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Editorial
No full textThe inaugural issue of International Journal of Speech and Language Pathology and Audiolog
Vowel Articulation in Patients with Spinocerebellar Ataxia
No full textObjective: Abnormalities in vowel articulation have been reported to be a common feature of dysarthria in spinocerebellar ataxia (SCA); however, findings about the degree and pattern of impaired vowel production are inconsistent. Therefore, the aim of the current study was to characterize the pattern of dysfunctional vowel production in patients with SCA by the means of acoustic analysis.Methods: 31 patients SCA and 32 healthy subjects were tested. Description of vowel articulation was based upon the frequencies of the first and second formant (F1 and F2) of the German vowels /α/, /i/ and /u/ extracted severalfold from defined words within a given reading passage. The mean as well as the coefficient of variance of the respective F1 and F2 values of each single vowel were taken as measures of distinctiveness and steadiness of vowel articulation.Results: In the SCA group, F1 and F2 values showed increased variability and a specifically restricted range which was particularly seen in the vowel /i/. Furthermore, the dysfunctional pattern differed between male and female patients with SCA.Conclusions: Measurement of F1 and F2 revealed dysfunctional vowel articulation in SCA – however, with some gender-related specifities – that can be explained by imprecision and reduced range of articulatory movements in ataxic speakers. Therefore, objective measurement of vowel formant frequencies provided additional information to the overall perceptual speech score. According to these preliminary findings, acoustic analysis of speech could be a promising tool for diagnosis, monitoring and detection of therapeutic effects in ataxic dysarthria
Clindamycin Induced Dysphagia – A Rare Concurrence
No full textAlthough dysphagia is a mechanical impedance in phase specific mechanism, drug induced dysphagia is an adverse event often caused due to esophagitis. Clindamycin is well known to cause esophagitis; itself causing dysphagia is not reported in literature. Herein, we report one such case recently seen by us who was diagnosed with Clindamycin induced dysphagia post debridement surgery for acute necrotizing fasciitis
Oropharyngeal Swallowing Disorders in Parkinson’s Disease: Revisited
No full textSwallowing impairments in Parkinson’s Disease (PD) affect patients’ nutritional status, the oral administration of medication, and of course quality-of-life, even in the earlier stages of the disease. Here, we provide a synopsis of the current state of neurological diagnosis and the clinical value of the assessment for nutritional status and swallowing impairments in patients with PD. The recent position statement by European Society for Swallowing Disorders (ESSD) on the clinical assessment of dysphagic PD patients is also reviewed and discussed. Here, we also attempt to summarize and explain the recent findings from neurophysiological studies attempting to underpin the underlying mechanisms of the disease, preceding a short review of the therapeutic approaches. With this review, we aim to increase awareness for the deliberating consequences of swallowing impairments and provide a range of unanswered questions on different levels (physiological, neurophysiological, assessment and therapeutic procedures). Further investigations and collaborative large-scale research studies together with neurophysiological studies seem to be warranted in order to shape more effective clinical practice in the future
A Study of Adaptive WDRC in Hearing Aids under Noisy Conditions
No full textBackground noise poses a great challenge to the speech recognition capability of hearing-impaired patients fitted with hearing aid (HA) devices. In an HA system, a speech enhancement unit is generally employed to enhance the signal-to-noise ratio (SNR) of noisy speech in order to yield better speech understanding for HA users in noisy conditions. However, previous studies reported that a subsequent static amplification scheme, such as wide-dynamic-range compression (WDRC), may deteriorate the enhanced speech and thus decrease the speech recognition capability. This work examines the performance of a recently proposed adaptive WDRC (AWDRC) amplification scheme when used in conjunction with a speech enhancement method in HA signal processing. Experimental results demonstrate that when integrated with the same speech enhancement method, AWDRC outperforms WDRC, in terms of long-term SNRs, at several typical hearing loss conditions. The results suggest that AWDRC can be a better choice than WDRC when combining with speech enhancement to improve speech recognition capabilities for HA users in noisy conditions
Climate Change and Type 2 Diabetes
No full textDiabetes is a global epidemic impacting the lives of many people on a daily basis. At present, it is estimated that 366 million people are living with diabetes globally and this number is expected to increase by 50.8 percent to 552 million by the year 2030. Paralleling the epidemic of type 2 diabetes is the phenomena of climate change, which has long been overlooked. However, these environmental changes are no longer scenarios of the future and the effects of climate change are observable today through variable weather patterns and rising sea levels, to name a few. Together, these global issues are impacting the health and well-being of the world’s most vulnerable populations, especially the health of women, children, the elderly, the poor and those in low socio-economic statuses (low SES), and those with underlying health conditions.By observing the global impact of climate change on T2D and the future changes in this metabolic disorder’s prevalence and incidence that may ensue, researchers may be able to curtail the detrimental effects of the associated comorbid conditions associated with diabetes (such as hypertension, cardiovascular disease and the Metabolic Syndrome) amongst the world’s most susceptible individuals
Gonadal Function in Men with Cushing Syndrome
No full textCushing syndrome (CS) is scarcely observed in males. Because of this rarity, the real prevalence of gonadal dysfunction in men with hypercortisolism is unknown. Our aim was to analyze gonadal abnormalities in 37 males with CS (median age=28.9±11years) comparatively to age matched healthy men (n=10). For the homogeneity of the study men over 50, children, patients taking medications and those with pituitary deficits were systematically excluded. For the remaining group, we took into account medical history, clinical examination, and hormonal assessment, by radio immunoassay, for testosterone (T), prolactin (PRL), follicle stimulating hormone (FSH), and luteinizing stimulating hormone (LH).Results: 21% consulted for impotency and/or gynecomastia. When questioned, 65.7% complained about decreased libido and erectile dysfunction. Except for 3, body hair growth and repartition, and testicular volume were normal. Gynecomastia was observed in 18.9%.Testosterone was equal to 2.79±1.62ng/ml vs 6.69±3.87ng/ml (p<0.0005). Low testosterone (<3ng/ml) was observed in 67.5%. PRL =9.8 ± 4.2ng/ml vs 4.9 ± 2.6ng/ml (p<0.01). FSH = 3.87 ± 1.9mu/ml vs 3.75 ± 2.25mU/ml (p<0.30). LH = 2.7 ± 2.2mU/ml vs 3.66 ± 0.86 (p<0.30). We have not found any correlation between cortisol and T, PRL or LH, but there was a positive and significant one with FSH (r=0.57, p<0.005).Conclusion: CS causes a franc hypogonadism in 65%. According to FSH and LH results glucocorticoids excess acts probably at hypothalamic pituitary level, but an increase in testosterone degradation and/or inhibition of testis receptors cannot be ruled out. So men with hypogonadism and/or gynecomastia should be systematically checked for CS