This study aims to outline Clostridioides difficile infection (CDI) trends and outcomes in Mexican healthcare facilities during the COVID-19 pandemic.

Observational study of case series.

Sixteen public hospitals and private academic healthcare institutions across eight states in Mexico from January 2016 to December 2022.

CDI patients.

Demographic, clinical, and laboratory data of CDI patients were obtained from clinical records. Cases were classified as community or healthcare-associated infections, with incidence rates calculated as cases per 10,000 patient days. Risk factors for 30-day all-cause mortality were analyzed by multivariate logistic regression.

We identified 2,356 CDI cases: 2,118 (90%) were healthcare-associated, and 232 (10%) were community-associated. Common comorbidities included hypertension, diabetes, and cancer. Previous high use of proton-pump inhibitors, steroids, and antibiotics was observed. Recurrent infection occurred in 112 (5%) patients, and 30-day mortality in 371 (16%). Risk factors associated with death were a high Charlson score, prior use of steroids, concomitant use of antibiotics, leukopenia, leukocytosis, elevated serum creatine, hypoalbuminemia, septic shock or abdominal sepsis, and SARS-CoV-2 coinfection. The healthcare-associated CDI incidence remained stable at 4.78 cases per 10,000 patient days during the pre-and pandemic periods. However, the incidence was higher in public hospitals.

Our study underscores the need for routine epidemiology surveillance and standardized CDI classification protocols in Mexican institutions. Though CDI rates in our country align with those in some European countries, disparities between public and private healthcare sectors emphasize the importance of targeted interventions.

The objective of the study is to examine the current state of research and technology related to objective olfactory assessment, highlighting the merits and demerits of the techniques. It aims to specifically explore olfactory event-related potentials, discussing their potential applications, benefits, drawbacks, and prospects in the field.

A five-month narrative review examined English-language articles from PubMed, Scopus, and Google Scholar, critically summarising titles, abstracts, and full texts, while excluding non-English and methodologically weak studies.

This study provides a detailed investigation into various objective methods utilised and the applicability of olfactory event-related potentials for assessing olfaction. We reviewed key elements, such as techniques, stimulus delivery methods, optimal electrode placement, and waveform analysis.

Olfactory event-related potentials offers substantial promise in enhancing the diagnostic accuracy of olfactory dysfunction across various clinical contexts. This thorough review highlights the utility and potential of olfactory event-related potentials in improving the precision and efficacy of olfactory assessments.

The purpose of this study is to investigate whether sex plays a role in donor-site dysfunction after head and neck reconstruction.

In this retrospective case series, 76 patients were assessed for donor-site morbidity using the Short Form 36, Short Musculoskeletal Function Assessment, disabilities of the arm, shoulder, and hand, and lower-limb core scale. Differences by sex were compared using t-tests. Multivariable linear regression analysis was conducted to adjust for potential confounders.

Females observed significantly greater disability for the SF-36 mental component summary score with a mean of 45.9 (standard deviation 10.5) compared to males, with a mean of 51.8 (standard deviation 10.2), p = 0.02. Sex is significantly related to SF-36 mental component summary score after controlling for neuropsychiatric disease and tracheostomy status.

Females reported significantly worse mental component scores compared to males undergoing free flap reconstruction of the head and neck.

Head and neck cancer has a 5 per cent incidence of synchronous primary cancer. Synchronous primary cancers are commonly detected with imaging and flexible nasoendoscopy. Routine panendoscopy is still being used to screen for synchronous primary cancers. The aim was to establish the method of detection of synchronous primary cancer.

A retrospective cohort study of newly diagnosed head and neck cancer patients with a synchronous primary cancer, presented at the West of Scotland Head and Neck Multidisciplinary Team from December 2020 to August 2022. This study is Level 3 evidence.

A total of 2325 patients were presented to the Multi-Disciplinary Team with head and neck cancer and 54 (2.3 per cent) had SPC; 63.8 per cent (30) of patients had a panendoscopy. All patients with comprehensive out-patient assessment had their synchronous primary cancer detected on examination or imaging, without the need for panendoscopy.

Panendoscopy did not detect any new synchronous primary cancer in patients assessed with flexible nasoendoscopy and imaging. With modern high-resolution imaging and fibreoptics, panendoscopy does not play a role in the detection of synchronous primary cancers.

To identify changes in hearing loss, tinnitus, vertigo, and migraine in individuals with Ménière’s disease diagnosed with coronavirus disease 2019 and during the UK national lockdown.

Patients were questioned regarding coronavirus disease 2019 status and how their symptoms of hearing loss, tinnitus, vertigo, and migraine changed because of the pandemic. Of the 411 participants recruited into this study, 382 had a self-reported coronavirus disease 2019 status.

Of those individuals with a positive coronavirus disease 2019 diagnosis, 43 (11.3 per cent) were more likely to experience worsening symptoms of hearing loss and tinnitus. Worsening symptoms of hearing loss and tinnitus, but improved symptoms related to vertigo, were observed during the UK national lockdown.

A diagnosis of coronavirus disease 2019 and/or experiencing the consequences of a national lockdown potentially resulted in a worsening of hearing loss and tinnitus symptoms. Symptoms of vertigo were found to have improved during the same period.

This study investigated the risk factors for developing pharyngocutaneous fistula, the most common complication following total laryngectomy.

We included all patients who underwent total laryngectomy and bilateral neck dissection from 2009 to 2021. Patients excluded were those with hypopharyngeal involvement, total or partial pharyngectomy, base of the tongue resection, large pharyngeal defects requiring free/pedicle flap reconstruction, or salvage laryngectomy.

A total of 164 patients participated in the study. Multivariate regression analysis identified two independent predictors of pharyngocutaneous fistula formation: pharyngeal reconstruction with simple interrupted sutures (odds ratio: 3.12, 95 per cent confidence interval: 1.31–17.00, p = 0.010) and radical neck dissection (odds ratio: 3.16, 95 per cent confidence interval: 1.13–8.82, p = 0.028).

Our findings suggest that pharyngeal reconstruction using simple interrupted sutures and radical neck dissection are independent risk factors for pharyngocutaneous fistula development. Based on this, we recommend using the modified Cushing suture technique over simple interrupted sutures due to its association with a significantly lower pharyngocutaneous fistula rate.

This study aimed to investigate the impact of vitamin D deficiency on vestibular function and recurrence in patients with benign paroxysmal positional vertigo.

This study enrolled 138 patients diagnosed with benign paroxysmal positional vertigo. Vestibular function was evaluated, including ocular vestibular evoked myogenic potentials, cervical vestibular evoked myogenic potentials and caloric tests. Vitamin D levels were recorded.

There was a significant difference in mean vitamin D levels between the normal and abnormal groups of the caloric test, cervical vestibular evoked myogenic potentials, and ocular vestibular evoked myogenic potentials. The likelihood of abnormal vestibular function was lower in patients with normal vitamin D levels than those with deficient levels (< 10 ng/ml). Vitamin D levels were the only predictive factor for recurrence among patients with benign paroxysmal positional vertigo.

A deficiency in vitamin D is more likely to result in abnormalities in the caloric test, cervical vestibular evoked myogenic potentials, and ocular vestibular evoked myogenic potentials in benign paroxysmal positional vertigo patients. The interaction among these factors may contribute to the recurrence.

Salvage neck dissection for squamous cell carcinoma is performed for residual or recurrent nodal disease after chemoradiotherapy or radical radiotherapy for locally advanced head and neck cancer. Our study aims to investigate the extent to which salvage neck dissection can be safely performed in treating recurrent or residual nodal metastasis.

A retrospective analysis of 53 patients with suspected residual or recurrent nodal disease after primary treatment (January 2016 to December 2018) was performed.

Pathological confirmation of viable squamous cell carcinoma following surgery was found in 43.4 per cent of patients. Post-operative infection, accessory and vagal nerve injuries were more common in patients with dissection of levels I–V than that of levels II–IV. There was no significant difference in three-year survival rate between patients with levels II–IV dissection and that of levels I–V dissection (p = 0.84).

The extent of salvage neck dissection can be limited to reduce post-operative complications while maintaining acceptable oncological outcomes.

This study aimed to describe outcomes of paediatric stapes surgery at an academic tertiary care centre.

Electronic medical records of patients younger than 21 years who underwent stapedotomy between September 2013 and July 2020 were reviewed.

A total of 17 patients (7 male, 10 female) were included in our study; 14 underwent surgery on one ear while 3 underwent surgery on both ears (20 ears total). Mean pre-operative air-bone gap was 34.5 dB (standard deviation, 11). At three months, the mean post-operative air-bone gap was 20.6 dB (standard deviation, 10.2), with a mean improvement of 17 dB (standard deviation, 12.1). Sixty-four per cent of patients had closure of their air-bone gap to 20 dB or less. A negative correlation between pre-operative body-mass index and post-operative air-bone gap was statistically significant (n = 14, p = 0.03, r = -0.57 [95% confidence interval -0.85, -0.04]).

Paediatric stapedotomy can be effective and safe. In this cohort, age was not correlated with improvement in air-bone gap; pre-operative body mass index was significantly correlated with post-operative air-bone gap.

Congenital hearing loss is a chronic condition which occurs worldwide. In the past, investigations focused on testing the most common genes associated with hearing loss (such as Connexin 26-related hearing loss). Targeted testing of specific genes was requested only when a particular syndrome was suspected. Recent advances have led to the development of a large gene panel which utilises next-generation sequencing to simultaneously test for pathogenic variants in many genes associated with hearing loss.

This review article aims to highlight the changes in the approach to congenital hearing loss in the context of the R67 gene panel, and how its use may increase the efficiency of the diagnosis and management of this condition.

The use of this large gene panel has revolutionised the approach to hearing loss. Uptake of this large gene panel has resulted in prompter diagnosis and therefore more appropriate clinical management.