A Comparison of Initial and Subsequent Follow-Up Strobovideolaryngoscopic Examinations in Singers.

OBJECTIVES: Previous studies have identified abnormal findings in up to 86.1% of singers on initial screening strobovideolaryngoscopy (SVL) examinations. No studies have compared the prevalence of abnormalities in singers on their subsequent follow-up SVL. Our study evaluates the frequency of these findings in both the initial and subsequent examinations. METHODS: Retrospective charts and SVL reports were reviewed on students from an opera conservatory from 1993 to 2014. All students had initial screening SVL, but only students who later returned with acute voice complaints were included in the study (n = 51, 137 follow-up visits). Normal SVL was defined as an examination without structural or functional abnormalities and reflux finding score ≤7. Data were analyzed using the chi-square test. RESULTS: For initial examinations, 90.2% (including reflux) and 88.2% (excluding reflux) were abnormal. In follow-up examinations, 94.9% (including reflux) and 94.2% (excluding reflux) had abnormal findings, which included muscle tension dysphonia (40.1%), vocal fold (VF) masses (unilateral 48.9%, bilateral 30.7%), vascular abnormalities (unilateral 27.0%, bilateral 5.8%), sulcus (unilateral 17.5%, bilateral 5.1%), VF hypomobility (unilateral 36.3%, bilateral 5.9%), phase (30.6%) and amplitude (44.8%) asymmetries, and glottic insufficiency (49.3%). Follow-up examinations revealed a significant increase in laryngopharyngeal reflux (χ(2) = 7.043; P \u3c 0.05). CONCLUSIONS: We found a higher prevalence of abnormal findings compared with previous studies, which we attributed to a more inclusive definition of abnormal pathologies, improvements in SVL technology, and possibly increased experience with SVL interpretation. This high prevalence of abnormal findings in asymptomatic singers further supports the importance of baseline examinations

Nature of orchestral noise

Professional orchestral musicians are at risk of exposure to excessive noise when at work. This is an industry-wide problem that threatens not only the hearing of orchestral musicians but also the way orchestras operate. The research described in this paper recorded noise levels within a professional orchestra over three years in order to provide greater insight to the orchestral noise environment; to guide future research into orchestral noise management and hearing conservation strategies; and to provide a basis for the future education of musicians and their managers. Every rehearsal, performance, and recording from May 2004 to May 2007 was monitored, with the woodwind, brass, and percussion sections monitored in greatest detail. The study recorded dBALEQ and dBC peak data, which are presented in graphical form with accompanying summarized data tables. The findings indicate that the principal trumpet, first and third horns, and principal trombone are at greatest risk of exposure to excessive sustained noise levels and that the percussion and timpani are at greatest risk of exposure to excessive peak noise levels. However, the findings also strongly support the notion that the true nature of orchestral noise is a great deal more complex than this simple statement would imply

Effectiveness of an Intervention to Increase Construction Workers' Use of Hearing Protection

In this project we tested the effectiveness of a theory-based intervention (video, pamphlets, and guided practice session) to increase the use of hearing protection devices (HPDs) among Midwestern construction workers and a national group of plumber/pipefitter trainers. Posttest measures were collected 10--12 months following this intervention. Pender's Health Promotion Model (1987) provided the conceptual basis for development of the training program. A total of 837 highnoise- exposed workers were included in the analysis: 652 regional Midwestern construction workers and 185 national plumber/pipefitter trainers. Effectiveness of the intervention was determined through the sequence of analyses recommended by Braver and Braver (1988) for the Solomon Four-Group Design. Analysis of variance and covariance of postintervention use and intention to use HPDs and a meta-analytic test were done. These analyses indicated that the intervention significantly increased use of HPDs but had no effect on intention to use HPDs in the future. Pretesting had no effect on use. Actual or potential applications of this research include guidance in the development of successful theorybased interventions to increase use of HPDs.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68025/2/10.1518_001872099779610969.pd

Gabapentin for tinnitus: a systematic review.

PURPOSE: The main aim of this study was to assess the effect of gabapentin on tinnitus via a systematic review. METHOD: An electronic search of literature as well as a hand search were conducted. Only double-blind randomized controlled trials (RCTs) that met all of the inclusion criteria were included in this review. The Cochrane Collaboration tool for risk of bias assessment was used to investigate the validity of the included studies. Meta-analysis was not appropriate due to inadequate details in reporting the data in the included studies. Hence, qualitative synthesis and interpretation of the data were carried out. RESULTS: Two studies that met the inclusion criteria were included in the review. Fourteen studies were excluded. There were substantive within-study clinical heterogeneities with regard to the baseline tinnitus handicap scores, duration of tinnitus, and severity of hearing loss in the included double-blind RCTs. CONCLUSION: The authors of both studies reported that gabapentin was not superior to placebo in their primary outcomes. However, following the assessment of risk of bias and within-study clinical heterogeneities, this review concludes that there is insufficient evidence regarding the effect of gabapentin on tinnitus

The Efficacy of Auditory Perceptual Training for Tinnitus: A Systematic Review

Auditory perceptual training affects neural plasticity and so represents a potential strategy for tinnitus management. We assessed the effects of auditory perceptual training on tinnitus perception and/or its intrusiveness via a systematic review of published literature. An electronic database search using the keywords ‘tinnitus and learning’ or ‘tinnitus and training’ was conducted, updated by a hand search. The ten studies identified were reviewed independently by two reviewers, data were extracted, study quality was assessed according to a number of specific criteria and the information was synthesised using a narrative approach. Nine out of the ten studies reported some significant change in either self-reported or psychoacoustic outcome measures after auditory training. However, all studies were quality rated as providing low or moderate levels of evidence for an effect. We identify a need for appropriately randomised and controlled studies that will generate high-quality unbiased and generalisable evidence to ascertain whether or not auditory perceptual training has a clinically relevant effect on tinnitus

First-line high-dose sequential chemotherapy with rG-CSF and repeated blood stem cell transplantation in untreated inflammatory breast cancer: toxicity and response (PEGASE 02 trial)

Despite the generalization of induction chemotherapy and a better outcome for chemosensitive diseases, the prognosis of inflammatory breast cancer (IBC) is still poor. In this work, we evaluate response and toxicity of high-dose sequential chemotherapy with repeated blood stem cell (BSC) transplantation administered as initial treatment in 100 women with non-metastatic IBC. Ninety-five patients (five patients were evaluated as non-eligible) of median age 46 years (range 26–56) received four cycles of chemotherapy associating: cyclophosphamide (C) 6 g m−2 – doxorubicin (D) 75 mg m−2 cycle 1, C: 3 g m−2 – D: 75 mg m−2 cycle 2, C: 3 g m−2 – D: 75 mg m−2 – 5 FU 2500 mg m−2 cycle 3 and 4. BSC were collected after cycle 1 or 2 and reinfused after cycle 3 and 4. rG-CSF was administered after the four cycles. Mastectomy and radiotherapy were planned after chemotherapy completion. Pathological response was considered as the first end point of this trial. A total of 366 cycles of chemotherapy were administered. Eighty-seven patients completed the four cycles and relative dose intensity was respectively 0.97 (range 0.4–1.04) and 0.96 (range 0.25–1.05) for C and D. Main toxicity was haematological with febrile neutropenia ranging from 26% to 51% of cycles; one death occurred during aplasia. Clinical response rate was 90% ± 6%. Eighty-six patients underwent mastectomy in a median of 3.5 months (range 3–9) after the first cycle of chemotherapy; pathological complete response rate in breast was 32% ± 10%. All patients were eligible to receive additional radiotherapy. High-dose chemotherapy with repeated BSC transplantation is feasible with acceptable toxicity in IBC. Pathological response rate is encouraging but has to be confirmed by final outcome. © 1999 Cancer Research Campaig