The comparison between pulmonary rehabilitation with music therapy and pulmonary rehabilitation alone on respiratory drive, cortisol level and asthma control in patients hospitalized with asthma exacerbation.

INTRODUCTION: Much emphasis is being placed on the role of music therapy as an easy-to-use, noninvasive and relatively cheap method of asthma treatment. The objective of this interventional double-blinded randomized controlled trial was to assess whether music therapy, as a complementary modality to pulmonary rehabilitation, can help to improve respiratory drive, asthma control and quality of life in patients with asthma exacerbation. METHODS: Hospitalized patients with asthma exacerbation enrolled in the study were randomly assigned to experimental (music therapy) or control (popular science program) group. Both groups during hospitalization received standard pharmacotherapy accompanied by respiratory physiotherapy. Respiratory drive, asthma control, quality of life and serum cortisol in all participants were assessed at the beginning and at the end of their hospitalizations. RESULTS: The experimental group consisted of 39 asthmatics and 34 subjects with asthma were assigned to the control group. During the hospitalization, the levels of the inspiratory occlusion pressure for the first 0.1 s of inspiration (P0.1) decreased (p = 0.004) and the maximum P0.1 increased (p = 0.041) only in the experimental group. The serum cortisol level decreased in both groups (p = 0.001). The changes in asthma control and quality of life did not reach significant levels in either subject group. CONCLUSION: Passive music therapy and its effects on the mental state of patients seem to improve the efficiency of the respiratory system. The results of this experimental study demonstrate that a complementary music therapy has beneficial effects on the treatment of asthma exacerbations in adults.

Posture commonly and considerably modifies stenosis of left common iliac and left renal veins in women diagnosed with pelvic venous disorder.

OBJECTIVE: Pelvic venous incompetence or pelvic congestion syndrome (commonly referred to as pelvic venous disorder [PVD]) is increasingly diagnosed, especially in multiparous women. This may be either primary or secondary to pelvic venous outflow obstruction-left common iliac vein (LCIV) or left renal vein (LRV) stenosis. Intravascular ultrasound (IVUS) examination performed in the supine position is commonly used for diagnosis of LRV and LCIV stenosis; however, body position may affect the cross-sectional area (CSA) of both of these veins during IVUS. The aim of the study was to test the hypothesis that postural changes may significantly affect the CSA of the LRV and LCIV. METHODS: A single-arm, single-center cohort study of women suffering from PVD was performed at a tertiary hospital in Poland. It comprised consecutive patients with either pelvic vein reflux or suggestion of LCIV or LRV obstruction but no signs of deep venous thrombosis. IVUS examination of the iliac veins, inferior vena cava, and LRV was performed in the supine position. IVUS of the LRV and LCIV was performed also with a Valsalva maneuver and with patients lying on the left side and standing. A 60% CSA reduction was used as a cutoff value between significant and nonsignificant vein stenosis. RESULTS: A total of 41 women were examined. Significant stenosis of the LRV was seen in 22 patients (55%) supine but in only 4 (10%) patients studied when lying on the left side and in 27 (67.5%) patients studied while standing. Significant stenosis of the LCIV was seen in 26 supine patients (63.4%), in 8 lying on the left side (19.5%), and in 10 (24.4%) standing. CONCLUSIONS: Postural changes dramatically affect CSA of the LCIV and LRV and thus the degree of stenosis in women diagnosed with PVD. Stenosis found in patients while supine often disappears when the position is changed to lying on the left side or to standing. Therapeutic decisions based on assessment of CSA reduction in the supine position are likely to be inadequate.

Monkeys head-gaze following is fast, precise and not fully suppressible.

Human eye-gaze is a powerful stimulus, drawing the observer's attention to places and objects of interest to someone else ('eye-gaze following'). The largely homogeneous eyes of monkeys, compromising the assessment of eye-gaze by conspecifics from larger distances, explain the absence of comparable eye-gaze following in these animals. Yet, monkeys are able to use peer head orientation to shift attention ('head-gaze following'). How similar are monkeys' head-gaze and human eye-gaze following? To address this question, we trained rhesus monkeys to make saccades to targets, either identified by the head-gaze of demonstrator monkeys or, alternatively, identified by learned associations between the demonstrators' facial identities and the targets (gaze versus identity following). In a variant of this task that occurred at random, the instruction to follow head-gaze or identity was replaced in the course of a trial by the new rule to detect a change of luminance of one of the saccade targets. Although this change-of-rule rendered the demonstrator portraits irrelevant, they nevertheless influenced performance, reflecting a precise redistribution of spatial attention. The specific features depended on whether the initial rule was head-gaze or identity following: head-gaze caused an insuppressible shift of attention to the target gazed at by the demonstrator, whereas identity matching prompted much later shifts of attention, however, only if the initial rule had been identity following. Furthermore, shifts of attention prompted by head-gaze were spatially precise. Automaticity and swiftness, spatial precision and limited executive control characterizing monkeys' head-gaze following are key features of human eye-gaze following. This similarity supports the notion that both may rely on the same conserved neural circuitry.

Assessing the precision of gaze following using a stereoscopic 3D virtual reality setting.

Despite the ecological importance of gaze following, little is known about the underlying neuronal processes, which allow us to extract gaze direction from the geometric features of the eye and head of a conspecific. In order to understand the neuronal mechanisms underlying this ability, a careful description of the capacity and the limitations of gaze following at the behavioral level is needed. Previous studies of gaze following, which relied on naturalistic settings have the disadvantage of allowing only very limited control of potentially relevant visual features guiding gaze following, such as the contrast of iris and sclera, the shape of the eyelids and--in the case of photographs--they lack depth. Hence, in order to get full control of potentially relevant features we decided to study gaze following of human observers guided by the gaze of a human avatar seen stereoscopically. To this end we established a stereoscopic 3D virtual reality setup, in which we tested human subjects' abilities to detect at which target a human avatar was looking at. Following the gaze of the avatar showed all the features of the gaze following of a natural person, namely a substantial degree of precision associated with a consistent pattern of systematic deviations from the target. Poor stereo vision affected performance surprisingly little (only in certain experimental conditions). Only gaze following guided by targets at larger downward eccentricities exhibited a differential effect of the presence or absence of accompanying movements of the avatar's eyelids and eyebrows.

Disparate substrates for head gaze following and face perception in the monkey superior temporal sulcus.

Primates use gaze cues to follow peer gaze to an object of joint attention. Gaze following of monkeys is largely determined by head or face orientation. We used fMRI in rhesus monkeys to identify brain regions underlying head gaze following and to assess their relationship to the 'face patch' system, the latter being the likely source of information on face orientation. We trained monkeys to locate targets by either following head gaze or using a learned association of face identity with the same targets. Head gaze following activated a distinct region in the posterior STS, close to-albeit not overlapping with-the medial face patch delineated by passive viewing of faces. This 'gaze following patch' may be the substrate of the geometrical calculations needed to translate information on head orientation from the face patches into precise shifts of attention, taking the spatial relationship of the two interacting agents into account.