Laryngeal sensory neuropathy in patients with diabetes mellitus

Assessment of the obesity based on voice perception

Human voice is an extremely important biological signal which contains information about sex, age, emotional state, health and physical features of a speaker. Estimating a physical appearance from a vocal cue can be an important asset for sciences including forensics and dietetics. Although there have been several studies focused on the relationships between vocal parameters and ratings of height, weight, age and musculature of a speaker, to our knowledge, there has not been a study examining the assessment of one’s BMI based on voice alone. The purpose of the current study was to determine the ability of female “Judges” to evaluate speakers’ (men and women) obesity and body fat distribution from their vocal cues. It has also been checked which voice parameters are key vocal cues in this assessment. The study material consisted of 12 adult speakers’ (6 women) voice recordings assessed by 87 “Judges” based on a 5-point graphic scale presenting body fat level and distribution (separately for men and women). For each speaker body height, weight, BMI, Visceral Fat Level (VFL, InBody 270) and acoustic parameters were measured. In addition, the accuracy of BMI category was verified. This study also aimed to determine which vocal parameters were cues for the assessment for men and women. To achieve it, two independent experiments were conducted: I: “Judges” had to choose one (obese) speaker from 3 voices (in 4 series); II: they were asked to rate body fat level of the same 12 speakers based on 5-point graphic scale. Obese speakers (i.e., BMI above 30) were selected correctly with the accuracy greater than predicted by chance (experiment I). By using a graphic scale, our study found that speakers exhibiting higher BMI were rated as fatter (experiment II). For male speakers the most important vocal predictors of the BMI were harmonics-to-noise ratio (HNR) and formant dispersion (Df); for women: formant spacing (Pf) and intensity (loudness). Human voice contains information about one’s increased BMI level which are hidden in some vocal cues.

Voice changes in reproductive disorders, thyroid disorders and diabetes: a review

The subject of vocal changes accompanying pathological conditions, although still not well explored, seems to be promising. The discovery of laryngeal receptors for sex hormones and thyroid hormones can strongly support the hypothesis of changes in voice due to various endocrinopathies. On the other hand, the impairment of the proper function of the vocal apparatus can also be caused in the process of the microvasculature complications of diabetes mellitus. This review was a comprehensive summary of the accessible literature concerning the influence of selected endocrinopathies on subjective and objective voice parameters. We analysed a total number of 16 English-language research papers from the PubMed database, released between 2008 and 2021, describing vocal changes in reproductive disorders such as polycystic ovary syndrome and congenital adrenal hyperplasia, thyroid disorders in shape of hypo- or hyperthyroidism and type 2 diabetes mellitus. The vast majority of the analysed articles proved some changes in voice in all mentioned conditions, although the detailed affected vocal parameters frequently differed between research. We assume that the main cause of the observed conflicting results might stem from non-homogeneous methodology designs of the analysed studies.

Perspectives on neuroinflammation contributing to chronic cough

Chronic cough can be a troublesome clinical problem. Current thinking is that increased activity and/or enhanced sensitivity of the peripheral and central neural pathways mediates chronic cough via processes similar to those associated with the development of chronic pain. While inflammation is widely thought to be involved in the development of chronic cough, the true mechanisms causing altered neural activity and sensitisation remain largely unknown. In this back-to-basics perspective article we explore evidence that inflammation in chronic cough may, at least in part, involve neuroinflammation orchestrated by glial cells of the nervous system. We summarise the extensive evidence for the role of both peripheral and central glial cells in chronic pain, and hypothesise that the commonalities between pain and cough pathogenesis and clinical presentation warrant investigations into the neuroinflammatory mechanisms that contribute to chronic cough. We open the debate that glial cells may represent an underappreciated therapeutic target for controlling troublesome cough in disease.

Thyroidectomy Complications in Patients with Diabetes Mellitus

Objective

To (1) analyze postoperative thyroidectomy outcomes in patients with diabetes mellitus (DM), who are prone to deleterious effects of glucose dysmetabolism, and (2) apply findings to optimize perioperative management of diabetics requiring thyroid surgery.

Study Design

Retrospective database analysis.

Setting

University hospital.

Subjects and Methods

The National Inpatient Sample was queried using International Classification of Diseases, Ninth Revision, Clinical Modification and Procedure Coding System (PCS) codes for patients with benign or malignant thyroid disease who underwent thyroid surgery between 2002 and 2013. An analysis of demographics, comorbidities, and postoperative outcomes was conducted between a DM vs non-DM cohort using bivariate and multivariate techniques.

Results

In total, 103,842 cases met inclusion criteria; 14.2% were diabetics. Diabetics had significantly higher rates of baseline comorbid chronic pulmonary disease, hypertension, obesity, and anemia. Following thyroidectomy, patients with DM were more likely to have vocal cord paresis or paralysis compared to non-DM patients (2.0% vs 1.3%; P < .001). However, when adjusting for demographics and comorbidities, there was no significant difference in this complication between the 2 groups. Diabetics had independently higher rates of cardiac, pulmonary, and urinary complications, as well as transfusion, reintubation, and in-hospital mortality. Diabetics had longer hospital stays (2.76 vs 1.97; P < .001) with higher incurred hospital charges (32,921 vs 25,198; P < .001).

Conclusion

Although DM often confers metabolic and ischemic derangements secondary to hyperglycemia such as neuropathy, this comorbidity was not independently associated with higher rates of vocal cord paresis or paralysis following thyroid surgery. However, DM predicted other adverse outcomes, including greater cardiac, pulmonary, and urinary complications, as well as transfusion, reintubation, and in-hospital mortality.