The article presents the results of a study of the acoustic characteristics of the voice in voice professionals and non-voice professionals. We examined 80 people aged 23 to 45 years with functional dysphonia of the hypotonic type, who applied to the phoniatric office of the St. Petersburg Research Institute of ENT. Of these, 23 were professional vocalists, 12 were representatives of speech professions, and 45 were non-professional voices. First, the phoniatrist examined the larynx and assessed its condition with video endostroboscopy (K. Storz) or video pharyngolaryngoscopy (VIVIDEO, KayPentax). Objective acoustic analysis was performed using the Multi-Speech software and hardware complex and the MDVP software (KayPentax). The numerical and graphical expressions of the following parameters were evaluated: noise-to-harmonic ratio (NHR), voice turbulence index (VTI), and soft phonation index (SPI). The results of the study showed that the SPI index is the most informative in assessing hoarseness in patients with hypotonic functional dysphonia. The lower values of this indicator in vocalists can be explained by the presence of a sufficiently developed resonator system of the vocal apparatus, which is reflected in the amplification of the high-frequency components of the voice spectrum.

Goals of the study were investigation the perception of vibro-acoustic signals, spreading in water, by deaf patients and the possibility of use hydrovibrotactile stimulation for habilitation of deaf children. In the first part of study 5 experienced cochlear implants (CI) users were involved – 2 adults and 3 children with congenital deafness. Participants were presented modulated tones (100-4000 Hz) and natural sounds (horn, pipe, march melody) though underwater loudspeakers in small swimming pool. Each participant was sitting in the swimming pool without CI during the stimulation. It was shown that deaf subjects are able to detect vibro-acoustic signals, spreading in water, which they feel as a vibrotactile sense. The most vibrotactile sensitivity was between 100 and 400 Hz, while stimuli between 1000 Hz and 4000 Hz didn’t evoke any sensation. In the second part of the study 30 early aged children with severe or profound sensorineural hearing loss without hearing aids or CI experience were participated. It was observed typical oriented behavioral reactions in response to test stimuli in water in 15 children from the experimental group, but there weren’t reactions to the acoustic component of stimuli on air (out of water). Hydrovibrotactile stimulation sessions prior amplification and CI processor fitting accelerated the development of oriented and stable condition motor reflex reactions to sounds in children with hearing aids and CI, including even near-threshold stimuli, in comparison with control group children, who got only traditional lessons with speech-language therapist. As a result, an adequate fitting of hearing aids or CI processor and spontaneous development of hearing behavior in everyday situations were achieved significantly faster.

The presented method makes it possible to create a meta-analysis diagram (forest plot, or blobbogram), calculate the basic meta-analysis statistics and interpret them correctly. The article describes an example of construction of a forest plot and creation of its elements in detail, explaining the calculation of the basic meta-analysis statistics: effect size, effect heterogeneity index. The authors provide a description of the underlying features of the meta-analysis of models with fixed and random effects, suggesting recommendations on the choice of model depending on the general concept of the study. Using the example of published data of randomized controlled trials of one of tonsillectomy methods – coblation, the authors built a meta-analysis diagram with the calculation of the main indicators evaluating the effect of clinical impact and its variability. To solve the statistical problems, the authors used R-language software environment, which is currently considered the most powerful and flexible tool for performing statistical analysis of medical data and visualizing its results. The description of the tasks is accompanied with the introduction of full R-language program code, which can be used for reproduction of the results of this study and solution of similar problems on other source data. The article uses terms and concepts related to the meta-analysis method both in English and in Russian.

The article discusses the concepts of measures of the effect of clinical effects, quantitative methods for their calculation and interpretation, their importance for making medical decisions. Algorithms for calculating effect measures are described for different clinical trial endpoints represented by quantitative (numerical) or binary types of variables, and for different types of effect size indicator (absolute, relative effect size, or clinical effectiveness indicator). It is shown that in the context of assessing the effect of therapeutic effects and clinical efficacy in general, measuring the size of the effect provides a valuable tool for data analysis. Evaluation and interpretation of the effect of the therapeutic modality only on the basis of the level of significance p obtained by testing statistical hypotheses without specifying the size of the effect is not sufficient to understand the importance of using the effect in clinical practice. To obtain an adequate quantitative assessment of the effect and its interpretation, the concept of the size of the effect is a convenient system of methods that is widely used. To illustrate the calculation and interpretation of the size of the effect, published data from clinical studies of the effectiveness of local anesthesia to reduce pain after septoplasty were used. It is shown how, using the presented technique, it is possible to efficiently calculate and easily interpret measures of the effect of the application of local anesthesia. All calculations were performed in the statistical program R.

The review summarizes information on the stages of independent assessments of the cause of patient death, presented in 1861 by Prosper Menier. The possibility of the presence of a symptom complex unknown to the author, characteristic of intracranial hypotension syndrome, is emphasized. Attention is drawn to the symptomatic similarity of neurological and common ENT diseases different in etiopathogenesis. The rarity of the onset of reduced intracranial pressure syndrome is questioned. Risk factors for intracranial hypotension syndrome are mentioned. A hypothetical justification of the cause of death in Prosper Menier is proposed.