Occupational Voice Disorders in Slovakia Today and in the Past

Abstract Introduction: Voice disorders primarily affect workers in professions with increased voice demands, such as teaching personnel in educational system, singers, lecturers, actors or managers. Severe voice disorders often require a permanent change of work position. Methods: Retrospective analysis of a set of patients with occupational voice disorders who were hospitalized at the Clinic of Occupational Medicine and Toxicology, Martin University Hospital (COMaT, MUH) in the years of 2000–2017. Comparison of the data obtained with the National Centre of Medical Information (NCMI) data on the occurrence of occupational voice disorders throughout the Slovak Republic (SR). Comparison with the retrospective analysis of reported occupational voice disorders in the years of 1967-1996. Case report of a patient with an occupational voice disorder. Results: We point to a long-term low incidence of occupational voice disorders. In the years of 2000-2017, 24 cases of occupational voice disorders were reported in Slovakia, of which 20 cases were reported under item 42-1 and 4 cases under item 42-2 in the List of Occupational Diseases. Through the COMaT, MUH 11 cases of occupational voice disorders were reported during these years, of which 9 cases were listed under item 42-1 and 2 cases under item 42-2. From 1967 to 1996 there were 52 occupational voice disorders reported in Slovakia, of which 45 were under item 42-1 and 7 under item 42-2. Conclusions: As there is a tendency to underestimate the voice difficulties among teaching staff, it is necessary to provide better information about the possible consequences, prevention, and treatment of these diseases. All of this should be in the competency of occupational health services.

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Multiple Perspectives on the Barriers to Identification and Management of Pediatric Voice Disorders

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp2.sig3.49 ◽

2017 ◽

Vol 2 (3) ◽

pp. 49-56

Author(s):

Jana Childes ◽

Alissa Acker ◽

Dana Collins

Keyword(s):

Academic Success ◽

Voice Disorders ◽

School Personnel ◽

Voice Disorder ◽

Multiple Perspectives ◽

Vocal Qualities ◽

High Prevalence ◽

Pediatric Populations ◽

Low Incidence ◽

University Settings

Pediatric voice disorders are typically a low-incidence population in the average caseload of clinicians working within school and general clinic settings. This occurs despite evidence of a fairly high prevalence of childhood voice disorders and the multiple impacts the voice disorder may have on a child's social development, the perception of the child by others, and the child's academic success. There are multiple barriers that affect the identification of children with abnormal vocal qualities and their access to services. These include: the reliance on school personnel, the ability of parents and caretakers to identify abnormal vocal qualities and signs of misuse, the access to specialized medical services for appropriate diagnosis, and treatment planning and issues related to the Speech-Language Pathologists' perception of their skills and competence regarding voice management for pediatric populations. These barriers and possible solutions to them are discussed with perspectives from the school, clinic and university settings.

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Treatment Efficacy

Journal of Speech Language and Hearing Research ◽

10.1044/jslhr.4101.s101 ◽

1998 ◽

Vol 41 (1) ◽

Cited By ~ 205

Author(s):

Lorraine Olson Ramig ◽

Katherine Verdolini

Keyword(s):

Medical Treatment ◽

Voice Disorders ◽

Voice Disorder ◽

Future Research ◽

Vocal Health ◽

Physical Conditions ◽

Voice Treatment ◽

Before And After ◽

The Voice

This article reviews the literature on the efficacy of treatment for voice disorders primarily using studies published in peer-reviewed journals. Voice disorders are defined, their frequency of occurrence across the life span is reported, and their impact on the lives of individuals with voice disorders is documented. The goal of voice treatment is to maximize vocal effectiveness given the existing disorder and to reduce the handicapping effect of the voice problem. Voice treatment may be (a) the preferred treatment to resolve the voice disorder when medical (surgical or pharmacological) treatments are not indicated; (b) the initial treatment in cases where medical treatment appears indicated; it may obviate the need for medical treatment; (c) completed before and after surgical treatment to maximize long-term post-surgical voice; and (d) a preventative treatment to preserve vocal health. Experimental and clinical data are reviewed that support these roles applied to various disorder types: (a) vocal misuse, hyperfunction and muscular imbalance (frequently resulting in edema, vocal nodules, polyps or contact ulcers); (b) medical or physical conditions (e.g., laryngeal nerve trauma, Parkinson disease); and (c) psychogenic disorders (e.g., conversion reactions, personality disorders). Directions for future research are suggested which maximize clinical outcomes and scientific rigor to enhance knowledge on the efficacy of voice treatment.

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Long-term outcomes of 0.1% tacrolimus eye drops in eyes with severe allergic conjunctival diseases

Allergy Asthma & Clinical Immunology ◽

10.1186/s13223-021-00513-w ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Hiroyuki Yazu ◽

Kazumi Fukagawa ◽

Eisuke Shimizu ◽

Yasunori Sato ◽

Hiroshi Fujishima

Keyword(s):

Medical Information ◽

Clinical Signs ◽

University Hospital ◽

Vernal Keratoconjunctivitis ◽

Bulbar Conjunctiva ◽

Eye Drops ◽

Long Term Outcomes ◽

Long Term Treatment ◽

Significant Difference

Abstract Background Because atopic dermatitis does not heal completely, associated severe atopic keratoconjunctivitis (AKC) and vernal keratoconjunctivitis (VKC) often require long-term treatment. This study aims to evaluate the long-term outcomes of using 0.1% tacrolimus eye drops to treat these severe allergic conjunctival diseases. Methods Two-hundred-and-seventy eyes of 135 patients diagnosed with AKC or VKC from April 2004 to April 2014 were screened retrospectively. Patient demographics and objective signs were extracted from the electronic medical records. The severity of 10 objective signs, related to the palpebral and bulbar conjunctiva, limbus, and cornea, and intraocular pressure (IOP) were observed at baseline, at 2 weeks, 1, 2, 3, 6, and 12 months after starting treatment, and every 1 year thereafter (average use period: 8.4 ± 2.9 years). Safety was evaluated based on the incidence and severity of adverse events. Results 12 patients (AKC; 7 cases, VKC; 5 cases) who were treated with 0.1% tacrolimus eye drops were enrolled in this study. The total score of clinical signs significantly decreased after 2 weeks and remained effective thereafter. Tacrolimus eye drops elicited a statistically significant difference in the mean total clinical scores and IOP over the course of treatment (P < 0.001). Elevated IOP was observed in 2 cases and corneal infection in 1 case; these effects were completely controlled with medication. Conclusions Topical tacrolimus may provide effective and long-term improvement in clinical signs of severe AKC and VKC cases that refractory to standard conventional treatment. Trial registration: University Hospital Medical Information Network (UMIN) 000034460.

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Long-term outcomes of antibiotic combination therapy for ulcerative colitis

Therapeutic Advances in Chronic Disease ◽

10.1177/20406223211028790 ◽

2021 ◽

Vol 12 ◽

pp. 204062232110287

Author(s):

Yuriko Nishikawa ◽

Nobuhiro Sato ◽

Shintaro Tsukinaga ◽

Kan Uchiyama ◽

Shigeo Koido ◽

...

Keyword(s):

Ulcerative Colitis ◽

Side Effects ◽

Adverse Events ◽

Medical Information ◽

Compliance Rate ◽

University Hospital ◽

Open Label ◽

Antibiotic Combination

Aims: An antibiotic combination of amoxicillin, tetracycline and metronidazole (ATM) is effective for ulcerative colitis (UC), but this regimen is discontinued in some cases due to adverse events. This study aimed to assess a revised combination, namely, amoxicillin, fosfomycin and metronidazole (AFM), in UC patients with the goal of reducing side effects while maintaining therapeutic efficacy. Methods: A prospective open-label trial was undertaken in 104 adult UC patients. A combination of oral amoxicillin (1500 mg), fosfomycin (3000 mg) and metronidazole (750 mg) was administered to patients daily for 2–4 weeks in addition to their conventional medication. Clinical assessment was performed using the Lichtiger index before treatment and at 0, 3, 6, 9 and 12 months and 2 and 3 years. Endoscopic evaluation was performed using the Mayo score before treatment and at 3 and 12 months. Results: The compliance rate was 99.2%. Response and remission rates were 80.8% and 63.5% at completion, 73.1% and 64.4% at 3 months, and 39.4% for both at 12 months, respectively. Of the 41 patients who were in remission at 12 months, 63.4% maintained that status until the 2-year follow-up. Similarly, 69.2% of those in remission at 2 years remained relapse free at the 3-year follow-up. Side effects were observed in 44.2% of the participants. Fever occurred in one patient (1.0%), which was lower than the rate observed with ATM therapy. Conclusion: These results indicate that AFM therapy induces remission and is appropriate for long-term maintenance of UC while producing fewer and milder adverse events than ATM therapy. Clinical trials: This study was registered in the University Hospital Medical Information Network (No. R000046546).

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Gut Microbiota Changes During Helicobacter Pylori Eradication with Vonoprazan-Containing Triple Therapy Among Adolescents: A Prospective Multicenter Study in Japan

10.21203/rs.3.rs-37210/v1 ◽

2020 ◽

Author(s):

Toshihiko kakiuchi ◽

Kentaroh Yamamoto ◽

Ichiro Imamura ◽

Kazutoshi Hashiguchi ◽

Hiroharu Kawakubo ◽

...

Keyword(s):

Helicobacter Pylori ◽

Gut Microbiota ◽

Beta Diversity ◽

Medical Information ◽

Eradication Therapy ◽

Alpha Diversity ◽

University Hospital ◽

Healthy Children ◽

Serious Adverse Events

Abstract Background: Whether the screening and treatment of Helicobacter pylori infection are safe for children is debated in Japan. This study aimed to evaluate the safety of Helicobacter pylori eradication therapy by examining long-term changes in the gut microbiota during therapy among children.Methods: Children with anti-Helicobacter pylori antibody in the urine and Helicobacter pylori antigen in the feces were enrolled in this study. Their stool samples were collected at three time points, which were as follows: prior to treatment, 1–2 days after treatment, and time of judgment of eradication therapy. After treatment, the relative abundance, alpha-diversity, and beta-diversity of the gut microbiota were assessed.Results: In 16 students finally included in the study, the number of Actinobacteria isolated decreased immediately after eradication therapy, and it returned to pretreatment condition at the judgment point. There was no change at the genus level. The alpha-diversity was lost immediately after eradication therapy. However, it recovered at the time of eradication judgment, and it was restored before eradication therapy. Meanwhile, there was no change in beta-diversity, and none of the participants experienced serious adverse events.Conclusion: Helicobacter pylori eradication therapy is safe even for children in the view point of gut microbiota. Thus, further long-term evaluations of changes in the gut microbiota after eradication therapy and an assessment of healthy children without Helicobacter pylori must be performed. These will in turn promote screening and treatment among adolescents to prevent gastric cancer.Trial registration: This study was registered with the University Hospital Medical Information Network Clinical Trials Registry (no. UMIN000028726, https://upload.umin.ac.jp/cgi-bin/ctr_e/ctr_view.cgi?recptno=R000032873) on 18 August 2017.

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A Retrospective Analysis of Our 15-year Experience with Bedside ‘Blind’ Positioning of Long-term Tunneled Groshong® Catheters in the Pre-ultrasound Era

Journal of the Association for Vascular Access ◽

10.2309/java.14-1-6 ◽

2009 ◽

Vol 14 (1) ◽

pp. 32-38 ◽

Cited By ~ 1

Author(s):

Mauro Pittiruti ◽

Marina Malerba ◽

Antonio La Greca ◽

Alessandro Emoli ◽

Lorenzo Nanni ◽

...

Keyword(s):

Parenteral Nutrition ◽

Retrospective Analysis ◽

Operating Room ◽

Pediatric Patients ◽

Jugular Vein ◽

Cost Effective ◽

Lateral Approach ◽

Low Costs ◽

Low Incidence

Abstract Long-term tunneled Groshong catheters have been widely used in our institution since 1987, both in adult and pediatric patients, for different purposes (chemotherapy, parenteral nutrition, etc.). In the period 1987–2003, most of these catheters were inserted adopting the ‘blind’ percutaneous venipuncture of the internal jugular vein, by the so called ‘low lateral’ approach (Jernigan's technique). Also, with the exception of selected pediatric cases, they have been inserted at the bedside, without intra-operative fluoroscopy. A retrospective analysis of 1848 tunneled Groshong catheters inserted at our institution over a 15 year period (1987–2003) showed that this protocol was particularly safe (low incidence of complications) and cost-effective (low costs: limited use of fluoroscopy and the operating room).

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Management of carbapenemase-producing Enterobacteriaceae in a low incidence area: A six-year experience in a university hospital

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2019.149 ◽

2019 ◽

Vol 40 (8) ◽

pp. 936-938 ◽

Cited By ~ 1

Author(s):

Audrey Emery ◽

Audrey Jeanvoine ◽

Pascale Bailly ◽

Houssein Gbaguidi-Haore ◽

Didier Hocquet ◽

...

Keyword(s):

Retrospective Analysis ◽

University Hospital ◽

Large Hospital ◽

Low Incidence

AbstractWe conducted a 6-year retrospective analysis of monitoring of carbapenemase-producing Enterobacteriaceae (CPE) in a large hospital in a low CPE incidence area, and we evaluated the “search and isolate” strategy implemented. In total, 40 CPE isolates were collected from 32 patients, and only 1.4% of contact patients screened were CPE carriers.

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