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Eighty-nine underwent LT, including 20 opioid-treated patients. There was no difference found between the opioid and non-opioid groups with regard to allograft loss, ED visits, and hospital readmissions at 2 years post-LT follow-up. CONCLUSIONS Opioid treatment was common among patients with cirrhosis. Tofacitinib We did not find increased negative outcomes among opioid users across the spectrum of cirrhosis. However, the sample for LT patients was small. © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.OBJECTIVES Determine the rates of, reasons for, and effectiveness of device reprogramming utilizing in-office awake endoscopy (AE) in subjects who underwent upper airway stimulation (UAS) surgery. STUDY DESIGN Retrospective chart review. METHODS Retrospective chart review at a tertiary care center on patients implanted with UAS devices from November 2015 to July 2018. RESULTS Sixty patients were implanted with UAS devices. Average pre- and postsurgical total apnea-hypopnea index (AHI) was 40.6 and 4.2 with a 36.4 total AHI reduction. Treatment success based on Sher criteria was observed in 88% of patients. Postoperative titration polysomnography revealed an average functional threshold (FT) and minimum therapeutic amplitude (MTA) of 1.6 and 2.1 V, respectively. A total of 24 AEs were performed in 19 (32%) patients. The most common complaints and reasons for AE were perceived stimulus discomfort (42%), frequent awakenings (32%), and persistent fatigue or non-normalized AHI (21%). After first AE, there was a 0.87 (53%) and 0.93 (45%) V reduction in FT and MTA, respectively. CONCLUSION Patients with obstructive sleep apnea continue to succeed with UAS. Fewer than one-third of patients had postsurgical complaints requiring device reconfiguration utilizing AE to assess the pharyngeal airway and optimize device settings. Reduction in the FT and MTA after AE may improve compliance by reducing discomfort and frequent awakenings. Periodic monitoring of patients with implanted UAS devices is necessary to optimize efficacy and maintain patient compliance. LEVEL OF EVIDENCE 4 Laryngoscope, 2020. © 2020 The American Laryngological, Rhinological and Otological Society, Inc.Lupus erythematosus-lichen planus (LE-LP) overlap syndrome represents a rare disorder with clinical and histopathological features of both lichen planus and lupus erythematosus presenting in the same lesions. However, lichen planus and lupus erythematosus can also coexist in the same patient. Blaschkoid lichen planus in the setting of concurrent childhood-onset systemic lupus erythematosus has not been previously described. © 2020 Wiley Periodicals, Inc.OBJECTIVE Dysphagia is common following facial nerve injury; however, research is sparse regarding swallowing-related outcomes and targeted treatments. Previous animal studies have used eye blink and vibrissae movement as measures of facial nerve impairment and recovery. The purpose of this study was to create a mouse model of facial nerve injury that results in dysphagia to enhance translational research outcomes. STUDY DESIGN Prospective animal study. METHODS Twenty C57BL/6J mice underwent surgical transection of the main trunk (MT) (n = 10) or marginal mandibular branch (MMB) (n = 10) of the left facial nerve. Videofluoroscopic swallow study (VFSS) assays for drinking and eating were performed at baseline and 14 days postsurgery to quantify several deglutition-related outcome measures. RESULTS VFSS analysis revealed that MT transection resulted in significantly slower lick and swallow rates during drinking (P ≤ .05) and significantly slower swallow rates and longer inter-swallow intervals during eating (P ≤ .05), congruent with oral and pharyngeal dysphagia. After MMB transection, these same VFSS metrics were not statistically significant (P > .05). CONCLUSION The main finding of this study was that transection of the facial nerve MT leads to oral and pharyngeal stage dysphagia in mice; MMB transection does not. These results from mice provide novel insight into specific VFSS metrics that may be used to characterize dysphagia in humans following facial nerve injury. We are currently using this surgical mouse model to explore promising treatment modalities such as electrical stimulation to hasten recovery and improve outcomes following various iatrogenic and idiopathic conditions affecting the facial nerve. LEVEL OF EVIDENCE NA Laryngoscope, 2020. © 2020 The American Laryngological, Rhinological and Otological Society, Inc.BACKGROUND The presence of a lower limb arteriovenous graft (LL-AVG) is indicative of a group of complex haemodialysis patients who have precarious long-term vascular access. The aim of this study is to describe our experience of the clinical decisions and interactions between LL-AVG and renal transplantation. METHODS The records of 23 patients who received a transplant in the presence of a LL-AVG between 2010 and 2018 were analysed firstly, to determine if patients with a LL-AVG received extended criteria transplants, the implantation procedure, and the management of the LL-AVG in the post-operative period. RESULTS Seventeen patients (74%) had 'end-stage access' and were thus considered for all offer stratified by the kidney donor profile index (KDPI) and donor type (DBD or DCD). In eleven patients (48%) a kidney with a high risk of delayed graft function was transplanted. Same-sided renal transplantation occurred in only 35% of cases, and of these only one LL-AVG was ligated immediately to improve transplant perfusion. CONCLUSION A patient-based approach applied in decision-making on management of the LL-AVG post-transplantation should include 1. the likelihood of delayed graft function, 2. the need for post-operative haemodialysis, 3. the side of proposed transplant compared to the LL-AVG, 4. local complications. This article is protected by copyright. All rights reserved.A 56-year-old man died following a fall resulting in complete submersion into a deep pit containing insulation material, expanded perlite. The most striking finding at autopsy was of impacted, moist pale yellow perlite that extended from the epiglottis into the main bronchi resulting in complete obstruction of the larger and smaller airways with cast formation. Perlite inhalation differs from inhalation of inert materials such as sand and wheat due to its hygroscopic properties and ability to expand forming an occlusive cast. Subsequent analyses of perlite from the worksite and within the airways indicated that hydration of perlite and adsorption of organic molecules into the perlite glass flakes had formed an interlocking, three-dimensional structure that was likely responsible for triggering a coagulation-flocculation process causing strong cohesion between the aggregates of glass flakes. This unique mechanism was likely responsible for the formation of the plug of perlite that obstructed the upper airway. © 2020 American Academy of Forensic Sciences.