Denver Health Medical Center, formerly named Denver General Hospital, is a hospital in the Lincoln Park neighborhood of Denver, founded in 1860. It is one of five Level I Trauma Centers in Colorado. Denver Health Medical Center is one of the primary teaching hospitals in Denver and is affiliated with the University of Colorado School of Medicine.
Saddle nose deformity results in functional nasal obstruction and significant aesthetic compromise. In advanced cases, rib cartilage remains the most reliable autologous source for reconstruction. However, achieving long-lasting symmetry and contour remains challenging. To evaluate the functional and aesthetic outcomes of a novel three-component autologous rib cartilage reconstruction technique incorporating a columellar strut, bilateral spreader grafts, and diced cartilage with perichondrial overlay. This retrospective cohort study included 37 patients (24 female, 13 male) with moderate to severe saddle nose deformity who underwent single-rib, triple-layer reconstruction. Preoperative and postoperative evaluations included the Visual Analog Scale (VAS) for nasal appearance, Nasal Obstruction Symptom Evaluation (NOSE) scale, and a 5-point Likert scale for patient satisfaction. Advanced statistical analyses were conducted to assess effect sizes and responder rates. VAS and NOSE scores improved significantly (p < 0.0001), with large effect sizes (Cohen’s d > 4.6). Mean operative time was 187 ± 21 min. Patient satisfaction was high (mean 4.16 ± 0.73), and over 86
Retrocolumellar perforations (RCPs) are rare complications of revision rhinoplasty, often associated with columellar retraction, shortened nasal length, and loss of tip projection. Their repair requires vascularized flaps that provide both mucosal coverage and structural support at the tip. To evaluate the surgical outcomes of RCP repair using endonasal and gingivobuccal flaps, with emphasis on perforation closure, nasal tip projection, and patient-reported outcomes. A cohort of 28 patients (mean age 35.6 years; 17 men, 11 women) underwent RCP repair. Most had ≥ 2 prior nasal surgeries (71.4 www.springer.com/00266 .
The dominant genres of the American healthcare system—electronic health records and research reports—are strategies for advancing commercial and empirical goals. These strategies have led us into an epistemic crisis in which clinicians and patients suffer from information overload, politicized health information, and conflicting narratives about medical practices across the lifespan, from vaccines in childhood to care at the end of life, resulting in a loss of trust between clinicians and patients. Two recent books offer insight into how previous epistemic crises were resolved by the patterning of physicians’ imaginations through genres now associated with health humanities. In her history of medicine in the early United States, the literary scholar Sari Altschuler shows how physicians used limericks, maps, and satires to address epistemic crises resulting from pandemics and the development of novel technologies. In her philosophy of art and imagination, the theologian Judith Wolfe shows how perceptual shifts can direct people and communities to new ends. When read in conversation, the works of Altschuler and Wolfe suggest the health humanities can provide novel strategies otherwise unavailable to physicians facing our current epistemic crisis.
BACKGROUND:Artificial intelligence (AI) is increasingly being integrated into health care, offering new possibilities for postoperative management. Large language models (LLMs) like ChatGPT-4 and Claude 3.5 Sonet have demonstrated potential in patient education and clinical support. This study evaluates their effectiveness in providing postoperative guidance following tympanoplasty, focusing on accuracy, clarity, and relevance. METHODS:Fifteen frequently asked postoperative tympanoplasty questions were compiled from 50 patients and validated by 15 otolaryngologists-ChatGPT-4 and Claude 3.5 Sonet generated responses under standardized conditions. AI-generated responses were assessed by the expert panel using a 5-point Likert scale for accuracy, response time, clarity, and relevance. Advanced statistical analysis was conducted to compare the models' performance, including Cohen kappa for inter-rater reliability, effect size calculations, and P -value analysis. RESULTS:Claude 3.5 Sonet consistently outperformed ChatGPT-4 across all evaluated parameters. It demonstrated superior accuracy, faster response times, improved clarity, and higher relevance in patient education ( P <0.001). Statistical analysis confirmed significant differences, with Claude achieving stronger inter-rater reliability and response consistency. CONCLUSION:Claude 3.5 Sonet demonstrated a notable advantage over ChatGPT-4 in providing structured and clinically accurate postoperative tympanoplasty guidance. These findings suggest that AI-driven conversational agents can enhance patient education and support postoperative care. However, further research is necessary to refine AI-based tools and evaluate their broader applicability in clinical practice. LEVEL OF EVIDENCE:Level III.
Lung cancer epidemiology varies widely across countries, yet local data remain scarce. This study analyzed 882 lung cancer cases registered in the Addis Ababa population-based cancer registry from 2012 to 2023 to characterize patient profiles, incidence rates, and trends. We used descriptive statistics, binary and multinomial logistic regression, Poisson regression, and joinpoint regression. We found the crude median age at diagnosis was 56 years (adjusted: 60 years), with one in four patients diagnosed before 45. Adenocarcinoma was the most common histological subtype (34.8%), significantly associated with females (AOR: 1.64, 95% CI: 1.21–2.21), followed by squamous cell carcinoma (8.8%). Carcinoma not otherwise specified (NOS) accounted for 45.2% of cases. Alarmingly, 93% of patients were diagnosed at a late stage. The age-standardized incidence rate (ASIR) was 3.1 per 100,000 (3.3 for males, 2.8 for females), with a male-to-female incidence rate ratio (IRR) of 1.13, showing a nonsignificant decline over time. The incidence rate increased with age and varied significantly across sub-cities (1.5–2.9 per 100,000). While the overall ASIR trend remained stable, sex-specific trends showed a 3% annual increase in female crude incidence rates, whereas male rates remained unchanged significantly. These findings highlight the urgent need for targeted lung cancer prevention, early detection, and treatment strategies tailored to local epidemiological patterns.
