The Impact of Socioeconomic Status on Voice Outcomes in Patients With Spasmodic Dysphonia Treated With Botulinum Toxin Injections

2019 ◽  
Vol 128 (4) ◽  
pp. 316-322 ◽  
Author(s):  
Dianne Valenzuela ◽  
Joel Singer ◽  
Terry Lee ◽  
Amanda Hu
Keyword(s):  
Socioeconomic Status ◽  
Botulinum Toxin ◽  
Household Income ◽  
Spasmodic Dysphonia ◽  
Median Household Income ◽  
Botulinum Toxin Injections ◽  
The Impact ◽  
The Voice ◽  
Professional Voice ◽  
Validated Instrument

Objectives: To determine the impact of socioeconomic status (SES) on voice outcomes for spasmodic dysphonia (SD) patients treated with botulinum toxin injections. Methods: This was a prospective cross-sectional study in a tertiary care, academic voice clinic in Canada. Adult SD patients returning to the voice clinic for their botulinum toxin injections were recruited from October 2017 to April 2018. Patients completed a questionnaire on demographic data, the Hollingshead Four-Factor Index for socioeconomic status (validated instrument based on education, occupation, gender, and marital status), and the Voice-Handicap Index 10 (VHI-10) (validated instrument on self-reported vocal handicap). Primary outcome was the association between VHI-10 and Hollingshead Index. Secondary variables were median household income by postal code, duration of disease, gender, age, and professional voice user. Descriptive statistics and multiple linear regression were conducted. Results: One hundred and one patients (age = 62.8 ± 13.7 years, 20.8% male) were recruited with VHI-10 of 22.1 ± 8.1 (out of 40) and Hollingshead Index of 46.3 ± 11.7 (range, 8-66). Median household income was $75 875 ± $16 393, which was above the Canadian average of $70 336. About 91.1% were Caucasian, 54.4% had university degree, 86.1% spoke English, and 43.5% were employed. In multiple linear regression, there was mild to moderate negative correlation (r = −.292, P = .004) between VHI-10 and Hollingshead Index when controlling for disease duration, age, gender, and professional voice use. Conclusion: SD patients treated with botulinum toxin were mostly affluent, Caucasian, well educated, and English speakers. Lower self-perceived vocal handicap was associated with higher socioeconomic status.

scholarly journals Treatment Efficacy of Electromyography versus Fiberscopy-Guided Botulinum Toxin Injection in Adductor Spasmodic Dysphonia Patients: A Prospective Comparative Study

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Jae Wook Kim ◽  
Jae Hong Park ◽  
Ki Nam Park ◽  
Seung Won Lee
Keyword(s):  
Botulinum Toxin ◽  
Treatment Efficacy ◽  
Botulinum Toxin Injection ◽  
Spasmodic Dysphonia ◽  
Total Dosage ◽  
Adductor Spasmodic Dysphonia ◽  
Prospective Comparative Study ◽  
The Mean ◽  
Botulinum Toxin Injections ◽  
The Voice

Introduction. This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group) and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group).Methods. Thirty patients with adductor spasmodic dysphonia (ADSD), who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. We assessed acoustic and aerodynamic voice parameters, and the voice handicap index (VHI) before injection and at 1, 3, and 6 months after injection.Results. The mean total dosage of botulinum toxin was similar for both groups: 1.7 ± 0.5 U for the EMG group and 1.8 ± 0.4 U for the fiberscopy group (P>0.05). There were no significant differences in outcomes between the two groups in either the duration of effectiveness or complications such as breathy voice and aspiration.Conclusion. Botulinum toxin injection under fiberscopic guidance is a viable alternative to EMG-guided botulinum toxin injection for the treatment of adductor spasmodic dysphonia when EMG equipment is unavailable.

The impact of long-term botulinum toxin injections on symptom severity in patients with spasmodic dysphonia

2004 ◽  
Vol 18 (3) ◽  
pp. 415-422 ◽  
Author(s):  
John F. Damrose ◽  
Stephen N. Goldman ◽  
Erik J. Groessl ◽  
Lisa A. Orloff
Keyword(s):  
Botulinum Toxin ◽  
Symptom Severity ◽  
Spasmodic Dysphonia ◽  
Botulinum Toxin Injections ◽  
The Impact

Abstract P142: The Impact of Regional Socioeconomic Status on Stroke Center Certification in the Northeastern United States

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Emily Chapman ◽  
Kurt Yaeger ◽  
J D Mocco
Keyword(s):  
United States ◽  
Socioeconomic Status ◽  
Household Income ◽  
Stroke Care ◽  
Median Household Income ◽  
Northeastern United States ◽  
Stroke Incidence ◽  
The Impact ◽  
The Relationship ◽  
The U.S

Introduction: The northeastern United States has been a national leader in stroke healthcare delivery. The current roster of designated comprehensive, primary, thrombectomy-capable and acute stroke ready centers is the result of respective state initiatives. Access to certified stroke centers (SCs) varies by county as states have widely varied certification processes and typically rely on certifying organizations (COs) to identify stroke centers. Previous research has found an association at the national level between likelihood of stroke certification and local socioeconomic status. Objective: This study describes the relationship between socioeconomic status of patient populations in the Northeast U.S. and their access to quality stroke care by comparing median household income and wealth in counties with and without certified SCs. Methods: Population and median household income for 218 counties in Connecticut, Delaware, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont were collected from the U.S. Census (2010), stroke epidemiological data were collected from the Center for Disease Control, and Area Deprivation Index (ADI) data (ranked within the U.S.) were collected from the Neighborhood Atlas, a project that quantifies disadvantage. Median household income has been used to quantify local population wealth and ADI to analyze community health risks. Certification data were mined from quality check databases for The Joint Commission and Det Norske Veritas, the most commonly used COs, and yielded 259 certified centers. Linear regression characterized the relationship between income and ADI with number of certified SCs, stroke incidence and stroke mortality. Results: Higher income (p<0.001) and lower ADI (p<0.001) were associated with having more certified SCs (p<0.001). Counties with a higher stroke incidence had significantly more certified SCs (p=0.01). Conclusions: Throughout the counties of the Northeastern U.S., access to quality stroke care depends on local wealth and resources. At the same time, the current analysis indicates that SC certification distribution does appear to correlate to those counties where stroke incidence is highest.

Abstract 20: Patterns of Stroke Center Certification and the Impact on Stroke Mortality in Counties of New York State

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Emily Chapman ◽  
Kurt A Yaeger ◽  
J D Mocco
Keyword(s):  
New York ◽  
Socioeconomic Status ◽  
Household Income ◽  
New York State ◽  
Stroke Care ◽  
Stroke Mortality ◽  
Median Household Income ◽  
Stroke Incidence ◽  
York State ◽  
The Relationship

Introduction: To establish a statewide stroke system in March 2019, New York State (NYS) created the Stroke Designation Program. Stroke centers (SCs) must be certified by a state-approved certifying organization (CO), which is tasked with initial designation and ongoing re-certification. Previous research has found an association at the national level between socioeconomic status and access to higher levels of acute stroke care. Objective: This study characterizes the relationship between socioeconomic status of NYS populations and stroke care level access by comparing median household income and wealth in counties with and without certified SCs. Methods: Population and median household income from the U.S. Census (2010), stroke epidemiological data from the Center for Disease Control, and Area Deprivation Index (ADI) data (ranked within NYS) from the Neighborhood Atlas, a project that quantifies disadvantage by census tract, were collected and averaged for each county. Income has been used to assess local wealth and ADI to analyze community health risks. Certification data were mined from quality check databases for The Joint Commission and Det Norske Veritas, the most commonly used COs. Student’s t-tests compared income and ADI in counties with at least one certified SC to those without. Linear regression characterized the relationship between income and ADI with number of certified SCs, stroke incidence and stroke mortality. Results: All 62 counties in NYS were investigated to yield 40 certified SCs. Counties with at least one certified SC had a significantly higher income ($68,183.63 vs. $57,155.12; p=0.03) and lower ADI (5.90 vs. 7.37; p=0.004) compared to counties with no certified SC. Higher income (p<0.001) and lower ADI (p<0.001) were also associated with more certified SCs. Counties with fewer certified SCs had significantly higher stroke mortality (p<0.001) despite having similar stroke incidence. Conclusion: Socioeconomic heterogeneity in NYS counties is correlated to differential access to certified SCs and quality stroke care, as fewer centers are found in lower-income and disadvantaged communities. Although populations with less access experience stroke at similar rates, this study finds higher death rates in these counties.

The Impact of Upper Face Botulinum Toxin Injections on Eyebrow Height and Forehead Lines

2018 ◽  
Vol 142 (5) ◽  
pp. 1212-1217 ◽  
Author(s):  
Samer F. Jabbour ◽  
Cyril J. Awaida ◽  
Joseph S. ElKhoury ◽  
Youssef A. Rayess ◽  
Rani B. Makhoul ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Upper Face ◽  
Botulinum Toxin Injections ◽  
The Impact

Correlating Geographic Location with Incidence of Motor Vehicle–Induced Pedestrian Injury

2018 ◽  
Vol 84 (6) ◽  
pp. 1049-1053 ◽  
Author(s):  
Neal Bhutiani ◽  
Keith R. Miller ◽  
Matthew V. Benns ◽  
Nicholas A. Nash ◽  
Glen A. Franklin ◽  
...  
Keyword(s):  
Household Income ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Multivariable Analysis ◽  
Geographic Location ◽  
Motor Vehicles ◽  
Median Household Income ◽  
Risk Of Death ◽  
Pedestrian Injury ◽  
The Impact

To date, no studies have examined the relationship between geographic and socioeconomic factors and the frequency of pedestrians sustaining traumatic injuries from a motor vehicle. The objective of this study was to analyze the impact of location on the frequency of pedestrian injury by motor vehicle. The University of Louisville Trauma Registry was queried for patients who had been struck by a motor vehicle from 2010 to 2015. Demographic and injury information as well as outcome measures were evaluated to identify those impacting risk of pedestrian versus motor vehicle accidents. Number of incidents was correlated with lower median household income. There was also a moderate correlation between the number of incidents and population density. Multivariable analysis demonstrated a significant association between increased median household income and distance from downtown Louisville and decreased risk of death following pedestrian versus motor vehicle accident. Incidence of pedestrian injury by motor vehicles is influenced by regional socioeconomic status. Efforts to decrease the frequency of these events should include further investigation into the mechanisms underpinning this relationship.

scholarly journals Safety of Simultaneous Bilateral Botulinum Toxin Injections for Abductor Spasmodic Dysphonia

2005 ◽  
Vol 131 (9) ◽  
pp. 793 ◽  
Author(s):  
Benjamin C. Stong ◽  
John M. DelGaudio ◽  
Edie R. Hapner ◽  
Michael M. Johns
Keyword(s):  
Botulinum Toxin ◽  
Spasmodic Dysphonia ◽  
Botulinum Toxin Injections

Longitudinal Phonatory Characteristics After Botulinum Toxin Type A Injection

1996 ◽  
Vol 39 (5) ◽  
pp. 968-980 ◽  
Author(s):  
Kimberly V. Fisher ◽  
Ronald C. Scherer ◽  
Chwen G. Guo ◽  
Ann S. Owen
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Spasmodic Dysphonia ◽  
Adductor Spasmodic Dysphonia ◽  
Wide Range ◽  
Glottal Flow ◽  
Vocal Quality ◽  
The Voice

Following Botulinum Toxin Type A injection, glottal competency of an adductor spasmodic dysphonia patient is thought to vary over a wide range. This study quantifies variability in laryngeal adduction for one such patient over a 10-week period. Analyses of kinematic and aerodynamic measures were used to track the voice weekly. The measures included the electroglottographic waveform width (EGGW50), nondimensional electroglottographic slope quotient (SLQ), glottal flow open quotient (FOQ), dc glottal flow, and nondimensional glottal flow peak quotient (FPQ). The results suggested that change in degree of glottal adduction over time can be observed even when vocal instability is present within each recording session. Perceptual ratings of vocal quality (breathy to pressed) were related to the laryngeal measures. The coefficient of variation for EGGW50 and the percentage of dichrotic phonations reached minima during sessions with predominantly breathy and hypoadducted phonation. The methods used in this study show potential to aid decisions about dose level and sources of perceptual adductor spasmodic dysphonia symptoms for a given patient.

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