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This study examines the effect of self-regulated learning strategies on students' multicultural competency development. Quantitative and qualitative data were collected from 26 students who took a semester-long multicultural counseling course. Results show statistically significant improvement in students' multicultural awareness and knowledge and statistical insignificance in multicultural skill development compared to their level of competence before the training. Implications of using this approach to teach multicultural counseling courses and future research are discussed.

This article discusses a case of a rare tumor called glomus tympanicum, which is a benign tumor that arises from cells in the middle ear. The patient in this case presented with severe nosebleeds and various neurological symptoms. The tumor was found to have extended into the nasopharynx and eroded adjacent structures. The patient underwent embolization and surgical resection, resulting in the resolution of symptoms and no evidence of tumor recurrence. This case highlights the importance of early diagnosis and understanding the anatomy of the skull base for effective treatment. [Extracted from the article]

Objective: To characterize migraine pathophysiology, presentation, and current treatment strategies, specifically in regard to vestibulocochlear manifestations of migraine. Methods: Narrative review of available literature. Results: Migraine disorder can be described as a spectrum of otologic manifestations, with vestibular migraine now recognized with fully‐fledged diagnostic criteria. Otologic manifestations are theorized to be due, in part, to trigeminal innervation of the inner ear structures and calcitonin gene‐related peptide (CGRP) expression within the labyrinth. Patients can experience vertigo, aural fullness, enhanced tinnitus, and hearing loss without the characteristic migraine headache, leading to under recognition of these symptoms as migraine‐related. Meniere's disease, mal de débarquement syndrome, persistent postural perceptual dizziness, and recurrent benign paroxysmal positional vertigo have close associations to migraine and may exist on the migraine spectrum. Migraine treatment consists of two goals: halting acute attacks (abortive therapy) and preventing attacks (prophylactic therapy). Abortive medications include triptans, corticosteroids, anti‐histamines, and anti‐emetics. Pharmacologic prophylaxis in conjunction with lifestyle modifications can decrease frequency and severity of symptoms and include tricyclic antidepressants, calcium channel blockers, anti‐epileptic medications, selective serotonin reuptake inhibitors, serotonin‐norepinephrine reuptake inhibitors, beta‐blockers, gepants, and monoclonal antibodies to CGRP. Promising evidence is emerging regarding the ability of migraine medications to positively treat the various otologic symptoms of migraine. Conclusion: Migraine disorder manifesting with primarily cochleovestibular symptoms can be challenging to diagnose and manage for practicing clinicians. Patients with various vestibulopathies that are closely related to migraine may benefit from migraine treatment. Lifestyle choices and prophylactic medications are key to satisfactorily preventing acute migrainous attacks and improve function. [ABSTRACT FROM AUTHOR]

In 2022, Mpox (MPX) has become clinically relevant as otolaryngologists are evaluating this exotic disease process due to its many otolaryngologic manifestations. To characterize our cohort of otolaryngology-relevant MPX confirmed cases. A descriptive case series was performed via retrospective review. Adult patients who underwent inpatient or emergency department otolaryngology consultation at an Emory University-affiliated tertiary care level hospital for MPX were included. Seven patients (age 18–58 years; median 32 years) were identified. All patients were male. Six patients (86%) were black and six patients (86%) were HIV positive with varied immunocompetence. Otolaryngology was consulted for lymphadenopathy (n = 2), pharyngeal involvement (n = 1), and airway evaluation (n = 4). All 6 patients with active MPX developed the classic rash, which developed after oropharyngeal symptoms in 3 patients. Three patients had laryngeal involvement. MPX manifests with symptoms requiring otolaryngology expertise, especially when the airway is involved. Infectious disease consultation is key. Mpox can be identified with a specific constellation of demographic identifiers and physical exam findings, which is key to determining appropriate treatment and protection for the consulting otolaryngologist. This is the first otolaryngologic study of Mpox and first description of Mpox laryngeal involvement. [ABSTRACT FROM AUTHOR]

Introduction: Improved preoperative localization facilitates minimally invasive parathyroidectomy for removal of parathyroid lesions therefore preventing an invasive bilateral neck exploration. As 4D-CT has emerged, its high specificity has helped with preoperative parathyroid lesion localization. A high negative predictive value (NPV) would serve to further confirm parathyroid lesion localization and limit unnecessary surgical exploration. This study's objective was to determine the NPV of preoperative 4D-CT and its facilitation of minimally invasive parathyroidectomy., Methods: A retrospective review was compiled for patients undergoing parathyroidectomy for primary hyperparathyroidism with a preoperative 4D-CT. Included patients were sorted into various groups for comparison: those with 4D-CT localizing to a single lesion, localizing to multiple lesions, and those with nonlocalizing findings; multiple hypercellular parathyroid gland versus single gland findings; extent of surgical exploration; lesion location; and patients with concomitant thyroid nodules. Negative predictive value was calculated and used to quantify the ability for 4D-CT to rule out biochemically significant parathyroid lesions., Results: In our review of 68 patients: sensitivity was 81.3%, specificity was 95.5%, positive predictive value was 87.1%, and negative predictive value was 93.3%. 86% had a single localizing 4D-CT, 7% had a non-localizing 4D-CT, and 7% had a multiple quadrant localizing 4D-CT. NPV for single and multi-localizing 4D-CT were 96.8% and 88.9%, respectively., Conclusion: Preoperative 4D-CT has a high negative predictive value (93.3%), suggesting in the majority of cases, a quadrant with no 4D-CT radiographic findings suspicious for parathyroid is unlikely to harbor biochemically significant parathyroid lesions., (Copyright © 2020 Elsevier Inc. All rights reserved.)