case of Sjögren’s syndrome (SS) first presenting as facial palsy, as well as a literature review of case reports describing SS-associated facial paralysis. A PubMed search for papers containing the keywords Sjögren’s syndrome or Sjögren’s disease, as well as facial paralysis, facial paresis, facial palsy, or Bell’s palsy, was performed. Articles not in English and cases of SS not involving facial paralysis were excluded. Appropriate articles were reviewed for patient demographics and symptoms of SS, including laterality of facial paralysis, cranial nerve involvement, and comorbid diseases. House–Brackmann grades were annotated based on either assignment by individual case reports or the authors’ descriptions when sufficient details were present. Of 43 peer-reviewed articles found, 14 were both in the English language and provided adequate information on a total of 16 patients with facial paralysis and SS diagnosis. Ultimately, SS and other systemic autoimmune disorders should be considered in the differential diagnosis of patients presenting with insidious onset facial paralysis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.