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1.
Psychol Med ; 49(14): 2287-2306, 2019 10.
Article in English | MEDLINE | ID: mdl-31474244

ABSTRACT

Music performance anxiety (MPA) is one of the most common disorders among professional musicians, nevertheless, little is known about the disease. With this systematic review, prevalence, risk factors and treatment procedures for MPA were assessed, and for the first time, quality assessments were carried out for all studies using standardized assessment tools. A systematic literature search was conducted via search algorithms in the databases MEDLINE, EMBASE, CINAHL, PsycArticles, PsycInfo and ERIC. Included were case reports, case-control, cohort, cross-sectional and intervention studies examining professional musicians with MPA. For quality assessment, adapted tools of the National Heart, Lung, and Blood Institute were used. A total of 43 studies were included (10 case reports, 21 intervention, 11 cross-sectional, one cohort study). Quality ratings ranged from -11 to 6 out of a maximum of 15/16 points for cross-sectional/cohort studies and -4 to 11 out of 18 points for intervention studies. The prevalence of MPA was between 16.5% and 60%. More women than men were affected and musicians older than 45-50 years reported less MPA than younger musicians. Regarding treatment cognitive behavioural therapy (CBT) and ß-blockers were most often researched with beneficial results for CBT. However, studies with adequate control groups for CBT interventions are needed to clarify its efficacy. Studies showed methodological weaknesses, especially in the selection of participants, recording of influencing factors, blinding of interventions, randomization of participants and analysis of comorbidity. Recommendations for further research are made.


Subject(s)
Cognitive Behavioral Therapy , Music , Performance Anxiety/epidemiology , Performance Anxiety/therapy , Age Factors , Humans , Prevalence , Risk Factors , Sex Factors
2.
BMC Complement Altern Med ; 18(1): 115, 2018 Apr 02.
Article in English | MEDLINE | ID: mdl-29609566

ABSTRACT

BACKGROUND: We aimed to investigate the effectiveness of two different forms of dry pulsatile cupping in patients with chronic low back pain (cLBP) compared to medication on demand only in a three-armed randomized trial. METHODS: 110 cLBP patients were randomized to regular pulsatile cupping with 8 treatments plus paracetamol on demand (n = 37), minimal cupping with 8 treatments plus paracetamol on demand (n = 36) or the control group with paracetamol on demand only (n = 37). Primary outcome was the pain intensity on a visual analogue scale (VAS, 0-100 mm) after 4 weeks, secondary outcome parameter included VAS pain intensity after 12 weeks, back function as measured with the 'Funktionsfragebogen Hannover Rücken' (FFbH-R) and health related quality of life questionnaire Short form 36 (SF-36) after 4 and 12 weeks. RESULTS: The mean baseline-adjusted VAS after 4 weeks was 34.9 mm (95% CI: 28.7; 41.2) for pulsatile cupping, 40.4 (34.2; 46.7) for minimal cupping and 56.1 (49.8; 62.4) for control group, resulting in statistically significant differences between pulsatile cupping vs. control (21.2 (12.2; 30.1); p < 0.001) and minimal cupping vs. control (15.7 (6.9; 24.4); p = 0.001). After 12 weeks, mean adjusted VAS difference between pulsatile cupping vs. control was 15.1 ((3.1; 27.1); p = 0.014), and between minimal cupping vs. control 11.5 ((- 0.44; 23.4); p = 0.059). Differences of VAS between pulsatile cupping and minimal cupping showed no significant differences after 4 or 12 weeks. Pulsatile cupping was also better (- 5.8 (- 11.5;-0.1); p = 0.045) compared to control for back function after 4 weeks, but not after 12 weeks (- 5.4 (- 11.7;0.8); p = 0.088), pulsatile cupping also showed better improvements on SF-36 physical component scale compared to control at 4 and 12 weeks (- 5.6 (- 9.3;-2.0); p = 0.003; - 6.1 (- 9.9;-2.4); p = 0.002). For back function and quality of life minimal cupping group was not statistically different to control after 4 and 12 weeks. Paracetamol intake did not differ between the groups (cupping vs. control (7.3 (- 0.4;15.0); p = 0.063); minimal cupping vs. control (6.3 (- 2.0;14.5); p = 0.133). CONCLUSIONS: Both forms of cupping were effective in cLBP without showing significant differences in direct comparison after four weeks, only pulsatile cupping showed effects compared to control after 12 weeks. TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov (identifier: NCT02090686 ).


Subject(s)
Acupuncture Therapy , Chronic Pain/therapy , Low Back Pain/therapy , Adult , Female , Humans , Male , Middle Aged , Pain Measurement
3.
Orthopade ; 38(9): 847-54, 2009 Sep.
Article in German | MEDLINE | ID: mdl-19609773

ABSTRACT

BACKGROUND: Complex forms of musculoskeletal dysfunction are thought to be risk factors for the development of chronic pain syndromes of the locomotor system. Unfortunately there are insufficient data on the reliability and validity of clinical tests for musculoskeletal dysfunctions. METHOD: The intrarater and interrater reliability of clinical tests for hypermobility and for the stabilisation system were examined in a multicentre trial. A total of 68 patients in 6 centres were functionally examined by 2 examiners once (intrarater reliability) and by 1 examiner twice (interrater reliability). RESULTS: The tests for hypermobility showed good to very good reliability. The results for the stabilisation system were more variable whereby 23 tests showed a kappa-coefficient greater than 0.5 and 15 tests good to very good reliability. DISCUSSION: All tests for hypermobility and 23 tests for the stabilisation system are suitable for further evaluation. The broad range in test reliability might be explained by the differences in examiner skills demanded by each test. Therefore, dependent on their validity, some tests will be useful in specialized centres while others might be used in primary care.


Subject(s)
Ataxia/diagnosis , Back Pain/etiology , Joint Instability/diagnosis , Movement Disorders/diagnosis , Postural Balance , Adult , Aged , Ataxia/complications , Biometry , Female , Humans , Joint Instability/complications , Male , Middle Aged , Movement Disorders/complications , Observer Variation , Pain Measurement/statistics & numerical data , Predictive Value of Tests , Prospective Studies , Young Adult
4.
Orthopade ; 30(8): 559-64, 2001 Aug.
Article in German | MEDLINE | ID: mdl-11552398

ABSTRACT

Bone metastases can be the first symptom of a tumor. The case of a 65-year-old patient with a thymoma exhibiting primary metastases in the lung and bone is presented. Initially, a tumor was suspected because of an osteolytic destruction of the right proximal femur posing a high risk of fracture. Further diagnostic procedures detected a partially sclerosing mediastinal bulk and bilateral lung metastases. The histological investigation of the resected proximal femur and needle biopsy of the mediastinal bulk showed an extrathoracically metastasized polygonal cell thymoma. This metastasizing pattern is common in thymic carcinoma but very rare in thymoma. In addition to the case presentation, a review of the current literature on histological classification, therapy, and prognosis is given.


Subject(s)
Femoral Neoplasms/secondary , Lung Neoplasms/secondary , Thymoma/secondary , Thymus Neoplasms , Aged , Antineoplastic Agents/therapeutic use , Combined Modality Therapy , Femoral Neoplasms/diagnostic imaging , Femoral Neoplasms/pathology , Femoral Neoplasms/surgery , Humans , Lung Neoplasms/pathology , Male , Meta-Analysis as Topic , Postoperative Care , Prognosis , Prospective Studies , Radiography, Thoracic , Randomized Controlled Trials as Topic , Thymoma/classification , Thymoma/diagnostic imaging , Thymoma/drug therapy , Thymoma/pathology , Thymoma/surgery , Thymus Neoplasms/classification , Thymus Neoplasms/diagnostic imaging , Thymus Neoplasms/pathology , Thymus Neoplasms/therapy , Tomography, X-Ray Computed
5.
Brain ; 122 ( Pt 1): 75-85, 1999 Jan.
Article in English | MEDLINE | ID: mdl-10050896

ABSTRACT

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.


Subject(s)
Auditory Perception/physiology , Cerebrovascular Circulation/physiology , Echoencephalography , Music , Ultrasonography, Doppler, Transcranial , Adult , Attention/physiology , Dominance, Cerebral/physiology , Female , Hemodynamics/physiology , Humans , Male , Pulse , Time Factors , Vascular Resistance/physiology
6.
Vasa ; 23(2): 109-13, 1994.
Article in German | MEDLINE | ID: mdl-8036833

ABSTRACT

Using colour coded duplex sonography in pre-operative diagnosis of insufficient perforant veins we succeeded in accomplishing a close correspondence between diagnostic methods and intraoperative findings. We examined 94 patients suffering from primary varicosis by duplex sonography and found 334 perforant veins in total, i.e. 2.4 per leg, which we marked with special ink. Nearly 50% of the patients had also been examined by phlebography, which was evaluated by the vascular surgeons only. One third of the phlebographies were not satisfactory. The vascular surgeon evaluated the accuracy of perforant veins marked by duplex sonography with 95.8%, whereas the sufficient phlebographies only reached an accuracy of 65%. The insufficient phlebographies showed only 16% of the duplex-sonographically marked perforant veins. The confluence of the insufficient minor saphenous vein with the popliteal vein corresponded in all of the 22 cases with the sonographic findings. The colour coded duplex sonography enables the vascular surgeon to localize the insufficient perforant veins exactly and also provides for minimal tissue damage, which means a relevant decrease of postoperative pain.


Subject(s)
Varicose Veins/diagnostic imaging , Venous Insufficiency/diagnostic imaging , Blood Flow Velocity/physiology , Evaluation Studies as Topic , Female , Humans , Leg/blood supply , Male , Phlebography , Prospective Studies , Ultrasonography , Varicose Veins/surgery , Venous Insufficiency/surgery
8.
Infect Control ; 7(7): 355-61, 1986 Jul.
Article in English | MEDLINE | ID: mdl-3525444

ABSTRACT

To better understand the role of plasmids and their importance in the endemic antibiotic resistance of Enterobacteriaceae, we began a prospective study of our combined medical intensive care/coronary care unit. An initial culture survey of the patients, ward staff, and environment was followed by a prospective sampling of 139 consecutive new admissions at the time of admission to the unit, and at regular intervals thereafter for the remainder of their stay. All cultures were planted on agar-containing gentamicin. Of the 147 patients studied, 12 (8.2%) were colonized with 20 strains of gentamicin-resistant gram-negative bacilli (GRGNB) at 29 sites. An additional four GRGNB were isolated from the environment. Of the 24 GRGNB strains, 7 (29%) Enterobacteriaceae carried plasmids shown to carry the gentamicin-resistance determinant. Plasmids were further characterized by restriction endonuclease digestion profiles of plasmid DNA purified from E. coli C600 transconjugants or transformants. A 93 kb plasmid introduced to the unit by a Serratia liquefaciens colonizing a patient transferred from another area in the hospital was identical to 93 kb plasmids carried by a C. amalonaticus and an E. aerogenes subsequently colonizing another patient on the unit. A 60 kb plasmid, first isolated from a S. marcescens colonizing a sink drain was later isolated from an E. cloacae colonizing a patient. Our results indicate that spread of specific R-plasmids may be one mechanism for dissemination of antibiotic resistance on our MICU/CCU.


Subject(s)
Gentamicins/pharmacology , Plasmids/drug effects , Drug Resistance, Microbial , Electrophoresis, Agar Gel , Enterobacteriaceae/drug effects , Escherichia coli/drug effects , Gram-Negative Bacteria/drug effects , Humans , Intensive Care Units , Phenotype , Prospective Studies , R Factors
10.
J Clin Microbiol ; 18(2): 227-35, 1983 Aug.
Article in English | MEDLINE | ID: mdl-6619279

ABSTRACT

A prospective epidemiological survey of a spinal cord injury unit for gentamicin-resistant, gram-negative bacilli was undertaken. The initial survey of the unit suggested a low level of cross-infection involving Pseudomonas aeruginosa and Providencia stuartii. However, a longitudinal study of new admissions revealed that only 13 of 52 nosocomial acquisitions could be considered to be due to cross colonization. Comparison of data on antibiotic use did not suggest selective pressure for resistant endogenous flora. Nosocomial acquisition was directly related to the length of the hospital stay. Antibiotic susceptibility testing of gentamicin-resistant, gram-negative bacilli showed only minor differences between nosocomial isolates and those present during the initial survey. Of the usual antimicrobial agents, amikacin, carbenicillin, and cefoxitin were the most active against all organisms, with the exception of Serratia spp. Of the new beta-lactams, ceftazidime and imipemide (N-formimidoyl thienamycin) were most active.


Subject(s)
Cross Infection/microbiology , Enterobacteriaceae/drug effects , Gentamicins/pharmacology , Hospital Units , Pseudomonas/drug effects , Spinal Cord Injuries/microbiology , Acinetobacter/drug effects , Anti-Bacterial Agents/pharmacology , Drug Resistance, Microbial , Enterobacteriaceae Infections/microbiology , Humans , Lactams , Microbial Sensitivity Tests , Prospective Studies , Pseudomonas Infections/microbiology
11.
Soc Biol ; 19(4): 401-4, 1972 Dec.
Article in English | MEDLINE | ID: mdl-4664677
12.
J Gen Psychol ; 81(1st Half): 45-52, 1969 Jul.
Article in English | MEDLINE | ID: mdl-5810610
13.
J Exp Psychol ; 79(3): 561-4, 1969 Mar.
Article in English | MEDLINE | ID: mdl-5786998
14.
J Soc Psychol ; 70(2): 275-80, 1966 Dec.
Article in English | MEDLINE | ID: mdl-5980226
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