COVID-19 and Seasonal Influenza: No Room for Two.

Objective With the outbreak of COVID-19 in December 2019 fears were expressed for a possible twindemic in the coming flu seasons. Fortunately, this was not the case for the 2019-2020 and 2020-2021 flu seasons as flu showed very low historical rates during these periods. The objective of our study was to look at the existing flu data for the 2019-2021 period and analyze possible reasons for the near absence of seasonal flu. Methods We performed retrospective surveillance regarding seasonal influenza rates for the years 2019-2021, the years that the COVID-19 was present. Epidemiological data concerning seasonal influenza for the years 2019-2021 were collected and analyzed Results Extremely low numbers of flu cases were reported in FluNet, FluView, and TESSy influenza surveillance systems during the years 2019, 2020, and 2021 compared to previous years prior to COVID-19. Conclusions A twindemic outbreak during the 2019-2021 flu seasons did not occur despite expressed concerns. The worldwide implementation of mitigation measures for individuals and communities to control severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission, the increased flu vaccination rate, the virus interference and the lower rate of testing for flu are the main reasons for the marked decrease in reported flu cases during 2019-2021 flu seasons.

Proton Pump Inhibitors for the Treatment of Laryngopharyngeal Reflux. A Systematic Review.

BACKGROUND: To give, if possible, an answer in the long-standing debate of the efficacy of proton pump inhibitors (PPIs) in treating laryngopharyngeal reflux (LPR) through published systematic reviews and meta-analyses. METHOD: PubMed, Cochrane Library, and EMBASE were searched from 1984, the year the term LPR first appeared in the literature, until October 2018. Systematic reviews and meta-analyses comparing the treatment response of PPI therapy in patients with LPR were included in our study. RESULTS: Nine eligible studies, two systematic reviews and seven meta-analyses, were identified and analyzed in our study. Three of these were published in 2006, one in 2007, one in 2013, and four in 2016. Five studies published before 2016 and one in 2016 showed no benefit from PPI therapy for LPR patients while the three remaining meta-analyses of 2016 showed a significant improvement in LPR symptoms but no significant difference in response rate and reflux finding scores (RFS) between PPI therapy and placebo treatment. CONCLUSIONS: Based on the existing data, the use of PPI therapy for the treatment of LPR remains questionable. Six out of the nine systematic reviews/meta-analyses concluded that PPI therapy is not superior to placebo and three concluded that PPI therapy significantly improved LPR symptoms although they did not identify any difference in the post-treatment laryngoscopic findings. There is still a long way to go until we can give a definite answer to this question but in the meantime, the use of PPI therapy for the treatment of LPR will continue even though existing evidence is poor and weak, coming mainly from individual uncontrolled studies.

The Role of Allergy in Phonation.

BACKGROUND: Allergies are among the most common chronic conditions worldwide affecting 10%-30% of adult individuals and 40% of children. Phonation can be affected by different allergic conditions in various ways. The role of allergy in phonation has been under-researched and poorly understood and the respective literature is poor. Several studies have investigated the role of certain allergic diseases in phonation. In this review, we tried to include all allergic conditions that can affect voice production. METHODS: We conducted a bibliography review looking for allergic conditions that can affect phonation. Allergic asthma, allergic laryngitis, allergic rhinitis and sinusitis, oral allergy syndrome, and angioedema were included in our search. RESULTS: The literature on the impact of allergy in phonation remains poor and many key questions concerning basic information for epidemiology, pathophysiology, and larynx pathology in allergic patients with phonation problems still remain unanswered. CONCLUSIONS: The role of allergy in voice production remains underinvestigated and many basic questions still remain open. Further research is needed to improve our understanding for these very common conditions.

Inhaled Corticosteroids and Voice Problems. What Is New?

BACKGROUND: Voice problems are the most common and most annoying local side effect of inhaled corticosteroids (ICS), affecting not only patients' treatment compliance but also their quality of life. The literature is very poor regarding prevalence, mechanism, prevention, and management of voice problems attributed to ICS use and especially for the new ICS, ciclesonide. Prevalence of dysphonia seems to be less common with the use of ciclesonide and beclomethasone dipropionate. METHOD: We conducted a bibliography review based on recently published data, including data from the recently introduced ICS, ciclesonide, which are lacking in previous reviews. RESULTS: Very little improvement, based on limited number of new papers published during previous years without any direct comparison between available ICS, has been made in our understanding of ICS local side effects. CONCLUSION: Our understanding concerning basic information of ICS effects on voice still remains poor, and further investigation is needed to have a better understanding on epidemiology, predisposing factors, mechanisms, prevention, and treatment of voice problems attributed to ICS.

Gastroesophageal reflux disease symptoms in the Greek general population: prevalence and risk factors.

BACKGROUND AND AIMS: Population-based data regarding the prevalence of gastroesophageal reflux disease (GERD) in Greece are very poor. This study estimated the prevalence of GERD symptoms and their risk factors in the Greek adult population. METHODS: A self-administered questionnaire was answered by a randomly selected population of 340 subjects. The question regarding "heartburn, chest pain, indigestion, or stomach acid coming up" as included in the Reflux Symptom Index was used for prevalence assessment. RESULTS: The monthly prevalence of GERD symptoms was found to be 52.0% in the Greek general population, with no statistically significant difference between the two sexes (P>0.05). The age group of 65-79 years showed a higher prevalence rate of GERD. Symptom severity was found to be mild (59.3%) or moderate (27.1%). The number of cigarettes smoked daily (but not smoking duration) as well as the number of alcoholic drinks consumed daily (but not the duration of alcohol drinking) were found to be related to GERD symptoms. No reported concomitant disease or medication was found to be related with GERD symptoms. CONCLUSION: The prevalence of GERD symptoms in the Greek general population was found to be 52.0%. Tobacco smoking and alcohol drinking but not concomitant disease or medications were found to be related with GERD symptoms.

Laryngopharyngeal reflux disease in the Greek general population, prevalence and risk factors.

BACKGROUND: To assess the prevalence of laryngopharyngeal reflux (LPR) in the Greek general population and its risk factors. METHODS: Questionnaire based epidemiological, adult participants' survey. The Reflux Symptom Index (RSI) was used for the assessment of LPR prevalence. The RSI questionnaire was completed by 340 (183 male and 157 female) randomly selected subjects. Subjects with RSI score ≥13 were considered as LPR patients and those with RSI score <13 were considered as non LPR subjects. RESULTS: The prevalence of LPR in the general Greek population was found to be 18.8 % with no statistically significant difference between the two genders (p > 0.05). The age group of 50-64 years showed the higher prevalence rate. Tobacco smoking and alcohol consumption were found to be related with LPR. No reported concomitant disease or medication was found to be related with LPR. CONCLUSIONS: LPR prevalence in the Greek general population was found to be 18.8 %. Tobacco smoking and alcohol consumption were found to be related with LPR.

Voice disorders in the general Greek population and in patients with laryngopharyngeal reflux. Prevalence and risk factors.

OBJECTIVES: To assess the prevalence of voice disorders in the general Greek population and in patients with laryngopharyngeal reflux (LPR) with the use of the reflux symptom index (RSI). STUDY DESIGN: Prospective epidemiological adult participant survey. SETTING: General Greek population. METHOD: The validated Greek version of the RSI was used to assess the prevalence of voice disorders in the general Greek population, as well as in patients with LPR, which were diagnosed using the RSI. The RSI questionnaire was completed by 340 (183 males and 157 females) randomly selected subjects. Subjects with RSI score of >13 were considered to be LPR patients. RESULTS: The prevalence of voice disorders, which was determined by the participants giving a positive response to the field "hoarseness or a problem with your voice," was found to be 38.5% in the general Greek population. In patients with LPR, "hoarseness or a problem with your voice" was present in 90.6%. The number of cigarettes smoked daily and the number of alcoholic drinks consumed daily, each correlated with the presence of voice disorders. No relationship was revealed between voice disorders and coexisting diseases and especially with gastroesophageal reflux disease, which was the most frequent reported disorder among peptic diseases. CONCLUSIONS: The prevalence of voice disorders, determined by a positive response to the question "hoarseness or a problem with your voice," is high (38.5%) in the general population and very high (90.6%) in patients with LPR. The number of tobacco cigarettes smoked daily and the number of alcoholic drinks consumed daily were found to be related to voice disorders.