Key Points
Question
Are promotion and tenure processes associated with gender disparities in career advancement in academic medicine?
Findings
In this qualitative study of 52 women at 16 medical schools across the US, participants experienced promotion and tenure processes to be poorly defined and inconsistently executed. They described a lack of recognition of or reward for their measurable accomplishments and observed their less-accomplished men colleagues advancing more quickly than they did.
Meaning
These findings suggest that current mechanisms for promotion and tenure may create opportunities for unequal treatment and evaluation of candidates and may contribute to well-documented patterns of gender disparities in career advancement.
Objective: The objective is to evaluate the long-term impact of sialendoscopic-assisted salivary duct surgery (SASDS) on sialadenitis symptoms using the Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire.Methods: The COSS questionnaire, which scores symptoms on a 0-100 scale, was administered prospectively to adult patients pre-operatively, 1-year, and 6-years post-operatively. We examined COSS scores and categories representing complete (<10), partial (10-25), and no (>25) resolution of symptoms with attention to factors significantly associated with incomplete resolution (≥10).Results: Approximately 6-years after SASDS, 111 patients reported scores for 128 symptomatic glands (72 with sialolithiasis, 56 without sialolithiasis). For glands with sialolithiasis, the median COSS score pre-SASDS was 27.5 (interquartile range [IQR]: 13.5-43), which was significantly reduced to 1.0 (IQR: 0-5.5) at 1-year and 1.5 (IQR 0-5) at 6-years postoperatively. Glands without sialolithiasis had a median COSS score of 40.5 (IQR: 23-52.5) preoperatively, that significantly reduced to 13.5 (IQR 5-21) at 1-year and 14 (IQR 6.5-25.5) at 6-years post-operatively. There was no significant difference in scores from 1-to 6-years. Intraoperative presence of sialolith, absence of stenosis, stenosis in the distal duct, and submandibular gland involvement were significant predictors of complete resolution of symptoms at 6-years.Conclusion: Approximately 6-years after SASDS for sialadenitis, the majority of patients have durable symptom improvement. The sialolithiasis group had higher rates of complete resolution compared to the non-sialolithiasis group. Presence of ductal stenosis on sialendoscopy, non-distal stenoses, and parotid gland involvement were risk factors for persistent long-term sialadenitis symptoms.
Over the past 15 years, transoral robotic surgery (TORS) has emerged as a powerful, less invasive tool to treat oropharyngeal cancers. The goal of surgical treatment is de-escalation therapy to decrease treatment morbidity and improve quality of life outcomes while maintaining overall and disease-free survival. 1 This may involve treatment with definitive surgery and adjuvant radiation with avoidance of adjuvant chemotherapy, or even decreasing radiation dose. 2 While typical complications after TORS are wellreported in the literature, we describe a rare case of spondylodiscitis and spinal abscess treated with computed tomography (CT)-guided needle aspiration and antibiotics. This case report met criteria for University of California San Francisco Institutional Review Board exemption.
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.