Tracheotomy in the pediatric population creates unique challenges for parents. Parents often feel underprepared to provide adequate tracheostomy care. Social media is used as a resource for many medical conditions. We looked at Facebook use among parents of children with a tracheostomy to determine how this resource is used as support and to assess common concerns that require improved education prior to discharge. We joined 8 Facebook groups focused on children with a tracheostomy, analyzed the posts for how the groups were used, and identified recurring content. The primary focus of the groups was parental support and general information about tracheostomy care. A common theme identified was patients not receiving medical supplies on time, and groups provided a forum to obtain supplies. Groups also provided general advice about how to travel with a tracheostomy and medical advice, such as when to worry about blood in the tracheostomy tube.
Objective: Laryngopharyngeal reflux (LPR) and associated symptoms can be refractory to treatment with acid suppressing medication. We investigated the role and evidence for complementary and alternative medicine (CAM) for LPR in this systematic review. Review Methods: Complementary and alternative treatment was defined in this systematic review as any non-acid suppressing medication, treatment, or therapy. A literature search was performed by two authors in consultation with a medical librarian using controlled vocabulary for “complementary and alternative medicine” and “laryngopharyngeal reflux” in the databases PubMed and EMBASE, with supplemental searches with Google Scholar. Results: Twenty articles were included in this review for the modalities: alginate, diet modification, prokinetics, respiratory retraining, voice therapy, rikkunshito (RKT), hypnotherapy, and sleep positioning. The studies were analyzed for bias based on the Cochrane criteria for RCTs and Methodological Index for non-RCT (MINORS) criteria for all other studies. For each modality a level of evidence was assigned to the current body of evidence using the GRADE approach. Conclusion: There is mixed evidence with a high degree of bias and heterogeneity between studies for the modalities presented in the paper. Based on this review, an anti-reflux diet is recommended for all patients and there is some low-quality evidence to support alkaline water. For patients with predominant vocal symptoms there is evidence that supports voice therapy. There is insufficient evidence to recommend prokinetics at this time. For patients with predominant globus symptoms, alginate, RKT, and relaxation strategies may be used in conjunction with acid suppressing medications for symptom relief.
Objectives: Acupuncture is a form of Traditional Chinese Medicine that has minimal side effects, is cost-effective, can be easily administered, and may serve as a useful non-pharmaceutical therapy for certain conditions. However, studies and clinical practice guidelines are inconsistent in conclusions and recommendations about acupuncture. This qualitative review addresses the evidence available for acupuncture use in otolaryngology. Methods: A literature review was completed using EMBASE, PubMed, and The Cochrane Collection for conditions within otolaryngology that have used and studied the comparative effects of acupuncture. Thirty studies ultimately fit the inclusion criteria and were used for this qualitative review. Results: Studies included in this review contained a variety of conditions within otolaryngology, including allergic rhinitis, chronic rhinitis, tinnitus, sudden sensorineural hearing loss, post-viral olfactory dysfunction, dysphonia, and tonsillectomies. Conclusion: Given its safety profile, cost, and perceived benefit, recommendations and guidelines supporting acupuncture as an alternative or adjunctive therapy are surfacing for certain conditions such as allergic rhinitis. However, stronger conclusions with specific recommendations are limited by varied methodology between majority of the studies. Additional high-quality randomized control studies with low risk of bias are required to continue to assess the effects of acupuncture in the field of otolaryngology before stronger recommendations can be made on other conditions.
RET is a receptor tyrosine kinase that mediates the response of cells to stimulation with members of the glial cell‐line derived neurotrophic factor (GDNF) family of neurotrophins, which are important in the development and maintenance of a subset of neuronal cells as well as in other cell types and tissues. Improved methods to measure RET receptor activation and function are sought after to support the development of GDNF family ligands as potential drugs. Reporter gene assays are valuable tools to measure transcriptional and signaling pathway changes. Here, we report the development and validation of a stable luciferase reporter cell‐line for activation of RET by the GDNF family neurotrophin artemin (ART), using a previously established murine NB41A3 cell‐line expressing the GFRα3 co‐receptor. We observed a robust, dose‐dependent luciferase response upon stimulation of the cells with ART, which was quantitatively consistent with RET activation in the same cells measured using our previously reported RET Kinase Receptor Activation (KIRA) ELISA, or by measuring levels of activated ERK or Akt. Through inhibitor studies, we validated that RET activation of our reporter cell‐line is directly related to transcriptional changes induced by activation of the ERK/MAPK pathway. The reporter gene assay can be used to quantify the activation of RET by ART in a sensitive, convenient and robust way. We additionally report the use of this assay to investigate signaling dynamics and the efficiency of receptor‐effector coupling when RET is activated by a variety of different agonist proteins.
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