Variations on the theme of musical expertise: cognitive and sensory processing in percussionists,vocalists and non‐musicians

Comparisons of musicians and non‐musicians have revealed enhanced cognitive and sensory processing in musicians, with longitudinal studies suggesting these enhancements may be due in part to experience‐based plasticity. Here, we investigate the impact of primary instrument on the musician signature of expertise by assessing three groups of young adults: percussionists, vocalists, and non‐musician controls. We hypothesize that primary instrument engenders selective enhancements reflecting the most salient acoustic features to that instrument, whereas cognitive functions are enhanced regardless of instrument. Consistent with our hypotheses, percussionists show more precise encoding of the fast‐changing acoustic features of speech than non‐musicians, whereas vocalists have better frequency discrimination and show stronger encoding of speech harmonics than non‐musicians. There were no strong advantages to specialization in sight‐reading vs. improvisation. These effects represent subtle nuances to the signature since the musician groups do not differ from each other in these measures. Interestingly, percussionists outperform both non‐musicians and vocalists in inhibitory control. Follow‐up analyses reveal that within the vocalists and non‐musicians, better proficiency on an instrument other than voice is correlated with better inhibitory control. Taken together, these outcomes suggest the more extensive engagement of motor systems during instrumental practice may be an important factor for enhancements in inhibitory control, consistent with evidence for overlapping neural circuitry involved in both motor and cognitive control. These findings contribute to the ongoing refinement of the musician signature of expertise and may help to inform the use of music in training and intervention to strengthen cognitive function.     

Changes in urinary excretion of water and sodium transporters during amiloride and bendroflumethiazide treatment

AIM:To quantify changes in urinary excretion of aquaporin2 water channels(u-AQP2),the sodiumpotassium-chloride co-transporter(u-NKCC2) and the epithelial sodium channels(u-ENa C) during treatment with bendroflumethiazide(BFTZ),amiloride and placebo.METHODS:In a randomized,double-blinded,placebocontrolled,3-way crossover study we examined 23 healthy subjects on a standardized diet and fluid intake.The subjects were treated with amiloride 5 mg,BFTZ 1.25 mg or placebo twice a day for 4.5 d before each examination day.On the examination day,glomerular filtration rate was measured by the constant infusion clearance technique with 51Cr-EDTA as reference substance.To estimate the changes in water transport via AQP2 and sodium transport via NKCC2 and ENa C,u-NKCC2,the gamma fraction of ENa C(u-ENa Cγ),andu-AQP2 were measured at baseline and after infusion with 3% hypertonic saline.U-NKCC2,u-ENa Cγ,u-AQP2 and plasma concentrations of vasopressin(p-AVP),renin(PRC),angiotensin Ⅱ(p-ANG Ⅱ) and aldosterone(p-Aldo) were measured,by radioimmunoassay.Central blood pressure was estimated by applanation tonometry and body fluid volumes were estimated by bio-impedance spectroscopy.General linear model with repeated measures or related samples Friedman's two-way analysis was used to compare differences.Post hoc Bonferroni correction was used for multiple comparisons of post infusion periods to baseline within each treatment group.RESULTS:At baseline there were no differences in u-NKCC2,u-ENa Cγ and u-AQP2.PRC,p-Ang Ⅱ and p-Aldo were increased during active treatments(P 0.001).After hypertonic saline,u-NKCC2 increased during amiloride(6% ± 34%;P = 0.081) and increased significantly during placebo(17% ± 24%;P = 0.010).U-AQP2 increased significantly during amiloride(31% ± 22%;P 0.001) and placebo(34% ± 27%;P 0.001),while u-NKCC2 and u-AQP2 did not change significantly during BFTZ(-7% ± 28%;P = 0.257 and 5% ± 16%;P = 0.261).U-ENa Cγ increased in all three groups(P 0.050).PRC,AngⅡ and p-Aldo decreased to the same extent,while AVP increased,but to a smaller degree during BFTZ(P = 0.048).c DBP decreased significantly during BFTZ(P 0.001),but not during amiloride or placebo.There were no significant differences in body fluid volumes.CONCLUSION:After hypertonic saline,u-NKCC2 and u-AQP2 increased during amiloride,but not during BFTZ.Lower p-AVP during BFTZ potentially caused less stimulation of NKCC2 and AQP2 and subsequent lower reabsorption of water and sodium.     

Atrial and ventricular volume and function evaluated by magnetic resonance imaging in patients with persistent atrial fibrillation before and after cardioversion

Atrial fibrillation (AF) is the most common cardiac arrhythmia and 25% of those >40 years old will experience AF. Left atrial size and left ventricular function are independently related to cardiovascular morbidity and mortality. Our aim was to evaluate cardiac volume and function using magnetic resonance imaging in patients with persistent AF and to describe the changes after cardioversion (CV). Sixty consecutive patients with persistent AF and 19 healthy volunteers had cardiac volumes evaluated by cinematographic breath-hold magnetic resonance imaging. Patients with AF were evaluated before CV and at 1, 30, and 180 days after CV, if still in sinus rhythm. All atrial and ventricular volumes and left ventricular mass decreased and ejection fractions increased significantly after CV (p <0.0001 for all variables). Atrial and ventricular diastolic volumes increased significantly the day after CV. The atrial diastolic volumes had decreased significantly at 30 days and ventricular volumes at 180 days. The atrial systolic volumes decreased significantly the day after CV, but the ventricular systolic volumes remained constant the day after CV and decreased thereafter. Only the right atrial volumes were normalized 180 days after CV. The same results were found in a subgroup of patients with lone AF. In conclusion, reversal of atrial dimensions and function happened earlier than ventricular reversal after CV in persistent AF. Atrial reversal began immediately and ventricular reversal was not seen before 30 days after CV. Our results suggest that the changes to the left atrium and both ventricles caused by AF could be permanent and that CV of AF may be preferable.     

Ribavirin monotherapy for chronic hepatitis C infection: a Cochrane Hepato-Biliary Group systematic review and meta-analysis of randomized trials

OBJECTIVES: Adding ribavirin to interferon improves treatment response for patients with chronic hepatitis C, but the effects of ribavirin monotherapy are unclear. We conducted a systematic review to assess the benefits and harms of ribavirin monotherapy for patients with chronic hepatitis C. METHODS: Randomized trials were identified through the Cochrane Hepato-Biliary Group Controlled Trials Register, The Cochrane Library, MEDLINE, and EMBASE (last search May 2005). The primary outcomes were sustained virological response (loss of HCV RNA) and liver-related morbidity plus all-cause mortality. Secondary outcomes included end-of-treatment virological response, biochemical response (normalization of transaminases), histological response, and adverse events. RESULTS: We included 11 randomized trials with 521 patients. Ten trials had unclear control of bias. Ribavirin had no significant effect on sustained (risk difference (RD), 0%; 95% confidence intervals (CI), -2% to 3%) or end-of-treatment virological response (RD, 0%; 95% CI, -3% to 3%). Ribavirin had no significant effect on liver-related morbidity plus mortality (RD, 0%; 95% CI, -2% to 3%). Ribavirin significantly improved histological response and end-of-treatment biochemical response, but not sustained biochemical response. Ribavirin significantly increased the risk of anemia and treatment discontinuation. CONCLUSIONS: We found no evidence to support ribavirin monotherapy for patients with chronic hepatitis C, but trials were small and type II errors cannot be excluded. Patients intolerant to interferon should not continue treatment with ribavirin alone outside randomized trials.     

Esophagitis: incidence and risk of esophageal adenocarcinoma--a population-based cohort study

OBJECTIVES: Although symptoms of reflux are common, our knowledge of the epidemiology and natural history of gastroesophageal reflux disease is sparse. The risk of esophageal adenocarcinoma is increased among patients with acid reflux, but the contribution of Barrett's lesions is unknown. METHODS: With the aim to estimate the incidence of diagnosed endoscopic esophagitis lesions and the risk of esophageal adenocarcinoma among patients with previously diagnosed esophagitis, we extracted data on endoscopies, esophagitis diagnoses, and gastroesophageal cancer diagnoses from five population-based databases covering the period from 1974 to 2002, and covering all citizens in Funen County (population 470,000). RESULTS: In 2002, the incidence of esophagitis lesions was 2.4 per 1,000 person-years (95% confidence interval 2.3-2.6), 18.3 per 1,000 persons (17.9-18.7) had previously diagnosed esophagitis. Incidence increased by calendar year and age, was higher among males than among females, and was closely related to rate of endoscopy. Among 11,129 patients with previously diagnosed esophagitis, 15 had esophageal adenocarcinoma during 58,322 person-years of follow-up (26 per 100,000 person-years). The expected number was 2.79 and the standardized incidence ratio was 5.38 (3.01-8.87). Ten of the 15 patients with esophageal adenocarcinoma had previously diagnosed Barrett's esophagus. CONCLUSION: The risk of esophageal adenocarcinoma is increased fivefold in patients with previously diagnosed esophagitis, but most of the adenocarcinomas occurred among patients with Barrett's esophagus.     

Oral administration of glucose promotes intracellular partitioning of fatty acid toward storage in white but not in red muscle

Lipid accumulation in non-adipose tissues is strongly associated with the metabolic syndrome, possibly due to aberrant partitioning of intracellular fatty acids between storage and oxidation. In the present study, we administered the non-metabolizable fatty acid analog [9,10-(3)H]-(R)-2-bromopalmitate, and authentic (14)C-palmitate to conscious rats, in order to directly examine the initial intracellular fate of fatty acids in a range of insulin-sensitive tissues, including white and red muscles, liver, white adipose tissue, and heart. Rats were studied after administration of an oral glucose load to examine the effect of physiological elevation of glucose and insulin. The tracer results showed that glucose administration partitioned fatty acid toward storage in white muscle (storage:uptake ratios, vehicle vs glucose; 0.64 +/- 0.02 vs 0.92 +/- 0.09, P < 0.05), and in liver (0.66 +/- 0.07 vs 0.98 +/- 0.04, P < 0.05), but not in red muscle (1.18 +/- 0.07 vs 1.36 +/- 0.11, P = not significant). These results demonstrate the physiological relevance of the so-called 'reverse' Randle cycle, but surprisingly show that it may be more important in white rather than oxidative red muscle.     

Etiology and risk factors for oesophageal adenocarcinoma: possibilities for chemoprophylaxis?

The rapid increase in the incidence of oesophageal adenocarcinoma, particularly among white males, seems to be a true increase occurring in many parts of the industrialised world during the last few decades. Some main risk factors have been established: i.e. Barrett's oesophagus, gastrooesophageal reflux, high body mass, male sex, tobacco smoking, and high dietary intake of fruit and vegetables. Several other potential risk factors have been studied for which the evidence is less clear, including medications that relax the lower oesophageal sphincter or diets high in fat or low in nutrients from plant foods. Other factors have been found to be possibly inversely linked with the risk of oesophageal adenocarcinoma, including infection with Helicobacter pylori and anti-inflammatory drugs (such as aspirin and other non-steroidal anti-inflammatory drugs, including cyclo-oxygenase inhibitors). The methodological problem of 'confounding by indication' makes it difficult to interpret the results of anti-inflammatory drugs, and currently such medication cannot be recommended for the prevention of oesophageal adenocarcinoma. Similarly, since there is no strong evidence of a preventive effect of medical or surgical antireflux therapy with regard to risk of oesophageal adenocarcinoma, such therapy cannot be recommended in the prevention of this cancer. Although some of the known risk factors might contribute to the increasing incidence of oesophageal adenocarcinoma, the explanation that can entirely explain this striking trend remains to be identified. Oesophageal adenocarcinoma is a highly deadly cancer, but the overall prognosis and the prognosis after oesophageal cancer surgery has improved during recent years.     

Improved detection methods for infected hip joint prostheses

Awareness of the role of bacterial biofilm in the pathogenesis of low-grade or chronic infections diagnosed in hip arthroplasty has been on the rise in recent years. The importance of bacterial biofilm for the development of prosthesis failure is probably underestimated, and terms like aseptic loosening, sterile pus and aseptic necrosis are up for revision. The diagnosis of biofilm has been, and still is, difficult, but new molecular biological techniques, alone or in combination with older established ones, have further helped us to uncover lesions, where biofilm is part of the pathology. This article based on a literature search and own observations is primarily focused on newer methods that help us identify the pathology behind infection-based prosthesis failure. We suggest that the fluorescence in situ hybridization technique on carefully selected biopsy material is used in the future to identify live as well as dead bacteria within their environment. The method is quick and sensitive and provides a reliable result with optimal detection rate.     

Chromosome 7 aberrations in a young girl with myelodysplasia and hepatoblastoma: an unusual association

We report a 30-month-old female with intrauterine growth retardation, postnatal failure to thrive, pancytopoenia and myelodysplasia with monosomy 7 in the marrow. The child succumbed to overwhelming sepsis, following a bone marrow transplant to facilitate chemotherapy for metastatic hepatoblastoma--a tumour that has not been previously reported in myelodysplasia syndromes. Cytogenetic, molecular and microarray analysis of peripheral blood, skin fibroblasts and bone marrow revealed unusual results, suggestive of somatic chromosome instability. A normal peripheral blood karyotype was documented in infancy. Monosomy 7 was found in the bone marrow. Molecular (microsatellite marker) results for a later peripheral blood specimen were suggestive of partial maternal isodisomy 7q, and this was supported by microarray data on single-nucleotide polymorphisms. Microarray data on gene copy number, collected for the same blood specimen, indicated cryptic mosaicism for the monosomy 7 cell line, with the monosomic line lacking the paternal copy. In fibroblasts, cytogenetic data showed mosaic partial trisomy for distal 7p.