ObjectivesThis study aimed to determine otolaryngology residents' quality of life and sleepiness.MethodsAn electronic survey was distributed to otolaryngology residents in the United States in October 2014 and May 2015. The survey included questions from the Physician Well‐Being Index (PWBI) and Epworth Sleepiness Scale (ESS). Data were analyzed using standard descriptive and frequency analyses, Spearman correlations, and Student's t‐test.ResultsThe 196 respondents (13% response rate) had a mean age of 29.9 years and worked an average of 70.88 hours/week. Higher PWBI score (lower quality of life) correlated with higher ESS (more sleepiness) for all respondents regardless of rotation (Spearman coefficient of .45; p = .001). PWBI scores were higher for head/neck oncology. Both PWBI and ESS scores were highest for postgraduate year two. PWBI showed a significant positive correlation with hours worked (correlation coefficient .35; p = .001) as well as a significant negative correlation with exercise time (correlation coefficient ‐.18; p = .010). There was a positive correlation between hours worked and ESS (correlation coefficient .48; p = .001).ConclusionFor the otolaryngology survey respondents, sleepiness and overall well‐being were better during the first year with a dramatic worsening during junior years followed by an improvement in the senior years. More work hours and poor quality of life was associated with less physically active residents. Focused interventions during these rotations may reduce distress, improve quality of life, and enhance learning.Level of EvidenceNA

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As the prevalence of childhood obesity increases, the incidence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis (NASH) also escalates. This study’s purpose was to identify the clinical criteria to aid in determining when a liver biopsy is indicated for this growing population because currently no guidelines exist. We performed a retrospective chart review on all patients who were seen in the Nutrition Exercise and Weight Loss Kids™ Program at the Children’s Hospital of Wisconsin from July 2003 through December 2004. We analyzed only individuals who underwent liver biopsy with the following criteria: (1) no evidence of other liver disease and (2) aspartate transaminase or alanine aminotransferase greater than 200 IU/L or any elevation of or for more than 6 months. Of the 284 patients reviewed, only eight patients (3%) met the criteria for analysis. Biopsy results demonstrated that 100% had histological evidence of NASH with steatosis, and seven of the eight (87.5%) had NASH with fibrosis, cirrhosis, or both. Obese children with an aspartate transaminase or alanine aminotransferase greater than 200 IU/L or any elevation of aspartate transaminase or alanine aminotransferase for more than 6 months, have a strong likelihood of having NASH with or without fibrosis, cirrhosis, or both.

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NA Laryngoscope, 126:E319-E324, 2016.

an academic medical center. Sex, gender, age, whether galeatomy was performed, and additional variables were recorded. The distance of hairline advancement was measured in the midline and at the left and right midpupillary line. Galeatomies and rapid intraoperative tissue expansion were performed as per standard surgical protocol.Results: For the group of 29 individuals who underwent the specified method for scalp advancement, the average differences for the glabella to the trichion, the right midpupillary line, and the left midpupillary line were 1.90 cm, 2.07 cm, and 2.07 cm, respectively. These differences between the pre-and post-observations were statistically significant at the 0.1% level (P < .001). The overall average difference in scalp advancement was 2.01 cm (also significantly different pre-and post-measurements at the 0.1% level; P < .001).Conclusions: Our technique of hairline advancement provides a significant improvement in the hairline in patients seeking out advancement due to an elongated forehead while undergoing facial feminization.

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