Do Cigarette Taxes Make Smokers Happier Than Nonsmokers?

Public health advocates justify cigarette taxes, claiming they discourage smoking, which results in a healthier population. However, the more pertinent issue with which health advocates should be concerned is that of smoker well‐being. In this paper, I investigate whether cigarette taxes make smokers relatively more satisfied than nonsmokers. Additionally, because poor smokers have a higher discount rate than wealthy smokers, and therefore, perceive the tax differently, I explore the effect that income, in conjunction with a cigarette tax increase, has on smokers’ life‐satisfaction. Using cross‐sectional and time‐series data from the 2005‐2010 Behavioral Risk Factor Surveillance System survey, this paper utilizes regression analysis to investigate the effect of cigarette tax on the happiness of smokers relative to nonsmokers and of poor smokers relative to wealthy smokers. Inflation‐adjusted tax data was collected from The Campaign for Tobacco Free Kids and state unemployment rates were collected from the Bureau of Labor Statistics. Inconsistent with the findings of Gruber and Mullainathan (2005), this paper finds that the satisfaction of smokers does not change relative to nonsmokers in response to cigarette taxes, implying that they do not act in a time‐inconsistent manner as was previously thought. In addition, this paper finds some evidence that the satisfaction of low‐income smokers increases relative to high‐income smokers in response to a cigarette tax. Policymakers should consider this result when enacting tax hikes

Unilateral Periorbital Swelling in a Pediatric Patient

Infratemporal fossa (ITF) tumors are rare in children and may present with a variety of symptoms. Teratomas are neoplasms derived from the 3 germ layers and approximately 6% to 10% are within the head and neck. Our study discusses one of the first reported cases of teratoma in the ITF in a pediatric patient. A 3-year-old girl presents with 2 years of recurrent monthly left periorbital swelling accompanied by fevers, skin discoloration, and pain. Prior episodes were treated with antibiotics with incomplete resolution. Imaging revealed a cystic lesion centered in the ITF. She was taken for endoscopic endonasal biopsy of the lesion and had no complications. Pathology revealed a mature teratoma composed primarily of pancreatic tissue. Providers should consider masses such as teratoma in the differential for ITF tumors and periorbital edema unresponsive to typical treatment

Presumed hydrochlorothiazide-associated immunologic-hypersensitivity-induced pericardial effusion

A 50-year-old Caucasian female presented for a second opinion regarding a newly diagnosed pericardial effusion. Seven months previously, hydrochlorothiazide was introduced into her pharmacologic regimen to aid in the management of her hypertension. A routine echocardiogram indicated a large pericardial effusion with signs of early cardiac tamponade. The patient subsequently underwent successful pericardiocentesis with complete drainage of the pericardial effusion. The effusion was empirically attributed to a viral etiology. Repeat echocardiograms showed recurrence of the pericardial effusion. Prior to undergoing a second pericardiocentesis with pericardial biopsy, as her physicians recommended, the patient sought a second opinion. While obtaining the patient’s history, an allergy to sulfa was elicited. The possibility that the pericardial effusion may be secondary to an immunologic-hypersensitivity reaction was considered. It was recommended the patient discontinue the use of hydrochlorothiazide. Nine days following discontinuation of hydrochlorothiazide and without any other intervention, an echocardiogram was reported to show the size of the pericardial effusion had subsided substantially. Nine weeks following discontinuation, almost complete resolution of the pericardial effusion was reported. It is hypothesized that when treated with hydrochlorothiazide, the patient had an immune response leading to the pericardial effusion

Free tissue transfer for skull base reconstruction - a review

Evolutions in skull base surgery and reconstructive technique have given surgeons the confidence to resect and repair increasingly advanced skull base pathologies. Free tissue transfer (FTT) provides a versatile option capable of addressing numerous simultaneous reconstructive goals. This review highlights some of the nuances, challenges, and considerations of performing FTT for skull base reconstruction in the anterior, central and lateral skull base. This review combines the expert opinion of the senior authors with those of the field at large as queried through PubMed searches regarding skull base reconstruction and FTT. Reconstructive goals include separation of intracranial from extracranial cavities, obliteration of dead space, and protection of vascular and neural structures. Atypical vascular pedicle management is commonly needed, especially for endonasal and central skull base resection. Virtual surgical planning may be beneficial for complex bony reconstruction. Familiarity with common complications such as cerebrospinal fluid leak, nasocutaneous fistula, and inferior flap displacement, as well as associations for their development, can help plan the reconstruction to minimize morbidity

Pigmented Melanotic Schwannoma of the Neck: Report of 2 Cases and Review of the Literature

Background: Melanotic schwannoma is a rare tumor with indeterminate biologic behavior and varying treatment recommendations. Methods: We report 2 cases of pigmented melanotic schwannoma of the head and neck and perform literature review. The pathologic and immunohistochemical characteristics of melanotic schwannoma are reviewed. Results: Two cases of melanotic schwannoma are presented. Both cases underwent surgical resection with one patient receiving adjuvant radiation therapy. Conclusions: Melanotic schwannoma is a rare nerve sheath tumor that is frequently mistaken for malignant melanoma. We describe 2 cases of pigmented melanotic schwannoma of the head and neck with different presentations and review the histopathological and immunohistochemical features

An algorithm for sellar reconstruction following endoscopic transsphenoidal surgery for pituitary adenoma: A review of 582 cases.

BACKGROUND: Several sellar reconstruction algorithms stratify patients based on risk of postoperative cerebrospinal fluid (CSF) leak. Many proposed algorithms employ techniques that are overly complex and confer morbidity. We review our experience with sellar reconstruction following transsphenoidal pituitary surgery and propose a highly effective, yet simple and low morbidity, algorithm. METHODS: A retrospective review of 582 patients who underwent transsphenoidal surgery for pituitary adenoma by a single neurosurgeon between 2005 and 2020 was performed. Patients without an intraoperative CSF leak and without a patulous diaphragm were repaired with an oxidized cellulose onlay (group 1). Patients with a low-flow intraoperative CSF leak or a patulous diaphragm were repaired with a synthetic dural substitute inlay (group 2). Patients with a persistent leak around the inlay repair or a high-flow leak were reconstructed with a synthetic dural substitute inlay and a nasoseptal flap onlay (group 3). RESULTS: There was an overall leak rate of 1.5% (9/582) to 1.0% (2/197) in group 1, 1.7% (6/347) in group 2, and 2.6% (1/38) in group 3. Group 3 had the highest rate of postoperative morbidity, including sinusitis (23.7% vs. 8.6% and 15.0% in groups 1 and 2, p = 0.018) and crusting (42.1% vs. 4.6% and 6.3% in groups 1 and 2, p \u3c 0.001). All techniques healed equally well radiographically. CONCLUSION: The proposed algorithm for sellar reconstruction is highly effective and minimizes complexity and morbidity, primarily utilizing single-layer reconstructions without the addition of packing material or lumbar drainage

International consensus statement on allergy and rhinology: Sinonasal tumors

Background: Sinonasal neoplasms, whether benign and malignant, pose a significant challenge to clinicians and represents a model area for multidisciplinary collaboration in order to optimize patient care. The International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors (ICSNT) aims to summarize the best available evidence and presents 48 thematic and histopathology-based topics spanning the field. Methods: In accordance with prior ICAR documents, ICSNT assigned each topic as an Evidence-Based Review with Recommendations, Evidence-Based Review, and Literature Review based on level of evidence. An international group of multidisciplinary author teams were assembled for the topic reviews using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses format, and completed sections underwent a thorough and iterative consensus-building process. The final document underwent rigorous synthesis and review prior to publication. Results: The ICNST document consists of 4 major sections: general principles, benign neoplasms and lesions, malignant neoplasms, and quality of life and surveillance. It covers 48 conceptual and/or histopathology-based topics relevant to sinonasal neoplasms and masses. Topics with a high level of evidence provided specific recommendations, while other areas summarized the current state of evidence. A final section highlights research opportunities and future directions, contributing to advancing knowledge and community intervention. Conclusion: As an embodiment of the multidisciplinary and collaborative model of care in sinonasal neoplasms and masses, ICSNT was designed as a comprehensive, international, and multidisciplinary collaborative endeavor. Its primary objective is to summarize the existing evidence in the field of sinonasal neoplasms and masses. This article is protected by copyright. All rights reserved

International consensus statement on allergy and rhinology: Sinonasal tumors.

BACKGROUND: Sinonasal neoplasms, whether benign and malignant, pose a significant challenge to clinicians and represents a model area for multidisciplinary collaboration in order to optimize patient care. The International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors (ICSNT) aims to summarize the best available evidence and presents 48 thematic and histopathology-based topics spanning the field. METHODS: In accordance with prior ICAR documents, ICSNT assigned each topic as an Evidence-Based Review with Recommendations, Evidence-Based Review, and Literature Review based on level of evidence. An international group of multidisciplinary author teams were assembled for the topic reviews using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses format, and completed sections underwent a thorough and iterative consensus-building process. The final document underwent rigorous synthesis and review prior to publication. RESULTS: The ICNST document consists of 4 major sections: general principles, benign neoplasms and lesions, malignant neoplasms, and quality of life and surveillance. It covers 48 conceptual and/or histopathology-based topics relevant to sinonasal neoplasms and masses. Topics with a high level of evidence provided specific recommendations, while other areas summarized the current state of evidence. A final section highlights research opportunities and future directions, contributing to advancing knowledge and community intervention. CONCLUSION: As an embodiment of the multidisciplinary and collaborative model of care in sinonasal neoplasms and masses, ICSNT was designed as a comprehensive, international, and multidisciplinary collaborative endeavor. Its primary objective is to summarize the existing evidence in the field of sinonasal neoplasms and masses. This article is protected by copyright. All rights reserved