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Kang YJ, Park SY, Chi SA, Chung MK, Jeong HS, Son YI, Choi N. Impact of Dietary Intake and Habits on Subjective Voice and Laryngeal Mucosal Diseases: Analysis From Korean National Health and Nutritional Examination Survey Between 2008 and 2021. J Voice 2024:S0892-1997(24)00141-3. [PMID: 38816300 DOI: 10.1016/j.jvoice.2024.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/16/2024] [Accepted: 04/16/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVES Dysphonia negatively affects social communication, leading to reduced quality of life. Comprehensive research on dysphonia and laryngeal mucosal diseases using large-scale epidemiological data is lacking. Therefore, we investigated how dietary and habitual factors influence dysphonia and laryngeal mucosal diseases using data from the Korean National Health and Nutritional Examination Survey. STUDY DESIGN A population-based cross-sectional study. METHODS The study included individuals aged 19 years and older who both underwent laryngoscopic examinations and completed a dysphonia survey. Dietary and habitual factors and results of the laryngoscopic examinations were collected. Risk factors for dysphonia and laryngeal mucosal diseases were identified. RESULTS The weighted frequency of dysphonia and laryngeal mucosal diseases was 6.4% and 6.0%, respectively. In univariable analyses for dysphonia, sex, body weight change, alcohol ingestion, and various minerals and vitamins showed statistically significant associations. However, in the multivariable analysis, only age, body weight, female sex, and vitamin A intake were significantly associated with dysphonia. Age, body weight, body mass index, sex, smoking, amount of sodium intake, and alcohol intake were associated with laryngeal mucosal diseases in the univariable analyses, but in the multivariable analysis, only age, smoking, and amount of niacin intake were significant factors. CONCLUSIONS In this large-scale epidemiological analysis, subjective dysphonia and laryngeal mucosal diseases had different frequencies and risk factors. Age was a risk factor for both dysphonia and mucosal diseases, but smoking was only a risk factor for laryngeal mucosal diseases. Diet types, calories, and water and alcohol intake were not significant risk factors for either laryngeal mucosal diseases or dysphonia.
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Affiliation(s)
- Yung Jee Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung Yool Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Otorhinolaryngology-Head and Neck Surgery, Inje University, College of Medicine, Busan Paik Hospital, Busan, Republic of Korea
| | - Sang Ah Chi
- Biomedical Statistics Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea; Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Man Ki Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Han-Sin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young-Ik Son
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Nayeon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Pasta A, Pelizzaro F, Marabotto E, Calabrese F, Formisano E, Djahandideh Sheijani S, Brandimarte G, Manes G, Gravina AG, Savarino EV. Patient journey in gastroesophageal reflux disease: real-world perspectives from Italian gastroenterologists, primary care physicians, and ENT specialists. Therap Adv Gastroenterol 2024; 17:17562848241239590. [PMID: 38524789 PMCID: PMC10960349 DOI: 10.1177/17562848241239590] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/28/2024] [Indexed: 03/26/2024] Open
Abstract
Background Gastroesophageal reflux disease (GERD) is a challenging condition that involves different physicians, such as general practitioners (GPs), gastroenterologists, and ears, nose and throat (ENT) specialists. A common approach consists of proton-pump inhibitors (PPIs) administration. Adjunctive pharmacological treatment may have a role in the management of non-responders to PPIs. Objectives We aimed to survey GPs and different medical specialists to investigate the medical approaches to patients reporting GERD symptoms. In addition, we examined the use of adjunctive pharmacological treatments in patients with GERD symptoms who do not respond to PPIs. Design Retrospective observational study. Methods A survey was conducted among a large sample of gastroenterologists, GPs, and ENT specialists. Symptoms were divided into typical and extraesophageal, and their severity and impact on quality of life were explored with the GERD Impact Scale and with Reflux Symptom Index (RSI). All therapies administered usually for GERD were investigated. Results A total of 6211 patients were analyzed in this survey. Patients with typical symptoms were 53.5%, while those with extraesophageal symptoms were 46.5%. The latter were more frequently reported by ENT patients (53.6%, p < 0.0001). The GSI was higher in patients followed by gastroenterologists (9 points) and GPs (9 points) than ENT specialists (8 points), but the RSI was higher in the ENT group (14.3 ± 6.93) than in GPs and gastroenterologist groups (10.36 ± 6.36 and 10.81 ± 7.30, p < 0.0001). Chest pain had the highest negative impact on quality of life (p < 0.0001). Of the 3025 patients who used PPIs, non-responders showed a lower GSI when treated with a combination of adjunctive pharmacological treatments and bioadhesive compounds, than with single-component drugs. Conclusion Patients with GERD referred to a gastroenterologist had more severe disease and poorer quality of life. The combination of adjunctive pharmacological treatments and bioadhesive compounds seems to be effective in the management of PPI refractory patients.
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Affiliation(s)
- Andrea Pasta
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Filippo Pelizzaro
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
- Gastroenterology Unit, Azienda Ospedale Università di Padova, Padova, Italy
| | - Elisa Marabotto
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Francesco Calabrese
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Elena Formisano
- Nutritional Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | | | - Giovanni Brandimarte
- Division of Internal Medicine and Gastroenterology, Cristo Re Hospital, Rome, Italy
| | - Giampiero Manes
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Rho, Italy
| | - Antonietta Gerarda Gravina
- Gastroenterology Unit, Department of Precision Medicine, University of Campania ‘Luigi Vanvitell’, Naples, Italy
- Andrea Pasta; Elisa Marabotto; Francesco Calabrese; Shirin Djahandideh Sheijaniare also affiliated to IRCCS, Policlinico San Martino, Genoa, Italy
| | - Edoardo Vincenzo Savarino
- Department of Surgery, Oncology and Gastroenterology, University of Padua, via Giustiniani 2, Padua 35128, Italy
- Gastroenterology Unit, Azienda Ospedale Università di Padova, Padova, Italy
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Carrillo-Gonzalez A, Camargo-Mendoza M, Cantor-Cutiva LC. Relationship Between Sleep Quality and Stress with Voice Functioning among College Professors: A Systematic Review and Meta-analysis. J Voice 2019; 35:499.e13-499.e21. [PMID: 31866075 DOI: 10.1016/j.jvoice.2019.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/31/2019] [Accepted: 11/04/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Sleeping is the most critical stage in the psychological and somatic recovery process. Sleep deficiency can lead to changes in the breath pattern that might contribute to the appearance and development of voice disorders. Sleep can also compromise the individual's communicative competence. Work-related stress is a risk factor for serious health and mental issues, including voice and sleep disorders. Recovery from stress is fundamental in order to preserve health, wellbeing, and work performance. No systematic review of the literature or meta-analysis concerning this relationship has been performed yet. OBJECTIVE To define the association of voice disorders with sleep quality and stress among teachers. METHODS A systematic review of literature and meta-analysis were performed. Three computerized databases were used to characterize the relationship between voice disorders among teachers with sleep quality and stress. Information such as year of publication, study population, sample size, stress/sleep exposure, voice outcome, and prevalence were extracted from each paper. All the included articles were measured in terms of their methodological quality. RESULTS In total, 10 publications met the criteria for inclusion. The point prevalence of voice disorders ranged widely for both sleep quality (12% to 81%), and for stress (17% to 81%). Teachers who reported stress at work were more likely to report voice disorders. Additionally, teachers who reported having slept more than 6 hours per day were less likely to report a voice disorder. CONCLUSION This study provides evidence about the relationship between sleep quality and work-related stress with voice functioning. Although, included studies had low quality and the number of studies was low, our results suggest that the increased occurrence of voice disorders among teachers with high stress and work and less than 6 hours/day of sleep. Future investigation should aim to identify how sleep quality and stress interact in relation to voice functioning.
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Affiliation(s)
| | - Maryluz Camargo-Mendoza
- Department of Speech and Language Pathology, Universidad Nacional de Colombia, Bogotá, Colombia
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Icht M, Zukerman G, Hershkovich S, Laor T, Heled Y, Fink N, Fostick L. The "Morning Voice": The Effect of 24 Hours of Sleep Deprivation on Vocal Parameters of Young Adults. J Voice 2018; 34:489.e1-489.e9. [PMID: 30527970 DOI: 10.1016/j.jvoice.2018.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 11/15/2018] [Accepted: 11/15/2018] [Indexed: 01/01/2023]
Abstract
Fatigue following sleep deprivation adversely affects various aspects of human performance. It also induces recognizable voice changes, but the literature is inconsistent regarding their nature. The current study used acoustical analyses to assess the effect of 24 hours of sleep deprivation on vocal parameters of young adults. Forty-seven participants (23 females and 24 males) were tested after nocturnal sleep and after 24 hours of sleep deprivation. Different voice samples were recorded (sustained phonation, words, and sentences) and analyzed for fundamental frequency (F0, in Hz), vocal intensity (in dB), harmonic-noise ratio (HNR, in dB), jitter, and shimmer (in %). The main finding was significantly higher HNR values following sleep deprivation than nocturnal sleep for females, across all voice samples. The HNR is a measure of the degree of acoustic periodicity, or the amount of noise compared to the harmonic quality present in the voice. As its values are higher, the voice quality is perceptually better. The current results indicate that females had a significantly higher ratio of vocal harmonics compared to vocal noise when they were sleep deprived. In contrast, following nocturnal sleep, the ratio of vocal harmonics compared to vocal noise was lower, which means the voice quality was poorer. This may explain the common perceptual impressions of decreased voice quality after sleep, which may be more pronounced in females.
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Affiliation(s)
- Michal Icht
- Department of Communication Disorders, Ariel University, Ariel, Israel.
| | - Gil Zukerman
- Department of Communication Disorders, Ariel University, Ariel, Israel
| | | | - Tal Laor
- School of Communication, Ariel University, Ariel, Israel
| | - Yuval Heled
- Heller Institute of Medical Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Nir Fink
- Department of Communication Disorders, Ariel University, Ariel, Israel; Israel Defense Forces, Medical Corps Hakirya, Tel-Aviv, Israel
| | - Leah Fostick
- Department of Communication Disorders, Ariel University, Ariel, Israel
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Lee YR, Kim HR, Lee S. Effect of teacher's working conditions on voice disorder in Korea: a nationwide survey. Ann Occup Environ Med 2018; 30:43. [PMID: 29988724 PMCID: PMC6029068 DOI: 10.1186/s40557-018-0254-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 06/12/2018] [Indexed: 12/02/2022] Open
Abstract
Background Korean teacher’s working conditions are deteriorating. There is concern about the deterioration of teachers’ health and voice disorder is one of the most common problems. Teacher’s vocal health is important for them and their students. The aim of the present study was to investigate working conditions that may affect voice disorders. Methods In all, 79 primary and secondary schools were randomly selected for a nationwide school system survey (N = 3345). In 64 schools, 1617 (48.3%) teachers participated via a postal self-report questionnaire from June 2016 to August 2016. After applying inclusion and exclusion criteria, data from 1301 teachers’ were used for analysis. Multiple logistic regression was used to investigate the associations between general, work-related factors, and frequent voice disorders (fVDs) to estimate the adjusted odds ratio(aOR). Results Teachers who reported voice symptoms more than once a week (fVD) made up 11.6%. In a multiple logistic regression, fVD was significantly associated with female, difficulty in applying for sick leave as needed, music teachers (primary school), and less than 6 h of sleep per day (primary school). The aOR for fVD was 2.72 (0.83–8.10) in the longest working hours group (> 52 h/wk) among the primary school teachers, and 1.90 (0.80–4.73) in the longest class hour group (≥ 20 h/wk), 1.52 (0.90–2.62) in homeroom teachers among the secondary school teachers, but not statistically significant. Conclusions Korean teachers’ working conditions are associated with fVDs. The school health system must take steps to prevent and treat voice disorders of teachers.
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Affiliation(s)
- Yi-Ryoung Lee
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137701 Republic of Korea
| | - Hyoung-Ryoul Kim
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137701 Republic of Korea
| | - Seyoung Lee
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137701 Republic of Korea
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