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  1. Article ; Online: Cefazolin for the Treatment of Central Nervous System Infections.

    Tunkel, Allan R

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2023  Volume 78, Issue 2, Page(s) 489–490

    MeSH term(s) Humans ; Cefazolin/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Staphylococcal Infections/drug therapy ; Central Nervous System Infections/drug therapy
    Chemical Substances Cefazolin (IHS69L0Y4T) ; Anti-Bacterial Agents
    Language English
    Publishing date 2023-09-15
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciad559
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  2. Book: Pediatric otorhinolaryngology

    Licameli, Greg R. / Tunkel, David E.

    (Otorhinolaryngology - head and neck surgery series)

    2013  

    Author's details Greg R. Licameli ; David E. Tunkel
    Series title Otorhinolaryngology - head and neck surgery series
    Keywords Kind ; Hals-Nasen-Ohren-Krankheit
    Subject Hals-Nasen-Ohren-Erkrankung ; Kindheit ; Kindesalter ; Kindschaft ; Kinder
    Language English
    Size XIII, 181 S. : Ill., graph. Darst.
    Publisher Thieme
    Publishing place Delhi u.a.
    Publishing country India
    Document type Book
    HBZ-ID HT017489735
    ISBN 978-93-82076-04-9 ; 978-93-82076-10-0 ; 93-82076-04-2 ; 93-82076-10-7
    Database Catalogue ZB MED Medicine, Health

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    Shelf markLoan statusLocation
    2012 A 4603 order for loan Magazin

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  3. Article ; Online: Office Insertion of Tympanostomy Tubes and the Role of Automated Insertion Devices.

    Rosenfeld, Richard M / Tunkel, David E / Schwartz, Seth R

    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

    2022  Volume 166, Issue 2, Page(s) 219–223

    Abstract: Objective: Insertion of tubes in an office setting and automated tube insertion devices were identified as high-priority quality improvement opportunities during the update process for the 2013 clinical practice guideline on tympanostomy tubes from the ... ...

    Abstract Objective: Insertion of tubes in an office setting and automated tube insertion devices were identified as high-priority quality improvement opportunities during the update process for the 2013 clinical practice guideline on tympanostomy tubes from the American Academy of Otolaryngology-Head and Neck Surgery. The guideline update group, however, decided to avoid any recommendations on these topics, based on limited research evidence, and instead selected a subset of group members to author this state of the art review, with the goal of facilitating informed decisions in clinical practice.
    Data sources: PubMed through September 2021, Google search of device manufacturer websites, and SmartTots research website for articles on anesthesia neurotoxicity.
    Review methods: A state of the art review format emphasizing evidence from the past 5 years, with manual cross-checks of reference lists of identified articles for additional relevant studies.
    Conclusions: The existing literature is too sparse to make recommendations about procedure setting and optimal technique or assess long-term outcomes. The role of automated devices is uncertain, given the increased equipment cost and limited information on characteristics of the proprietary preloaded tubes, including intubation duration and rates of otorrhea, obstruction, medialization, granulation tissue, and persistent perforation.
    Implications for practice: Whether to undertake in-office tube insertion in awake children should be based on clinician experience, clinician ability to interact with and reassure caregivers, shared decisions with caregivers, and judgment regarding the level of cooperation (or lack thereof) to be expected from a given child. Clinicians should remain alert to new research and expect increasing queries from patients and families.
    MeSH term(s) Automation ; Child ; Child, Preschool ; Humans ; Infant ; Middle Ear Ventilation/instrumentation ; Otitis Media/surgery ; Physicians' Offices ; Practice Guidelines as Topic ; United States
    Language English
    Publishing date 2022-02-09
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 392085-9
    ISSN 1097-6817 ; 0161-6439 ; 0194-5998
    ISSN (online) 1097-6817
    ISSN 0161-6439 ; 0194-5998
    DOI 10.1177/01945998221074528
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Four distinct ipsilateral vestibular schwannomas: A case of mosaic NF2-related schwannomatosis.

    Tunkel, Alexandra E / Youner, Emily R / Barseghyan, Hayk / Fu, Yulong / Bhattacharya, Surajit / Bornhorst, Miriam / Monfared, Ashkan S

    American journal of clinical pathology

    2024  

    Abstract: Objectives: Distinguishing between sporadic and germline/mosaic NF2-related schwannomatosis is important to ensure that patients have appropriate long-term care. With this report, we describe a unique case of a patient with 4 ipsilateral schwannomas and ...

    Abstract Objectives: Distinguishing between sporadic and germline/mosaic NF2-related schwannomatosis is important to ensure that patients have appropriate long-term care. With this report, we describe a unique case of a patient with 4 ipsilateral schwannomas and identify a combination of sequencing modalities that can accurately diagnose mosaic NF2-related schwannomatosis.
    Methods: We present a 32-year-old woman with a familial history of vestibular schwannoma in her father and right-sided schwannomas involving the apical and basal turns of cochlea, lateral semicircular canal, and internal auditory canal (IAC). Genetic analysis of blood and frozen tissue from 2 tumors (intralabyrinthine and IAC tumors) was performed using next-generation sequencing (NGS), multiplex ligation-dependent probe amplification (MLPA), and optical genome mapping (OGM).
    Results: Germline testing for NF2, LZTR1, and SMARCB1 was negative. Tumor genetic testing revealed a shared NF2 pathogenic variant between the 2 tumors ("first hit") but distinct "second hit" NF2 variants, including mosaic loss of chromosome 22 in the IAC tumor seen only with OGM, consistent with mosaic NF2-related schwannomatosis.
    Conclusions: Multimodality sequencing, including NGS, MLPA, and OGM, was required to ensure appropriate diagnosis of mosaic NF2-related schwannomatosis in this patient. A similar approach can be used for other patients with multiple ipsilateral tumors and suspected tumor predisposition.
    Language English
    Publishing date 2024-03-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 2944-0
    ISSN 1943-7722 ; 0002-9173
    ISSN (online) 1943-7722
    ISSN 0002-9173
    DOI 10.1093/ajcp/aqae027
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  5. Article: Perspectives on Diagnosis and Management of All-Cause Encephalitis: A National Survey of Adult Infectious Diseases Physicians.

    Le Maréchal, Marion / Diaz-Arias, Luisa A / Beekmann, Susan E / Polgreen, Philip / Messacar, Kevin / Tunkel, Allan R / Thakur, Kiran T / Venkatesan, Arun

    Open forum infectious diseases

    2023  Volume 10, Issue 4, Page(s) ofad132

    Abstract: Background: Encephalitis is widely recognized as a challenging condition to diagnose and manage. The care of patients with encephalitis typically involves multiple disciplines, including neurologists and infectious disease (ID) physicians. Our objective ...

    Abstract Background: Encephalitis is widely recognized as a challenging condition to diagnose and manage. The care of patients with encephalitis typically involves multiple disciplines, including neurologists and infectious disease (ID) physicians. Our objective was to describe the perspectives and needs of ID physicians regarding encephalitis, using a cross-sectional questionnaire survey.
    Methods: We performed a survey among physician members of the Infectious Diseases Society of America's (IDSA) Emerging Infections Network (EIN).
    Results: Response rate was 33% (480 among 1472 active EIN physician members). More than 75% of respondents reported caring for patients with suspected encephalitis. Although one-third were involved in the care of multiple patients with autoimmune encephalitis (AE) annually, comfort in diagnosing and managing encephalitis, and in particular AE, was low. Experience with advanced diagnostic tools was variable, as were approaches toward deployment of such tools. Respondents noted that training could be improved by incorporating a multidisciplinary approach taking advantage of online and virtual platforms. ID physicians report a heavy reliance on the 2008 IDSA guidelines for the management of encephalitis, and indicated strong support for a formal update.
    Conclusions: ID physicians play an important role in the diagnosis and management of all-cause encephalitis. Despite exposure to AE, few ID physicians are comfortable in recognizing, diagnosing, and treating AE. Moreover, comfort with and use of advanced diagnostic tools for infectious encephalitis was highly variable. Training in encephalitis should include a focus on use and stewardship of advanced diagnostic tools and on collaborative approaches with neurologists and other practitioners on mechanisms and clinical presentations of AE. There is a need for a formal update of 2008 guidelines on the management of encephalitis.
    Language English
    Publishing date 2023-03-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2757767-3
    ISSN 2328-8957
    ISSN 2328-8957
    DOI 10.1093/ofid/ofad132
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  6. Article ; Online: Health disparities education - the time is now.

    Tunkel, Allan R

    Rhode Island medical journal (2013)

    2014  Volume 97, Issue 9, Page(s) 21

    MeSH term(s) Curriculum ; Education, Medical, Undergraduate ; Healthcare Disparities ; Humans ; Rhode Island ; Schools, Medical
    Language English
    Publishing date 2014-09-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2707068-2
    ISSN 2327-2228 ; 2327-2228
    ISSN (online) 2327-2228
    ISSN 2327-2228
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  7. Article ; Online: The allogeneic shell technique for alveolar ridge augmentation: a multicenter case series and experiences of more than 300 cases.

    Kämmerer, Peer W / Tunkel, Jochen / Götz, Werner / Würdinger, Robert / Kloss, Frank / Pabst, Andreas

    International journal of implant dentistry

    2022  Volume 8, Issue 1, Page(s) 48

    Abstract: Purpose: Allogeneic cortical bone plates (CP) might be used for alveolar ridge augmentation as an alternative to autogenous grafts (AG) and bone substitutes (BS). We report about a multicenter case series and our experiences of more than 300 cases using ...

    Abstract Purpose: Allogeneic cortical bone plates (CP) might be used for alveolar ridge augmentation as an alternative to autogenous grafts (AG) and bone substitutes (BS). We report about a multicenter case series and our experiences of more than 300 cases using CP and the shell technique for reconstruction of the alveolar process to illustrate surgical key steps, variations, and complication management.
    Methods: Different types of alveolar ridge defects were augmented using the shell technique via CP. The space between the CP and the alveolar bone was filled with either autogenous or allogeneic granules (AUG, ALG) or a mixture of both. Implants were placed after 4-6 months. Microscopic and histological assessments were performed. In addition, space filling using AUG, ALG and bovine BS was discussed.
    Results: Scanning electron microscopy demonstrated the compact cortical structure of CP and the porous structure of ALG allowing micro-vessel ingrowth and bone remodeling. Histological assessment demonstrated sufficient bone remodeling and graft resorption after 4-6 months. In total, 372 CP cases and 656 implants were included to data analysis. The mean follow-up period was about 3.5 years. Four implants failed, while all implant failures were caused by peri-implantitis. Next, 30 CP complications were seen, while in 26 CP complications implant placement was possible. CP rehydration, stable positioning by adjusting screws, smoothing of sharp edges, and a tension-free wound closure were identified as relevant success factors. Space filling using ALG and a mixture of AUG/ALG resulted in sufficient bone remodeling, graft resorption and stability of the augmented bone.
    Conclusions: CP and the shell technique is appropriate for alveolar ridge augmentation with adequate bone remodeling and low complication rates. Allografts can prevent donor site morbidity and therefore may decrease discomfort for the patient.
    MeSH term(s) Cattle ; Animals ; Humans ; Alveolar Ridge Augmentation/methods ; Dental Implantation, Endosseous/methods ; Bone Transplantation/methods ; Bone Substitutes ; Hematopoietic Stem Cell Transplantation
    Chemical Substances Bone Substitutes
    Language English
    Publishing date 2022-11-01
    Publishing country Germany
    Document type Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2198-4034
    ISSN (online) 2198-4034
    DOI 10.1186/s40729-022-00446-y
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  8. Article ; Online: Donald Kaye: 1931-2020, in Memoriam.

    Sobel, Jack D / Bush, Larry M / Tunkel, Allan R

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2020  Volume 72, Issue 12, Page(s) 2244–2245

    Language English
    Publishing date 2020-08-05
    Publishing country United States
    Document type Letter
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciaa1159
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  9. Article ; Online: One Size Does Not Fit All: Flexible Scheduling of USMLE Step 1 as a Component of Competency-Based Medical Education.

    Green, Emily P / George, Paul / Tunkel, Allan R

    Academic medicine : journal of the Association of American Medical Colleges

    2020  Volume 95, Issue 5, Page(s) 665

    MeSH term(s) Education, Medical ; Educational Measurement ; Licensure ; United States
    Language English
    Publishing date 2020-04-18
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 96192-9
    ISSN 1938-808X ; 1040-2446
    ISSN (online) 1938-808X
    ISSN 1040-2446
    DOI 10.1097/ACM.0000000000003182
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  10. Article ; Online: The evaluation of a multi-day testing approach with antigen lateral flow devices for people eligible for community-based COVID-19 treatments.

    Fowler, Tom / Fellows, Alasdair / MacISaac, Rachael / Kolade, Olumide / Singh, Bhupinder / Eccles, Adam / Blandford, Edward / Tunkel, Sarah A

    The Journal of antimicrobial chemotherapy

    2023  Volume 78, Issue Suppl 2, Page(s) ii12–ii17

    Abstract: Background: COVID-19 therapeutics including antiviral and monoclonal antibody treatments (hereafter 'COVID-19 treatments') require rapid administration to be effective. As part of the community-based antiviral and therapeutic treatment pathway for COVID- ...

    Abstract Background: COVID-19 therapeutics including antiviral and monoclonal antibody treatments (hereafter 'COVID-19 treatments') require rapid administration to be effective. As part of the community-based antiviral and therapeutic treatment pathway for COVID-19 there has been a move from PCR testing in those eligible to a rapid antigen lateral flow testing regime.
    Objectives: To determine whether a multi-day lateral flow device (LFD) testing regime is a feasible alternative to PCR for diagnosing symptomatic patients eligible for COVID-19 treatments. An LFD regime might return a positive result more quickly than a PCR and hence expedite access to COVID-19 treatments.
    Methods: A retrospective analysis was conducted of diagnostic testing for SARS-CoV-2 with a combination of PCR and LFDs of symptomatic patients eligible for COVID-19 treatments. LFD testing patterns were not assigned. Patients self-censored and the patterns were retro-fitted to the observed results.
    Results: The LFD testing patterns offered high sensitivity, close to 92%; however, the false positive rate also increased, with most of the multi-day testing patterns having a false positive rate greater than 3%. The highest sensitivity was seen among patients who tested with LFD on the same day as PCR.
    Conclusions: There were multiple observed testing behaviours. We conclude that multi-day LFD testing for COVID-19 provides a feasible alternative to PCR to in eligible patients, allowing swift prescription of COVID-19 treatments in most cases. This approach requires acceptance of a trade-off for a small increase in false-positive and -negative results.
    MeSH term(s) Humans ; COVID-19/diagnosis ; SARS-CoV-2 ; COVID-19 Drug Treatment ; COVID-19 Testing ; Retrospective Studies ; Antiviral Agents/therapeutic use ; Sensitivity and Specificity
    Chemical Substances Antiviral Agents
    Language English
    Publishing date 2023-11-23
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 191709-2
    ISSN 1460-2091 ; 0305-7453
    ISSN (online) 1460-2091
    ISSN 0305-7453
    DOI 10.1093/jac/dkad313
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