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Otolaryngology, ENT & Sinus News Provided by the California Sinus CentersThe Bradford Hill Criteria and Zinc-Induced Anosmia: A Causality Analysis [Original Article]July 1, 2010, 12:00 pm by Archives of Otolaryngology Head & Neck SurgeryObjective To apply the Bradford Hill criteria, which are widely used to establish causality between an environmental agent and disease, to evaluate the relationship between over-the-counter intranasal zinc gluconate therapy and anosmia. Design Patient and literature review applying the Bradford Hill criteria on causation. Setting University of California, San Diego, Nasal Dysfunction Clinic. Patients The study included 25 patients who presented to the University of California, San Diego, Nasal Dysfunction Clinic complaining of acute-onset anosmia after intranasal application of homeopathic zinc gluconate gel. Main Outcome Measures Each of the 9 Bradford Hill criteria—strength of association, consistency, specificity, temporality, biological gradient (dose-response), biological plausibility, biological coherence, experimental evidence, and analogy—was applied to intranasal zinc gluconate therapy and olfactory dysfunction using published, peer-reviewed medical literature and reported clinical experiences. Results Clinical, biological, and experimental data support the Bradford Hill criteria to demonstrate that intranasal zinc gluconate therapy causes hyposmia and anosmia. Conclusions The Bradford Hill criteria represent an important tool for scientifically determining cause between environmental exposure and disease. Increased Food and Drug Administration oversight of homeopathic medications is needed to monitor the safety of these popular remedies.
More from Archives of Otolaryngology Head & Neck Surgery Professional Burnout Among Microvascular and Reconstructive Free-Flap Head and Neck Surgeons in the United States [Original Article] Archives of Otolaryngology Head & Neck Surgery: August 16, 2010, 12:00 pm Objectives To determine the prevalence of professional burnout among microvascular free-flap (MVFF) head and neck surgeons and to identify modifiable risk factors with the intent to reduce MVFF surgeon burnout.Design A cross-sectional, Iguazu Falls [About the Cover] Archives of Otolaryngology Head & Neck Surgery: August 1, 2010, 12:00 pm About This Journal [About This Journal] Archives of Otolaryngology Head & Neck Surgery: August 1, 2010, 12:00 pm The Learning Curve of Sialendoscopy With Modular Sialendoscopes: A Single Surgeon's Experience [Original Article] Archives of Otolaryngology Head & Neck Surgery: August 1, 2010, 12:00 pm Objective To assess the learning curve of sialendoscopy with modular endoscopes based on operative parameters and a postoperative performance rating. Design Prospective study, case series. Setting Tertiary referral hospital. Patients The study included 50 consecutive Dexamethasone Administration and Postoperative Bleeding Risk in Children Undergoing Tonsillectomy [Original Article] Archives of Otolaryngology Head & Neck Surgery: August 1, 2010, 12:00 pm Objective To assess whether administration of dexamethasone during tonsillectomy is associated with a dose-dependent increased rate of postoperative tonsillectomy hemorrhage. Design Retrospective review of 2788 children and adolescents who underwent tonsillectomy with or
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