Kathy Huet

Voice outcomes of laryngopharyngeal reflux treatment: a systematic review of 1483 patients

The aim of this study is to explore voice quality modifications in laryngopharyngeal reflux (LPR) disease and to understand better the pathophysiological mechanisms underlying the development of communicative disability. Biological Abstracts, BioMed Central, Cochrane database, PubMed and Scopus were assessed for subject headings using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) recommendations. Relevant studies published between January 1990 and December 2015 describing the evaluation of voice quality in LPR disease were retrieved. Issues of clinical relevance, such as LPR diagnosis method, treatment efficacy and outcomes, were evaluated for each study. We determined the grade of recommendation for each publication according to the Oxford Centre for Evidence-Based Medicine evidence levels. The search identified 145 publications, of which 25 studies met the inclusion criteria for a total of 1483 LPR patients. Data were extracted by 2 independent physicians who identified 16 trials with a IIb evidence level, 7 trials with a IIa evidence level and 2 RCTs with a Ib evidence level where 4 patient-based instruments and 5 clinician-based instruments were used. The main voice assessment outcomes reported were hoarseness assessments by physicians or patients, followed by acoustic parameters; 15 and 14 articles, respectively, demonstrated significant improvements in subjective and objective voice assessments after treatment. The methodology used to measure acoustic parameters (i.e. sustained vowel duration, the sample portion choice for measurement, etc.) varied from one study to another. The majority of studies indicated that voice quality assessments (especially acoustic parameters) remain an interesting outcome to measure the effectiveness of treatment, but further studies using standardised and transparent methodology to measure acoustic parameters are necessary to confirm the place of each tool in the LPR disease evaluation.

Current achievements of the DELPHI ring imaging Cherenkov detector

Abstract The DELPHI experiment has already collected 2.5 million Z 0 decays with the ring imaging Cherenkov detector (RICH) operational. This detector, covering most of the solid angle, is designed to perform π K separation from 0.8 to 20 GeV/ c and K/p separation from 0.8 to 35 GeV/ c . After a brief detector description we discuss the actual operating conditions, the data monitoring and the signal treatment. The collected data from Z 0 decays and the detector response to signals from the calibration system are used to evaluate the performance of the RICH system.

Change of signs, symptoms and voice quality evaluations throughout a 3- to 6-month empirical treatment for laryngopharyngeal reflux disease

To assess the usefulness of voice quality measurements as a treatment outcome in patients with laryngopharyngeal reflux (LPR)‐related symptoms.

Phonetic compliance: a proof-of-concept study

In this paper, we introduce the concept of “phonetic compliance,” which is defined as the intrinsic individual ability to produce speech sounds that are unusual in the native language, and constitutes a part of the ability to acquire L2 phonetics and phonology. We argue that phonetic compliance represents a systematic source of variance that needs to be accounted for if one wants to improve the control over the independent variables manipulated in SLA experimental studies. We then present the results of a two-fold proof-of-concept study aimed at testing the feasibility of assessing phonetic compliance in terms of gradient. In study 1, a pilot data collection paradigm is implemented on an occasional sample of 10 native French speakers engaged in two reproduction tasks involving respectively vowels and aspirated stops, and data are analyzed using descriptive statistics. In study 2, complementary data including L1-typical realizations are collected, resulting in the development of a first set of indicators that may be useful to appropriately assess, and further refine the concept of, phonetic compliance. Based on a critical analysis of the contributions and limitations of the proof-of-concept study, general discussion formulates the guidelines for the following stages of development of a reliable and valid test of phonetic compliance.

Gender differences in the presentation of dysphonia related to laryngopharyngeal reflux disease: a case-control study

ObjectiveTo investigate the voice quality impairments in patients with laryngopharyngeal reflux (LPR) according to the gender.DesignControlled multi-center study.Materials and methods80 LPR patients (40 males and 40 females) with reflux finding score (RFS) > 7 and reflux symptom index (RSI) > 13 were included and clinically compared according to gender. To be considered as LPR patients, subjects responded to an empiric therapeutic trial based on pantoprazole intake and diet recommendations for 3 months or had positive pH/Impedance metry. Voice Handicap Index (VHI); Short Form Healthy Survey 36 (SF36), blinded Grade, Roughness, Breathiness, Asthenia, Strain and Instability (GRBASI); aerodynamic and acoustic measurements were assessed in all patients and compared with 80 healthy controls (40 males and 40 females) according to gender.ResultsThe most common reasons for the consultation were, respectively, globus sensation in males (22.5%) and dysphonia (27.5%) in female who complained more of breathing difficulties and choking episodes related to LPR than males (p = 0.024). From a quality of life standpoint, female had increased significant impact of LPR disease on vitality and mental health than male. Compared to healthy subjects, both LPR male and female patients had stronger values of G, R, B, S, I, VHI, percent jitter, percent shimmer, and soft palate index than controls. In addition, LPR female had stronger values of lowest fundamental frequency and all aerodynamic measurements than controls.ConclusionAs showed in many other laryngeal conditions, voice quality of female could be more impaired by LPR than male. Some anatomical, histological and functional factors can be suspected and need additional future researches.

Voice quality outcomes of idiopathic Parkinson's disease medical treatment: A systematic review

To investigate voice quality (VQ) impairments in idiopathic Parkinsons disease (IPD) and to explore the impact of medical treatments and L‐Dopa challenge testing on voice.

The ring imaging Cherenkov detectors of DELPHI

A ring imaging Cherenkov (RICH) detector system has been built and is now in full operation within the DELPHI experiment. Large data samples of Z/sup 0/ decays are being collected with good resolution on the observed Cherenkov angles. Several studies of Z/sup 0/ decays using the RICH have already been performed on limited samples. Disturbance of the detector operation caused by shrinkage of polymeric construction materials and by migration of radiator substance is reported. These effects have been counteracted and do not endanger the quality of the data. >

Performance of the ring imaging Cherenkov detector of DELPHI

Abstract The general purpose particle detector DELPHI at the Large Electron Positron collider at CERN was built to give the complete information of each event. DELPHI uses ring imaging Cherenkov counters to provide hadron identification in most of the momentum range below 45 GeV/ c and over almost the full solid angle. Charged particles traversing gaseous and liquid fluorocarbon radiators create photons used for Cherenkov angle reconstruction. Some of the design features of the detector will be presented, with emphasis on the experience which was gained in the operation of these large systems. The hadron identification power of the ring imaging Cherenkov detector closely meets the main design values. Data processing and performance of the detector will be discussed using dimuon events collected during 1994. Pion rejection factors for kaon tagging will be shown.

Performance of the Barrel Ring Imaging Cherenkov counter of DELPHI

The Barrel Ring Imaging Cherenkov detector of the DELPHI experiment at LEP provides particle identification by the detection of the radiation emitted in UV transparent perfluorocarbons. We will present the principles of the operation of the detector together with a discussion of the automatized control of all the relevant physical parameters. The observed performances of the detector are very close to their design values. >

Voice Quality as Therapeutic Outcome in Laryngopharyngeal Reflux Disease: A Prospective Cohort Study

PURPOSE To study the usefulness of voice quality as therapeutic outcome in laryngopharyngeal reflux disease. MATERIAL AND METHODS A total of 80 patients with reflux finding score (RFS) > 7 and reflux symptom index (RSI) > 13 were treated with pantoprazole, diet, and lifestyle recommendations for 3 months. The therapeutic effectiveness was assessed with RSI; RFS; Voice Handicap Index; blinded Grade, Roughness, Breathiness, Asthenia, Strain, and Instability (GRBASI); aerodynamic and a panel of acoustic measurements before and after treatment. A correlation analysis between symptoms, videolaryngostroboscopic signs, and acoustic measurements was conducted. RESULTS Compared to baseline, means of RSI, RFS, Voice Handicap Index, perceptual dysphonia, and roughness significantly decreased. Significant improvements of phonatory quotient, percent jitter, percent shimmer, Relative Average Perturbation, Pitch Perturbation Quotient, Phonatory F0 Range, Amplitude Perturbation Quotient, smooth Amplitude Perturbation Quotient, and Peak-to-Peak Amplitude Variation were found at the end of treatment. Studies of correlation did not identify relevant correlation between videolaryngostroboscopic signs, especially vocal folds edema, and objective voice quality evaluations. CONCLUSION Voice quality assessments can help to better understand voice disorders and can be used as indicators of the treatment effectiveness in patients with laryngopharyngeal reflux-related symptoms.