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Objectives: Tall cell variant (TCV) papillary thyroid cancer (PTC) is a subtype of PTC associated with aggressive tumor behavior, advanced stage, and higher rates of recurrence and mortality. The present study aimed to test an established dynamic risk stratification tool in the TCV population, with the goal of better predicting the postoperative course of these patients., Study Design: Retrospective chart review., Methods: A total of 94 patients with TCV who underwent total thyroidectomy with radioactive iodine ablation were retrospectively reviewed from 1998 through 2020. Biochemical, structural, and overall response to treatment was determined for each patient, based on postoperative thyroglobulin levels and imaging findings. Primary outcomes were locoregional and distant recurrence, presence of disease at final follow-up, need for additional intervention, and disease-specific mortality., Results: Patients with TCV who were stratified as having an excellent overall response to treatment had lower rates of locoregional recurrence than indeterminate, biochemical incomplete, and structural incomplete responses (2.0%, 33.3%, 55.0%, and 85.7% at 5 years respectively, p < 0.001). The same was true for distant recurrence as well (2.0%, 9.0%, 35.1%, and 42.9%, p < 0.001). An excellent response was also associated with lower rates of presence of disease at final follow-up, need for additional intervention, and disease-specific mortality., Conclusions: Although TCV is an aggressive subtype associated with worse clinical outcomes than classical PTC, patients with an excellent overall response to treatment have significantly improved outcomes when compared to indeterminate, biochemical incomplete, and structural incomplete responses., Level of Evidence: 3 Laryngoscope, 133:2430-2438, 2023., (© 2023 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)

The title salt, C3H6N3S2 (+)·Cl(-)·H2O, crystallized with two organic cations, two chloride anions and two water mol-ecules in the asymmetric unit. The methyl C atoms deviate from their respective bound ring planes by 0.081 and 0.002 Å. In the crystal, the components are connected via N-H⋯O, N-H⋯Cl and O-H⋯Cl hydrogen bonds, forming sheets lying parallel to (100). The sheets are linked into bilayers by O-H⋯Cl hydrogen bonds involving the chloride ions and water mol-ecules. Within the bilayers there are π-π inter-actions [inter-centroid distances = 3.4654 (4) and 3.4789 (4) Å] involving inversion-related cations.

In the title hydrated mol-ecular salt, 2C5H8N3O(+)·SO4 (2-)·H2O, the components are linked by N-H⋯Os and Ow-H⋯Os (s = sulphate, w = water) hydrogen bonds, generating a layer by a+b+c and 2a-b translations. The cations are arranged nearly in parallel and show displaced π-π stacking centroid-centroid distance = 4.661 (2) Å between adjacent layers.

The asymmetric unit of the title compound, [K3(C4H2N3O4)3(H2O)2] n , contains two potassium cations (one in general position, one located on a twofold rotation axis), one and a half oxonate anions (the other half generated by twofold symmetry) and one water mol-ecule. As a result of the twofold symmetry, one H atom of the symmetric anion is statistically occupied. Both potassium cations are surrounded by eight oxygen atoms in the form of distorted polyhedra. Adjacent cations are inter-connected by oxygen bridges, generating layers parallel to (100). The aromatic ring system of the oxonate anions link these layers into a network structure. The crystal packing is stabilized by N-H⋯O, O-H⋯O and O-H⋯N hydrogen bonds, three of which are bifurcated. In addition, inter-molecular π-π stacking inter-actions exist between neighboring aromatic rings with a centroid-centroid distance of 3.241 (2) Å.

In the crystal structure of the title organic-inorganic hybrid material, (C10H22N2)[ZnCl4], the tetrachloridozincate anions and 1-cyclohexylpiperazine-1,4-diium dications are interconnected via N-H...Cl and C-H...Cl hydrogen bonds to form layers parallel to the (001) plane. The cyclohexyl groups from adjacent chains interdigitate, thus building the three-dimensional structure. The piperazinium and cyclohexyl rings exhibit regular spatial chair conformations. The title salt was also characterized by FT-IR and Raman spectroscopic analyses.

In the title compound, [Mg(C3H3N2)4(H2O)2]Cl2, the Mg(II) cation lies on a crystallographic inversion centre and is coordinated by two water mol-ecules and four N-atom donors from monodentate imidazole ligands, giving a slightly distorted octa-hedral stereochemistry. In the crystal, water O-H⋯Cl and imidazole N-H⋯Cl hydrogen bonds give rise to a three-dimensional structure.

In the title compound, C5H9N4 (+)·NO3 (-), the organic cations and the nitrate anions have both crystallographically imposed mirror symmetry and are linked via N-H⋯O hydrogen bonds, forming infinite chains running along the c-axis direction. The values of the N-O bond lengths [1.2256 (19)-1.2642 (18) Å] and O-N-O angles [118.39 (16)-121.64 (15)°] indicate that the nitrate anion exhibits a slightly distorted C3h geometry. The N atom of the NH2 group has sp (2) character.

In the title molecular salt, C6H10N2 (2+)·2ClO4 (-), the Cl-O bond lengths [anion 1: 1.369 (3)-1.415 (3); anion 2: 1.420 (2)-1.441 (2) Å] and the O-Cl-O angles [anion 1: 105.4 (2)-111.8 (4); anion 2: 107.8 (1)-110.3 (1)°] indicate a slight distortion of the perchlorate anions from regular tetra-hedral symmetry. In the crystal, the components are linked into columns along the a-axis direction via N-H⋯O and C-H⋯O hydrogen bonds, with stacks of the organic mol-ecules being surrounded by stacks of perchlorate anions.

In the title mol-ecular salt, C6H10N2 (2+)·NO3 (-)·Cl(-), the complete cation is generated by a crystallographic mirror plane. The complete nitrate ion is also generated by reflection, with the N atom and one O atom lying on the mirror plane; the chloride ion also lies on the reflection plane. In the crystal, the components are linked by N-H⋯Cl and N-H⋯(N,O) hydrogen bonds, forming (001) layers with the benzene rings projecting into the inter-layer regions. The layers are linked by weak C-H⋯O hydrogen bonds, generating a three-dimensional network.

The asymmetric unit of the title salt, C(6)H(9)ClN(2) (2+)·2H(2)PO(4) (-), contains two dihydrogenphosphate anions and one 2-chloro-benzene-1,4-diaminium dication. The H(2)PO(4) (-) anions are inter-connected through strong O-H⋯O hydrogen bonds to form two-dimensional infinite layers parallel to (001). The organic entities are anchored to the inorganic layers through N-H⋯O hydrogen bonds, and through weak C-Cl⋯O halogen bonds [3.159 (2) Å, 140.48 (7)°]. No π-π stacking inter-actions between neighboring aromatic rings or C-H⋯π inter-actions towards them are observed. Minor disorder is observed for the Cl atom and one hy-droxy group [minor-component occupancy = 3.29 (9)%].

In the crystal structure of the title molecular salt, 3C2H5N4(+)·HPO4(2-)·H2PO4(-)·3H2O, the phosphate-based framework is built upon layers parallel to (010) made up from the H2PO4(-) and HPO4(2-) anions and water mol-ecules, which are inter-connected through O-H⋯O hydrogen bonds. The organic cations are located between the phosphate-water layers and are connected to them via N-H⋯O hydrogen bonds. The bond-length features are consistent with an imino resonance form for the exocyclic amino group, as is commonly found for a C-N single bond involving sp(2)-hybridized C and N atoms.

The structure of the title compound, C(6)H(18)N(3)·HPO(4)·H(2)PO(4), is characterized by two kinds of inorganic chains running along the a-axis direction. The first one is composed of HPO(4) (2-) anions, while the second one is built up by H(2)PO(4) (-) anions. Both types of chains are held together by O-H⋯O hydrogen bonds. The organic cations are attached to these chains through N-H⋯O and C-H⋯O hydrogen bonds. The piperazin-1,4-diium ring adopts a chair conformation.

The asymmetric unit of the title compound, 2C(10)H(18)N(+)·HPO(4) (2-)·1.5C(4)H(4)O(4), contains two adamantan-1-aminium cations, one hydrogen phosphate anion, and one and a half mol-ecules of fumaric acid, one of which exhibits crystallographic inversion symmetry. Each HPO(4) (2-) anion is hydrogen bonded, via all of its O atoms, to four NH(3) (+) groups of the adamantan-1-aminium cations, forming chains along [100]. These chains are, in turn, inter-connected via a set of O-H⋯O hydrogen bonds involving the fumaric acid solvent mol-ecules, forming layers parallel to (001). Weak C-H⋯O inter-actions lead to a consolidation of the three-dimensional set-up.

In the title hydrated salt, C(8)H(11)N(2)O(+)·NO(3) (-)·H(2)O, the N-C bond distances [1.349 (2) and 1.413 (2) Å] along with the sum of the angles (359.88°) around the acetamide N atom clearly indicate that the heteroatom has an sp(2) character. The ammonium group is involved in a total of three N-H⋯O hydrogen bonds, two of these are with a water mol-ecule, which forms two O-H⋯O hydrogen bonds. All these hydrogen bonds link the ionic units and the water mol-ecule into infinite planar layers parallel to (100). The remaining two N-H⋯O inter-actions in which the ammoniun group is involved link these layers into an infinite three-dimensional network.

In the title compound, {(C(5)H(14)N(2))[Cd(2)Cl(6)]·H(2)O}(n), the asymmetric unit contains one piperazinediium cation, one [Cd(2)Cl(6)](2-) anion and a water mol-ecule. The coordination geometries of the two Cd(2+) cations are distorted octa-hedral. Adjacent Cd(II) atoms are inter-connected alternately by paired chloride bridges, generating polymeric chains parallel to [010]. Neighbouring chains are connected by O-H⋯Cl hydrogen bonds involving the water mol-ecules, forming layers at z = n/2. The crystal packing is further stabilized by inter-molecular N-H⋯Cl and N-H⋯O hydrogen bonds, one of which is bifurcated.

In the title compound, C(5)H(8)N(3)O(+)·ClO(4) (-)·C(5)H(7)N(3)O·H(2)O, each perchlorate anion is paired with a protonated cationic 2-amino-6-methyl-pyrimidin-4(1H)-one and another non-protonated entity of the same organic pyrimidinone. The crystal structure is stabilized by N-H⋯O(org), N-H⋯O(water), N-H⋯O(ClO4), O-H⋯O(ClO4), N-H⋯N and C-H⋯O(ClO4) hydrogen bonds between the anions, organic entities and water mol-ecules. Inter-molecular π-π stacking inter-actions between neighbouring organic rings are observed with a face-to-face distance of 3.776 (2) Å, and O-H⋯O hydrogen bonds link the perchlorate anions and the water mol-ecules into chains along the b-axis direction. The perchlorate anion and the inter-stitial water mol-ecule are disordered over two mutually incompatible positions with a common occupancy ratio of 0.678 (16):0.322 (16).

The asymmetric unit of the title compound, (C(7)H(7)N(2)S)(2)[ZnCl(4)], contains a network of 2-amino-benzothia-zolium cations and tetra-hedral [ZnCl(4)](2-) anions. The crystal packing is influenced by cation-to-anion N-H⋯Cl and C-H⋯Cl hydrogen bonds. The [ZnCl(4)](2-) anions have a distorded tetra-hedral geometry. Inter-molecular π-π stacking inter-actions are present between neighboring benzene rings, thia-zole and benzene rings and neighboring thia-zole rings [centroid-centroid distances = 3.711 (2), 3.554 (1), 3.536 (2) and 3.572 (1) Å].

A new noncentrosymmetric organic-inorganic hybrid material, (C(8)H(12)N)(2)[ZnCl(4)], has been synthesized as single crystals at room temperature and characterized by X-ray diffraction and solid-state NMR spectroscopy. Its novel structure consists of two 4-methylbenzylammonium cations and one [ZnCl(4)](2-) anion connected by N-H···Cl and C-H···Cl hydrogen bonds, two of which are three-centre interactions. The Zn(II) metal centre has a slightly distorted tetrahedral coordination geometry. Results from (13)C CP-MAS NMR spectroscopy are in good agreement with the X-ray structure. Density functional theory calculations allow the assignment of the carbon peaks to the independent crystallographic sites., (© 2011 International Union of Crystallography)

In the title compound, (C(12)H(20)N(2))[ZnCl(4)]·H(2)O, the two piperazine N atoms are protonated and the [ZnCl(4)](2-) anions adopt a slightly distorted tetra-hedral configuration. In the crystal, O-H⋯Cl hydrogen bonds link the tetra-chloridozincate anions and the water mol-ecules into corrugated inorganic chains parallel to [010]. The crystal structure is stabilized by N-H⋯Cl, N-H⋯O and O-H⋯Cl hydrogen bonds, with the N-H hydrogen bond originating from one of the two N atoms being trifurcated.

The asymmetric unit of the title compound, (C(5)H(6)ClN(2))(2)[ZnCl(4)], contains two 2-amino-5-chloro-pyridinium cations and one [ZnCl(4)](2-) dianion which are held together by N-H⋯Cl and C-H⋯Cl hydrogen bonds. The [ZnCl(4)](2-) anions have a distorted tetra-hedral geometry. Weak inter-molecular π-π stacking inter-actions exist between neighbouring aromatic rings of the cations with a centroid-centroid distance of 3.712 (7) Å.

In the crystal structure of the title salt, C(8)H(12)NO(+)·Cl(-), the methoxy group of the cation is co-planar with the phenylene moiety with an r.m.s. deviation from the mean plane of only 0.005 Å. The ammonium N atom deviates from this plane by 1.403 (1) Å. In the crystal, the (4-meth-oxy-phen-yl)methan-aminium cations and chloride anions are linked by N-H⋯Cl and C-H⋯O hydrogen bonds, resulting in an open framework architecture with hydrogen-bonded ammonium groups and chloride anions located in layers parallel to (011), separated by more hydrophobic layers with interdigitating anisole groups.

In the title compound, (C(4)H(12)N(2))[CdCl(4)]·H(2)O, the [CdCl(4)](2-) anions adopt a slightly distorted tetra-hedral configuration. In the crystal, O-H⋯Cl hydrogen bonds link the anions and water mol-ecules into corrugated inorganic chains along the b axis which are inter-connected via piperazinediiumN-H⋯O and N-H⋯Cl inter-actions into a three-dimensional framework structure.

In the title compound, (C(7)H(11)N(2))(2)[ZnCl(4)], [ZnCl(4)](2-) anions and 4-(dimethyl-amino)-pyridinium cations are held together by various inter-molecular inter-actions including Coulombic attraction, hydrogen bonding and π-π stacking inter-actions. Three Cl atoms of the [ZnCl(4)](2-) tetra-hedron act as acceptors in N-H⋯Cl hydrogen bonds. The hydrogen bonds, both of which are bifurcated, lead to the formation of a three-dimensional network. Within the network, inter-molecular π-π stacking inter-actions with a centroid-centroid distance of 3.5911 (7) Å arrange the 4-(dimethyl-amino)-pyridinium cations into anti-parallel dimers.

In the crystal structure of the title compound, C(12)H(12)N(+)·H(2)PO(4) (-), the dihydrogen phosphate anions and the 2-phenyl-anilinium cations are associated via O-H⋯O and N-H⋯O hydrogen bonds so as to build inorganic layers around the x = 1/2 plane. The organic entities are anchored between these layers through C-H⋯O hydrogen bonds, forming a three-dimensional infinite network. The dihedral angle between the aromatic rings is 44.7 (4)°.

In the title compound, [CdCl(2)(C(5)H(7)N(3)O)(2)], the Cd(II) atom is six-coordinated by two heterocyclic N atoms [Cd-N = 2.261 (2) and 2.286 (2) Å] and two O atoms [Cd-O = 2.624 (2) and 2.692 (2) Å] from two bidentate chelate 2-amino-6-methyl-pyrimidin-4(1H)-one ligands and two chloride ions [Cd-Cl = 2.4674 (6) and 2.4893 (7) Å]. The crystal packing is characterized by an open-framework architecture with the crystal packing stabilized by inter-molecular N-H⋯Cl and N-H⋯O hydrogen bonds.

In the title compound, [Cu(ClO(4))(2)(C(12)H(8)N(2))(H(2)O)(2)], the Cu(II) atom is coordinated in a square-planar fashion by the two N atoms of a chelating 1,10-phenanthroline ligand and by two water mol-ecules trans to the N atoms. The coordination sphere of the metal atom is augmented by O atoms of two weakly bonded perchlorate anions, thus yielding a strongly distorted CuN(2)O(4) octa-hedral environment. The crystal packing is stabilized by O-H⋯O hydrogen bonds between the water mol-ecules and the perchlorate anions. In addition, the organic mol-ecules are associated by π-π stacking inter-actions between symmetry-equivalent anti-parallel non-nitro-gen aromatic rings, with inter-planar distances of 3.543 (2) Å.

In the title compound, [ZnCl(HPO(4))](C(5)H(8)NO), polymeric inorganic layers constructed from ZnO(3)Cl and PO(4) tetra-hedra are linked by O atoms: O-H⋯O hydrogen bonds occur within the layers. The organic cations occupy the interlayer regions and interact with the layers by way of N-H⋯O, N-H⋯Cl, and C-H⋯Cl hydrogen bonds.

The asymmetric unit of the title compound, (C(11)H(18)N(2))(2)[CdCl(6)]·2H(2)O, consists of one 1-benzyl-piperazine-1,4-diium dication, one water mol-ecule and one-half of a [CdCl(6)](4-) anion, located on an inversion centre. The crystal packing is governed by an extensive three-dimensional network of inter-molecular O-H⋯Cl, C-H⋯Cl, N-H⋯O and N-H⋯Cl hydrogen bonds, two of them bifurcated.

In the title compound, C(11)H(18)N(2) (2+)·2ClO(4) (-)·H(2)O, one perchlor-ate anion is disordered over two orientations in a 0.66 (3):0.34 (3) ratio. Inter-molecular O-H⋯O, N-H⋯O and C-H⋯O hydrogen bonds link the cations, anions and water mol-ecules into ribbons extending along [100].

The title compound, (C(8)H(12)NO)(C(16)H(18)NO(2))[ZnCl(4)]·H(2)O, was obtained as a by-product of the Zn(2+) and HCl catalyzed condensation of (2-meth-oxy-phen-yl)methanamine in water. Both cations feature an intra-molecular N-H⋯O hydrogen bond. In the crystal, the components are linked by an extensive three-dimensional network of N-H⋯O, O-H⋯Cl and N-H⋯Cl hydrogen bonds (three of them bifurcated). Weak C-H⋯O intera-ctions also occur.

In the title compound, [Cd(NO(3))(2)(C(5)H(7)N(3)O)(2)], the Cd(II) atom is eight-coordinated by two amine N atoms and two O atoms from two zwitterionic, biodentate 2-amino-6-methyl-pyrimidin-1-ium-4-olate ligands and by four O atoms from two nitrate groups. Intra-molecular N-H⋯O hydrogen bonds occur. The crystal packing is stabilized by inter-molecular N-H⋯O and C-H⋯O hydrogen bonds, two of which are bifurcated, between the nitrate anions and the organic groups.

In the crystal structure of the title compound, C(9)H(22)N(2) (2+)·2H(2)PO(4) (-)·H(2)O, the H(2)PO(4) (-) anions are hydrogen bonded to each other, forming a ribbon parallel to the b axis. The water mol-ecules connect these ribbons via O-H⋯O hydrogen bonds. The organic cations are attached to the dihydrogen phosphate anions and water mol-ecules through N-H⋯O and C-H⋯O hydrogen bonds, forming an infinite three-dimensional network.

In the title compound, (C(7)H(18)N(2)O)[ZnCl(4)], the Zn(II) ion is coordinated by four Cl atoms in a close to tetra-hedral geometry. The crystal packing exhibits C-H⋯Cl, N-H⋯Cl and N-H⋯O hydrogen bonds.

The title compound, C(6)H(10)N(2) (2+)·2Cl(-), contains a network of 4-(ammonio-meth-yl)pyridinium cations and chloride anions which are inter-connected by N-H⋯Cl hydrogen bonds. The crystal packing is also influenced by inter-molecular π-π stacking inter-actions between identical anti-parallel organic cations with a face-to-face distance of ca 3.52 Å.

The title compound, C(12)H(19)N(2) (+)·Cl(-)·H(2)O, contains a network of 4-(2,3-dimethyl-phen-yl)piperazin-1-ium cations, water mol-ecules and chloride anions. The crystal packing is influenced by O-H⋯Cl, N-H⋯Cl, N-H⋯O, C-H⋯O and C-H⋯Cl hydrogen bonds, resulting in structure with an open-framework architecture.

In the crystal structure of the title compound, (C(10)H(15)ClN(2))[ZnCl(4)]·H(2)O, the Zn atom is coordinated by four Cl atoms in a tetrahedral geometry. The water mol-ecules and the 1-(4-chloro-phen-yl)piperazine-1,4-diium cations inter-act with the [ZnCl(4)](2-) anions through O-H⋯Cl, N-H⋯Cl, N-H⋯O and C-H⋯Cl hydrogen bonds (five simple and one bifurcated). Inter-molecular π-π stacking inter-actions are present between adjacent aromatic rings of 1-(4-chloro-phenyl)-piperazine-1,4-diium cations (the centroid-centroid distance is 3.453 Å).

The Script Concordance Test (SCT) assesses reasoning in the context of uncertainty. Because there is no single correct answer, scoring is based on the comparison of answers provided by examinees with those provided by members of a reference panel made up of experienced practitioners. The study aimed to assess the discriminatory power of the SCT based on the variability of the reference panel's answers. Items from a bank covering different family medicine domains were classified into 3 groups according to the degree of variability of answers provided by a pool of experienced doctors. A variability index (mean squared error) was used to select items in the low, moderate and high variability categories. A 102-item test (Cronbach's alpha 0.70), made up of 3 subtests of each category, was administered to 3 contrasting groups in family medicine: 157 clerkship students, 30 residents and 30 practising doctors. anova and effect size (ES) were used to quantify and test the discrimination power of the 3 subtests. The high variability subtest showed high effect size for discrimination between extreme groups (ES = 1.5; F = 16.3, P < 0.001), whereas the moderate variability subtest showed less effect size (ES = 0.56; F = 57, P = 0.041). The low variability subtest did not discriminate significantly (ES = 0.31; F = 2.9, P = 0.06). Variability of answers within the reference panel is a key component of the discriminatory power of the SCT. In accordance with theory, the presence of variability ensures discrimination between levels of clinical experience. These results imply important considerations for the construction of efficient SCTs.

Hürthle cell-predominant thyroid fine needle aspirations (FNA) are encountered frequently in routine practice, yet they are often challenging to diagnose accurately and are associated with significant interobserver variability. This is largely due to the ubiquity of Hürthle cells in thyroid pathology, ranging from nonneoplastic conditions to aggressive malignancies. Although limitations in cytomorphologic diagnoses likely will remain for the foreseeable future, our knowledge of the molecular pathogenesis of Hürthle cell neoplasia and application of molecular testing to cytologic material have increased dramatically within the past decade. This review provides context behind the challenges in diagnosis of Hürthle cell lesions and summarizes the more recent advances in diagnostic tools., (© 2020 American Cancer Society.)

Background: Morphologic and genetic analysis of thyroid nodules may be performed from a single vial. Preanalytic variables that affect nucleic acid extracted from a single vial are evaluated., Methods: Thyroid fine-needle aspiration (FNA) specimens collected in CytoLyt were evaluated. A ThinPrep slide was prepared. Extracted nucleic acids were analyzed using Oncomine Comprehensive Panel, version 2, after Ion AmpliSeq library preparation. A pathologist and a cytotechnologist enumerated specimen cellularity., Results: Fifty-six samples were collected from 55 nodules in 53 patients. Bethesda category correlated with cellularity (P = .01), and storage time (median, 43 days; range, 7-77 days) was longer for specimens in categories II and III than for those in categories IV and VI (P = .01). The mean specimen DNA concentration was 4.5 ng/µL (range, 0-23.8 ng/µL), and 25 (45%) had concentrations >3.3 ng/µL. The mean specimen RNA concentration was 4.8 ng/µL (range, 0-42.4 ng/µL), and 31 (55%) had concentrations >1.4 ng/µL. Nucleic acid quantity increased with epithelial cellularity. Storage time weakly correlated with the quantity of extracted DNA, independent of cellularity, but not extracted RNA. Greater proportions of cell-free DNA and lesser proportions of long, intact RNA fragments were extracted from a subset of samples with longer storage time. Among 15 single nucleotide variants, the median mutant allelic fraction was 15.1%. One false-negative result was identified. Five specimens subsequently determined to harbor a genetic alteration failed quality metrics., Conclusions: Cellularity and storage time affect the quantity and quality of nucleic acid extracted from thyroid FNA specimens collected in CytoLyt. Further investigation will serve to quantify the magnitude of such effects and to elucidate other contributing factors., (© 2020 American Cancer Society.)

There is a narrow window of opportunity between surgical scheduling and the operative date to optimize patients for an elective surgical procedure. Traditionally, preoperative care has involved extended routine testing batteries with intermittent referrals for medical clearance. These traditions are costly, inefficient, and yield no clear reduction in perioperative morbidity and mortality. Evidence, which has evolved over the past decade, suggests that optimal preoperative care requires a patient-centric, personalized, and often multidisciplinary approach. We present an up-to-date overview of this literature with a focus on the otolaryngologic surgical population. An algorithmic approach to preoperative patient assessment is also proposed in hopes of both optimizing patient outcome and streamlining routine clinical workflow. Laryngoscope, 130:38-44, 2020., (© 2019 The American Laryngological, Rhinological and Otological Society, Inc.)