The cerebral haemodynamics of music perception. A transcranial Doppler sonography study. (1/1022)

The perception of music has been investigated by several neurophysiological and neuroimaging methods. Results from these studies suggest a right hemisphere dominance for non-musicians and a possible left hemisphere dominance for musicians. However, inconsistent results have been obtained, and not all variables have been controlled by the different methods. We performed a study with functional transcranial Doppler sonography (fTCD) of the middle cerebral artery to evaluate changes in cerebral blood flow velocity (CBFV) during different periods of music perception. Twenty-four healthy right-handed subjects were enrolled and examined during rest and during listening to periods of music with predominant language, rhythm and harmony content. The gender, musical experience and mode of listening of the subjects were chosen as independent factors; the type of music was included as the variable in repeated measurements. We observed a significant increase of CBFV in the right hemisphere in non-musicians during harmony perception but not during rhythm perception; this effect was more pronounced in females. Language perception was lateralized to the left hemisphere in all subject groups. Musicians showed increased CBFV values in the left hemisphere which were independent of the type of stimulus, and background listeners showed increased CBFV values during harmony perception in the right hemisphere which were independent of their musical experience. The time taken to reach the peak of CBFV was significantly longer in non-musicians when compared with musicians during rhythm and harmony perception. Pulse rates were significantly decreased in non-musicians during harmony perception, probably due to a specific relaxation effect in this subgroup. The resistance index did not show any significant differences, suggesting only regional changes of small resistance vessels but not of large arteries. Our fTCD study confirms previous findings of right hemisphere lateralization for harmony perception in non-musicians. In addition, we showed that this effect is more pronounced in female subjects and in background listeners and that the lateralization is delayed in non-musicians compared with musicians for the perception of rhythm and harmony stimuli. Our data suggest that musicians and non-musicians have different strategies to lateralize musical stimuli, with a delayed but marked right hemisphere lateralization during harmony perception in non-musicians and an attentive mode of listening contributing to a left hemisphere lateralization in musicians.  (+info)

Antiproteinuric efficacy of verapamil in comparison to trandolapril in non-diabetic renal disease. (2/1022)

BACKGROUND: Non-dihydropyridine calcium antagonists such as verapamil are equally effective in reducing proteinuria as ACE inhibitors in hypertensive patients with diabetic nephropathy. To date it is unknown whether verapamil elucidates such an antiproteinuric capacity in non-diabetic renal disease. METHODS: We performed a double-blind, placebo-controlled, random cross-over study which compared the antiproteinuric effect of 6 weeks treatment with verapamil SR (360 mg) to that of the ACE inhibitor trandolapril (4 mg), and their fixed combination vera/tran (180 mg verapamil SR and 2 mg trandolapril) in 11 non-diabetic patients with proteinuria of 6.6 (5.1-8.8) g/day, a creatinine clearance of 87 (74-106) ml/min, and a 24-h blood pressure of 136/85 (126/76-157/96) mmHg at baseline. RESULTS: Twenty-four-hour mean arterial pressure did not change during verapamil, whereas both trandolapril and vera/tran induced a significant reduction in MAP. Verapamil showed no significant effects on renal haemodynamics. Trandolapril and vera/tran did not significantly change GFR, but ERPF increased and FF decreased during both treatments (P<0.05). The antiproteinuric response of verapamil was significantly less compared to that of trandolapril and vera/tran (-12% (-17/-1) vs -51% (-56/-25) and -41% (-50/-19) respectively). The blood pressure and antiproteinuric response during verapamil tended to be greater in hypertensive patients than in normotensive patients, although this difference was not significant. Baseline blood pressure was related to the change in blood pressure during verapamil (r = -0.70; P < 0.02). CONCLUSIONS: The antiproteinuric and antihypertensive response of verapamil is less than that of the ACE inhibitor trandolapril in patients with non-diabetic renal disease. In contrast to the antiproteinuric response of trandolapril, the antiproteinuric reponse of verapamil seems to be completely dependent from effective blood pressure reduction. The fixed combination of verapamil and ACE inhibition at half doses has similar effects as ACE inhibition at full dose.  (+info)

Relative bradycardia is not a feature of enteric fever in children. (3/1022)

We investigated pulse-temperature relationships in 66 children with enteric fever (group 1) and in 76 with other infections (group 2). Group 1 children were older than group 2 children (mean age +/- SD, 91 +/- 36 vs. 66 +/- 32 months, respectively; P < .001) and had mean oral temperatures +/- SD similar to those of group 2 children (38.3 +/- 1.0 vs. 38.3 +/- 0.9 degrees C, respectively; P > .2); however, group 1 children had lower mean baseline pulse rates +/- SD than did group 2 children (119 +/- 25 vs. 127 +/- 28 beats/min, respectively; P < .001). In a multiple linear regression model, pulse rate was independently associated with age (inversely; P < .001) and oral temperature (positively; P < .006) but not with diagnostic group or gender (P > .5). After adjustment of the mean initial pulse rate +/- SD to age of 72 months, there was no difference between group 1 and group 2 children (126 +/- 24 vs. 126 +/- 20 beats/min, respectively; P > .5). From 4 to 72 hours after commencement of treatment, the mean oral temperature in group 1 patients was approximately 0.3 degrees C higher than that in group 2 patients, and the age-adjusted pulse rate was 5 beats/min higher in group 1 children than in group 2 children. These data suggest that relative bradycardia is not characteristic of enteric fever in children.  (+info)

Effect on nasal resistance of an external nasal splint and isotonic exercise. (4/1022)

OBJECTIVES: The now commonplace wearing of external nasal splints by sportsmen and athletes has never been scientifically evaluated. The present study looks into the effect of isotonic exercise on nasal resistance, and examines whether this effect is altered by the wearing of an external nasal splint. METHODS: Twenty subjects not suffering from rhinitis were tested. Nasal resistance measurements were recorded using an anterior rhinomanometer before and after isotonic exercise with and without an external nasal splint. Pulse and blood pressure were measured before and after exercise. RESULTS: Significant changes were observed in pulse (p < 0.001) and both systolic (p < 0.002) and diastolic (p < 0.001) blood pressure in response to exercise. Significant differences were seen in nasal resistance when the splint was applied (p < 0.001) and after exercise (p < 0.003). No significant difference was observed after exercise when the splint was worn (p = 0.167). CONCLUSIONS: External nasal splints decrease nasal resistance at rest but are of little value during isotonic exercise.  (+info)

Chronic critical limb ischemia: diagnosis, treatment and prognosis. (5/1022)

Chronic critical limb ischemia is manifested by pain at rest, nonhealing wounds and gangrene. Ischemic rest pain is typically described as a burning pain in the arch or distal foot that occurs while the patient is recumbent but is relieved when the patient returns to a position in which the feet are dependent. Objective hemodynamic parameters that support the diagnosis of critical limb ischemia include an ankle-brachial index of 0.4 or less, an ankle systolic pressure of 50 mm Hg or less, or a toe systolic pressure of 30 mm Hg or less. Intervention may include conservative therapy, revascularization or amputation. Progressive gangrene, rapidly enlarging wounds or continuous ischemic rest pain can signify a threat to the limb and suggest the need for revascularization in patients without prohibitive operative risks. Bypass grafts are usually required because of the multilevel and distal nature of the arterial narrowing in critical limb ischemia. Patients with diabetes are more likely than other patients to have distal disease that is less amenable to bypass grafting. Compared with amputation, revascularization is more cost-effective and is associated with better perioperative morbidity and mortality. Limb preservation should be the goal in most patients with critical limb ischemia.  (+info)

Does psychological stress improve physical performance? (6/1022)

The purpose of this study is to determine whether psychological stress enhances physical performance and how personality traits affect it. The annual physical test was chosen as the psychological stressor. Ninety three students ran 50 meters as part of the test and one week after that as a control. The pulse rate and time were measured and pulse rate was used as an indicator of psychological stress. All students took the anxiety-trait scale test of the State-Trait Anxiety Inventory. The pulse rate was higher and the time record was better in the annual physical test compared with that of control. When we categorized the subjects by the anxiety-trait scale test, only the high anxiety-trait students could run faster when faced with higher stress. In conclusion, psychological stress can enhance the physical performance of certain students. It is possible that psychological stress and personality traits interact and both of them affect physical performance.  (+info)

Preoperative prediction of graft patency for infrapopliteal arterial bypass using pulse-generated runoff. (7/1022)

OBJECTIVE: to assess: (i) pulse-generated runoff (PGR) as a tool for preoperative prediction of graft patency; (ii) the effect of PGR use on graft patency. DESIGN: retrospective analysis of continuous patient data. MATERIALS: all patients undergoing bypass to the infrapopliteal vessels in the Oxford Regional Vascular Unit between 1989 and 1993. METHODS: preoperative assessment using ankle-brachial indices, intra-arterial digital subtraction angiography and PGR. Six-monthly and then yearly clinical and duplex sonography follow-up to assess graft patency. Univariate analysis of graft patency to assess discriminatory ability of PGR for graft patency. RESULTS: a biphasic signal in the artery of insertion was associated with significantly better graft patency rate at 1 month and at maximum follow-up than was a monophasic signal. A monophasic signal was associated with a 12-month patency of 25% and a mortality of 37.7%. Use of PGR did not affect graft patency significantly. CONCLUSION: PGR is a useful, non-invasive, means of preoperative patient assessment to determine the potential for maintained graft patency.  (+info)

Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients. (8/1022)

Large artery damage is a major contributory factor to cardiovascular morbidity and mortality of patients with hypertension. Pulse wave velocity (PWV), a classic evaluation of arterial distensibility, has never been ascertained as a cardiovascular risk marker. To determine the factors influencing aortic PWV and the potential predictor role of this measurement, we studied a cohort of 710 patients with essential hypertension. Atherosclerosis alterations (AA) were defined on the basis of clinical events. Calculation of cardiovascular risks, by use of Framingham equations, was performed in subjects without AA. PWV was higher in the presence of AA (14.9+/-4.0 versus 12.4+/-2.6 m/s, P<0.0001), even after adjustments on confounding factors and was the first determinant (P<0.0001) of the extent of atherosclerosis assessed as the sum of the atherosclerotic sites. In patients without AA, all cardiovascular risks increased constantly with PWV. Furthermore, at a given age, aortic PWV was the best predictor of cardiovascular mortality. The odds ratio of being in a high cardiovascular mortality risk group (>5% for 10 years) for patients in the upper quartile of PWV was 7.1 (95% confidence intervals 4.5 to 11.3). The presence of a PWV >13 m/s, taken alone, appeared as a strong predictor of cardiovascular mortality with high performance values. This study shows that aortic PWV is strongly associated with the presence and extent of atherosclerosis and constitutes a forceful marker and predictor of cardiovascular risk in hypertensive patients.  (+info)