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Purpose of Review There is a paucity of peer-reviewed evidence to guide medical management of stuttering priapism. The purpose of this review is to summarize the current understanding regarding the pathophysiology of priapism and management options for stuttering priapism. Recent Findings Conducting large-scale, randomized, placebo-controlled trials that elucidate the optimal treatment of stuttering priapism is challenging. Therefore, recent treatment guidelines are based upon small case series, retrospective studies, and expert opinions. Nonetheless, multiple compounds from various drug classes have shown promise in treating stuttering priapism, and a few pharmacotherapies such as Crizanlizumab are currently under active investigation. Summary Stuttering priapism is an under-investigated disorder with a complex pathophysiology. Currently, there is no wildly adopted universal therapeutic strategy. Further research is warranted to identify the appropriate treatment of stuttering priapism and to determine the long-term side effects of current pharmacotherapies.

OBJECTIVE/HYPOTHESIS To assess and characterize online ratings and comments on pediatric otolaryngologists and determine factors that correlate with higher ratings. STUDY DESIGN Online database analysis. METHODS All American Society of Pediatric Otolaryngology (ASPO) members were queried on Healthgrades, Vitals, RateMDs, and Yelp for their online ratings and comments as of June 2020. Ratings were normalized for comparison on a five-point Likert scale. All comments were categorized based on context and positive or negative quality. RESULTS Of the 561 ASPO members, 489 (87%) were rated on at least one online platform. Of those rated, 410 (84%) were on Healthgrades, 429 (88%) on Vitals, 236 (48%) on RateMDs, and 72 (15%) on Yelp. Across all platforms, the average overall rating was 4.13 ± 0.03 (range, 1.00-5.00). We found significant positive correlations between overall ratings and specific ratings (P

OBJECTIVES: To investigate the clinical presentation, treatment breakdown, and overall survival (OS) outcomes of patients with NF2-associated bilateral vestibular schwannoma (NVS). METHODS: The 2004–2016 National Cancer Database was queried for patients with a diagnosis of VS. The “Laterality” code was utilized to stratify patients into sporadic unilateral vestibular schwannoma (UVS) and NVS. RESULTS: Of the 33,839 patients with VS, 155 (0.46%) were coded for NVS with an average age and tumor size of 37.4±20.5 years and 23.5±18.2 mm. Patients underwent observation (45.3%), surgery (29.3%), and radiotherapy (20.0%), and had a 5.8% 5-year mortality rate. Compared to UVS, NVS was negatively associated with receiving surgery (40.2% vs. 29.3%, p=0.02) while watchful observation was more prevalent (30.1% vs. 45.3%, p=0.001). In NVS, undergoing surgery was associated with larger tumor size (34.5±21.2 vs. 17.8±13.3 mm, p=0.001) and shorter diagnosis-to-treatment time (49.1±60.6 vs. 87.0±78.5 days, p=0.02), radiotherapy was associated with older age (44.4±18.9 vs. 35.2±20.6 years, p=0.02) and longer diagnosis-to-treatment time (85.9±77.9 vs. 53.9±65.5 days, p=0.04), and observation was associated with smaller tumor size (17.8±15.9 vs. 28.0±19.2 mm, p=0.01). Kaplan-Meier log-rank analysis demonstrated similar 10-year OS between NVS and UVS patients (p=0.58) without factoring the earlier age of presentation. Furthermore, there were no temporal changes in presentation/management of NVS, and OS was not dependent on the received treatment (p=0.30). CONCLUSIONS: This is the first study utilizing a national cancer database to investigate a large NVS cohort. With younger age, larger tumors, and more conservative management, NVS’s OS was not treatment-dependent and was similar to sporadic UVS, though the latter should not be interpreted as similar life expectancies due to the much earlier presentation.

SUMMARY Atrophy of neurons in the prefrontal cortex (PFC) plays a key role in the pathophysiology of depression and related disorders. The ability to promote both structural and functional plasticity in the PFC has been hypothesized to underlie the fast-acting antidepressant properties of the dissociative anesthetic ketamine. Here, we report that, like ketamine, serotonergic psychedelics are capable of robustly increasing neuritogenesis and/or spinogenesis both in vitro and in vivo. These changes in neuronal structure are accompanied by increased synapse number and function, as measured by fluorescence microscopy and electrophysiology. The structural changes induced by psychedelics appear to result from stimulation of the TrkB, mTOR, and 5-HT2A signaling pathways and could possibly explain the clinical effectiveness of these compounds. Our results underscore the therapeutic potential of psychedelics and, importantly, identify several lead scaffolds for medicinal chemistry efforts focused on developing plasticity-promoting compounds as safe, effective, and fast-acting treatments for depression and related disorders., In Brief Ly et al. demonstrate that psychedelic compounds such as LSD, DMT, and DOI increase dendritic arbor complexity, promote dendritic spine growth, and stimulate synapse formation. These cellular effects are similar to those produced by the fast-acting antidepressant ketamine and highlight the potential of psychedelics for treating depression and related disorders.

ObjectiveTo evaluate whether increased body mass index (BMI), age, or frailty influence vestibular schwannoma (VS) short-term surgical morbidity.MethodsThe 2005-2017 National Surgical Quality Improvement Program database was queried for patients with VS undergoing surgical resection. Age was stratified according to age