Minimizing pharyngocutaneous fistula after total laryngectomy is a perpetual focus for head and neck surgeons.  https://www.selleckchem.com/products/propionyl-l-carnitine-hydrochloride.html  Multiple intrinsic and extrinsic factors have been implicated in the wound healing process. Activated fibrin glue uniquely promotes healing as a tissue adhesive as well as a biochemical growth factor.
 
  We present a pilot case series of total laryngectomy with simple pharyngeal closure with a single surgeon. Fibrin tissue adhesive was incorporated in all patients along with standardized pre-operative, operative, and post-operative care. Outcomes measured included pharyngocutaneous fistula rate, perioperative complications, and other wound complications as well as long term swallowing function and voice rehab outcomes. We also present a review of the literature for the theoretical basis of using fibrin glue as well as other similar applications.
 
  Fibrin tissue adhesive was successfully used in 18 consecutive patients undergoing total laryngectomy and pharyngoplasty. Despite the presence of a variety of wound healing risk factors including prior radiation and tobacco use, there were no pharyngocutaneous fistulas or other significant wound problems. No locoregional or free tissue overlay flap was done.
 
  Fibrin tissue glue is a readily available, easily applied, and cost-effective adjunct that may reduce pharyngocutaneous fistula.
 Fibrin tissue glue is a readily available, easily applied, and cost-effective adjunct that may reduce pharyngocutaneous fistula.
  The aim of this study was to evaluate the vestibular functions and dual-task performances of individuals with noise induced hearing loss.
 
  Fifty individuals with noise induced hearing loss and 25 healthy individuals were included in the study. Individuals with noise induced hearing loss were divided into 2 groups according to the pure tone average. Twenty-five patients with bilateral pure tone average between 20dB HL and 40dB HL were included in group I and 25 patients with bilateral pure tone average higher than 40dB HL were included in group II. One-leg standing test, functional reach test, timed-up and go test, head impulse test, head shaking test, spontaneous nystagmus test and caloric test were carried out to evaluate the vestibular systems of all individuals. Visual analog scale was used to evaluate the imbalance intensity of individuals. In order to evaluate the dual-task performances of the individuals, individuals were given cognitive and motor tasks simultaneously with timed up and go test.
 
  Individuals in group II had more abnormal caloric responses than the control group and individuals in group I. Also, individuals with higher hearing loss exhibited worse performance than other groups in eyes-closed one-leg standing test and dual-task situations.
 
  Individuals with higher hearing loss (>40dB) had more abnormal vestibular test results and worse dual-task performance than other groups. Vestibular evaluation and dual-task performance evaluation of factory workers with noise induced hearing loss can provide useful information to determine the risk of falling and fall prevention strategies in these individuals.
 40 dB) had more abnormal vestibular test results and worse dual-task performance than other groups. Vestibular evaluation and dual-task performance evaluation of factory workers with noise induced hearing loss can provide useful information to determine the risk of falling and fall prevention strategies in these individuals.
  Patient Satisfaction (PS) is a commonly used metric in health care settings to assess the quality of care given by physicians. Monitoring physicians in this way may impact physician quality of life. Studies evaluating this impact are not available. This study sought to examine the physician experience of measuring PS among practicing otolaryngologists.
 
  Using an online survey platform, a 34-item survey was given to practicing otolaryngologists through email distribution. The survey included questions about physician, practice and patient demographics, as well as inquiries regarding the way in which PS was measured and how it affected physician work and personal life. Data from these questions were reviewed and analyzed.
 
  174 otolaryngologists responded to the survey. A majority of physicians' (55.3%) PS scores had been tracked with 89.9% reporting being tracked for a length of at least 1year. PS scores for individual physicians were noted to be inconsistent and vary significantly between reports. Measuring patient satisfaction led to increased occupational stress, yet most physicians (63.8%) felt the monitoring did not lead to improvements in their practice. Some physicians (36.2%) reported that the collection of patient satisfaction scores had negatively influenced the way they practiced medicine, including the pressure to order superfluous tests or to prescribe unnecessary medications.
 
  Overall, physicians are negatively affected by the tracking of patient satisfaction scores. Occupational stress caused by the collection of patient satisfaction scores may contribute to physician burnout.
 Overall, physicians are negatively affected by the tracking of patient satisfaction scores. Occupational stress caused by the collection of patient satisfaction scores may contribute to physician burnout.Large-scale cultivation of Haematococcus pluvialis is frequently contaminated by the destructive fungus Paraphysoderma sedebokerense, which can cause huge losses in astaxanthin production. Here, we propose the use of four commercial surfactants to control P. sedebokerense contamination in H. pluvialis cultures. In laboratory experiments, sodium dodecylbenzene sulfonate, sodium dodecyl sulfate and primary alcohol ethoxylate treatments showed inhibitory effects on fungal contamination. Moreover, sodium dodecylbenzene sulfonate was the most promising because treatment at 7 mg L-1 was effective against fungal infection without negatively affecting the growth or astaxanthin contents of H. pluvialis. This could be ascribed to their different cell coverings and structures. Additionally, applying sodium dodecylbenzene sulfonate to open raceway ponds prevented fungal contamination, and astaxanthin production reached 1.82 g m-2. Therefore, sodium dodecylbenzene sulfonate can be used as an effective and economical control agent for commercial production of astaxanthin fromH.