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Becker DR, Welch B, Monti E, Sullivan H, Helou LB. Investigating Past Trauma in Laryngoresponders Versus Non-Laryngoresponders: Piloting New Methods in an Exploratory Study. J Voice 2022:S0892-1997(22)00144-8. [PMID: 35701254 DOI: 10.1016/j.jvoice.2022.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/13/2022] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES/HYPOTHESIS This exploratory pilot study aimed to probe the relationship between past experiences of trauma in people who self-identify as "laryngoresponders" compared to those who do not. It also explored the communicative context of past traumatic events in laryngoresponders versus non-laryngoresponders. STUDY DESIGN Prospective, within-subjects experimental design. METHODS 29 vocally healthy cisgender women (ages 19 to 56) completed a battery of validated self-report measures relating to their past traumatic experiences. Participants also completed two original self-report measures designed to provide insight about (1) where stress tends to manifest in their body and (2) communicative settings of participants' past trauma. RESULTS Six participants (21%) self-identified a predictable laryngeal and/or vocal response to acute stress and thus comprise the laryngoresponders group. Laryngoresponders exhibited worse scores on 75% of all trauma-related variables compared to non-laryngoresponders, and Emotional Neglect was disproportionately represented in laryngoresponders. Participants with a reported history of childhood Emotional Neglect (83% of laryngoresponders, 35% of nonlaryngoresponders) reported quantitatively "less ideal" communication experiences in the context of past traumatic experiences. CONCLUSIONS Other investigators identify the larynx as a "vulnerable body pathway" for some women. This pilot study of adult women without voice complaints revealed several commonalities amongst self-reported laryngoresponders, and compels further exploration of the voice-trauma relationship.
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Affiliation(s)
| | - Brett Welch
- Department of Communication Science and Disorders, The University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Elisa Monti
- Department of Psychology, The New School, New York City, New York
| | | | - Leah B Helou
- Department of Communication Science and Disorders, The University of Pittsburgh, Pittsburgh, Pennsylvania.
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Kang CH, Zhang N, Lott DG. Muscle Tension Dysphagia: Contributing Factors and Treatment Efficacy. Ann Otol Rhinol Laryngol 2020; 130:674-681. [PMID: 33090008 DOI: 10.1177/0003489420966339] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine factors contributing to disease etiology and treatment efficacy. STUDY DESIGN Original Report. SETTING Tertiary academic center. METHODS IRB approved prospective study of 20 patients with reported dysphagia who exhibited normal oropharyngeal and esophageal swallowing function as evidenced by videofluoroscopic swallow study, esophagogastroduodenoscopy, high-resolution esophageal manometry with stationary impedance, and Bravo pH probe off proton pump inhibitor. Patients underwent speech-language pathology intervention. RESULTS Atypical laryngeal muscle tension was present in 100% of patients. Forty percent of patients had diagnosed positive gastroesophageal reflux disease. Sixty-five percent of patients showed signs of non-specific laryngeal inflammation and laryngeal hyperresponsiveness during strobolaryngoscopy. All patients reported a mean of 90% recovery by the completion of voice therapy directed toward unloading muscle tension. CONCLUSION The study results suggest an association between laryngeal muscle tension and these patients' dysphagia symptoms regardless of associated conditions. Speech-language pathology intervention showed high treatment efficacy. LEVEL OF EVIDENCE 2c- Outcomes research.
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Affiliation(s)
- Christina H Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Division of Laryngology, Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Nan Zhang
- Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - David G Lott
- Department of Otorhinolaryngology-Head and Neck Surgery, Division of Laryngology, Mayo Clinic Arizona, Phoenix, Arizona, USA
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Voice Handicap Index-Throat: Translation and Cross-Cultural Adaptation to Brazilian Portuguese. J Voice 2020; 36:143.e1-143.e7. [PMID: 32381274 DOI: 10.1016/j.jvoice.2020.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/27/2020] [Accepted: 04/13/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aims to translate and cross-culturally adapt the throat scale of the Voice Handicap Index to the Brazilian Portuguese language.uracy. MATERIAL AND METHODS This was performed in five phases translation, synthesis, back translation, review, and pretest. Fifty subjects participated in the pretest, of which 22 participants had chronic cough, 13 had laryngopharyngeal reflux, and 15 had behavioral dysphonia. Of the 50 participants, 40 were female and 10 male, with an average age of 44 years and six months. RESULTS In the translation process, only question four had to be translated by a fourth judge. After the back-translation and committee review steps, it was necessary to make adjustments to questions one, four, five, seven, eight, nine, and 10. With regard to question five, the "never" option was significantly associated with the clinical group with behavioral dysphonia (P = 0.016), and with regard to question eight, the option was occasionally significantly associated with the clinical group with laryngopharyngeal reflux (P = 0.015). For question six, all the response categories of the questionnaire, had a significantly higher proportion compared to "not applicable" (P < 0.001). For the other questions, no participants selected the "not applicable" option. CONCLUSION The translation and cross-cultural adaptation of the throat scale of the Voice Handicap Index to Brazilian Portuguese was performed successfully; the Voice Handicap Index in Brazilian Portuguese prepared herein was called the Índice de Desvantagem Vocal-Garganta.
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Kayalı Dinc AS, Cayonu M, Sengezer T, Sahin MM. Smoking Cessation Improves the Symptoms and the Findings of Laryngeal Irritation. EAR, NOSE & THROAT JOURNAL 2019; 99:124-127. [PMID: 31608685 DOI: 10.1177/0145561319881559] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Smoking is known to increase laryngeal inflammation and laryngopharyngeal reflux (LPR), which cause laryngeal irritation. Thus, the aim of this study is to evaluate the changes in the symptoms and the findings of laryngeal irritation in smokers after a smoking cessation period. The reflux symptom index (RSI) and the reflux finding score (RFS) were used for evaluating the symptoms and findings of laryngeal irritation in smokers. Endoscopic examination of the laryngeal structures for RFS and symptom inquiry for RSI were performed at the beginning of the study and after a 2 months of cigarette cessation period. This study was carried out in 24 volunteers (14 female and 10 male), between the ages of 24 and 62 years. When we compared the results of RSI and RFS that were performed before and after the cigarette cession period, we found that there was a significant improvement both in RSI and in RFS (P < .001 and P < .001, respectively). Also, there was significant correlation between the cigarette smoking period and RFS score that was determined at the beginning of the study (P = .006, r = .54). A significant improvement was found both in RSI and in RFS after smoking cessation period, which might be the evidence of improvement in laryngeal irritation possibly caused by inflammation due to smoking and LPR. A significant positive correlation was found between smoking period and RFS, especially with vocal fold edema and posterior commissure hypertrophy.
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Affiliation(s)
- A Secil Kayalı Dinc
- Department of Otorhinolaryngology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Melih Cayonu
- Department of Otorhinolaryngology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Tijen Sengezer
- Department of Family Medicine, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - M Melih Sahin
- Department of Otorhinolaryngology, Ankara Numune Training and Research Hospital, Ankara, Turkey
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Campagnolo A, Benninger MS. Allergic laryngitis: chronic laryngitis and allergic sensitization. Braz J Otorhinolaryngol 2019; 85:263-266. [PMID: 30898484 PMCID: PMC9442838 DOI: 10.1016/j.bjorl.2019.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Andrea Campagnolo
- Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil; Otolaryngology Clinic, Rio de Janeiro, RJ, Brazil.
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Fuentes-López E, Fuente A, Contreras KV. Inadequate vocal hygiene habits associated with the presence of self-reported voice symptoms in telemarketers. LOGOP PHONIATR VOCO 2017; 44:105-114. [DOI: 10.1080/14015439.2017.1414302] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Eduardo Fuentes-López
- Programa de Doctorado en Salud Pública, Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
- Carrera de Fonoaudiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Adrian Fuente
- École d’orthophonie et d’audiologie, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, Québec, Canada
| | - Karem V. Contreras
- Escuela de Fonoaudiología, Facultad de Ciencias de la Salud, Universidad San Sebastian, Santiago, Chile
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Abstract
IgE-mediated allergy plays a well-established role in both nasal and pulmonary diseases due to the common epithelium and shared mediator responses of the upper and lower airways. This "unified airway" concept has also been described in other sites within the head and neck that contain similar respiratory mucosa: the middle ear and the larynx. This review will highlight the data suggesting a role for IgE-mediated allergic disease in chronic laryngopharyngeal and middle ear disease and the role for allergy testing to aid in diagnosis and treatment of these disorders.
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Agu KA, Nwosu JN, Akpeh JO. Evaluation of Vocal Cord Function Before Thyroidectomy: Experience from a Developing Country. Indian J Surg 2016; 80:211-215. [PMID: 29973749 DOI: 10.1007/s12262-016-1577-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 12/16/2016] [Indexed: 10/20/2022] Open
Abstract
Vocal cord palsy (VCP) is a major complication of thyroidectomy. Some patients have preexisting VCP prompting the need for routine or selective preoperative evaluation of the vocal cords. The study aims at ascertaining the prevalence of preoperative VCP and making appropriate recommendations. This is a retrospective study of all adult patients who had thyroidectomy at the University of Nigeria Teaching Hospital. Case notes of patients who had thyroidectomy at the hospital from July 2010 to June 2015 were retrieved. Variables studied included biodata, duration of goiter, preoperative hoarseness, outcome of indirect laryngoscopy (IDL), histology of specimen, duration of follow-up, and incidence of postoperative hoarseness. Descriptive statistical analysis was done using SPSS version 20. Of the 91 patients aged 21-70 years (mean 42.08 years, SD 15.40), females outnumbered males with a M:F ratio of 1:10.4. Five patients had preoperative hoarseness, but only three had VCP. IDL was done for 25 (27.4%) patients out of which 22 (88.0%) had normal studies while the remaining three (all from the five with hoarseness) had VCP. Histology of the specimens showed malignancy in 10 (11%), benign in 55 (60.4%), and no report in 26 (28.6%). Five of the malignant histology patients showed normal findings on IDL, three had VCP and two had no preoperative IDL. There was no case of asymptomatic VCP. Vocal cord evaluation is recommended for patients with voice symptoms and those with malignant goiter.
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Affiliation(s)
- Kenneth A Agu
- 1Department of Surgery, University of Nigeria Teaching Hospital, Ituku/Ozalla, P.M.B. 01129, Enugu, 400001 Nigeria
| | - Jones N Nwosu
- 2Department of Otorhinolaryngology, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
| | - James O Akpeh
- 2Department of Otorhinolaryngology, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
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Schuster M, Betz C. [Globus sensation: etiology and diagnostics]. MMW Fortschr Med 2016; 158:74-80. [PMID: 27757913 DOI: 10.1007/s15006-016-8611-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Maria Schuster
- Klinik für Hals-Nasen-Ohrenheilkunde, Klinikum der Universität München, Campus Großhadern, München, Deutschland.
- Abteilung für Audiologie, Phoniatrie und Pädaudiologie der Klinik für Hals-Nasen-Ohrenheilkunde, Klinikum der Universität München, Campus, Großhadern, Marchioninistraße 15, D-81377, München, Deutschland.
| | - Christian Betz
- Klinik für Hals-Nasen-Ohrenheilkunde, Klinikum der Universität München, Campus Großhadern, München, Deutschland
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Brook CD, Platt MP, Reese S, Noordzij JP. Utility of Allergy Testing in Patients with Chronic Laryngopharyngeal Symptoms. Otolaryngol Head Neck Surg 2015; 154:41-5. [DOI: 10.1177/0194599815607850] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 09/02/2015] [Indexed: 11/15/2022]
Abstract
Objective To determine the utility of allergy evaluation in patients with chronic refractory laryngeal symptoms. Study Design Case series with chart review. Setting Tertiary academic medical center. Subjects All patients who underwent in vitro allergy testing at a single institution from 2006 to 2010, for a total of 998 patients. Methods Charts of patients who underwent in vitro allergy testing were identified. The charts were reviewed for the primary indication for allergy testing, as categorized into rhinitis complaints, chronic sinusitis, otitis media, and refractory laryngeal symptoms (globus, cough, throat clearing, increased secretions, and hoarseness). Results of allergy tests and comorbid conditions were analyzed and compared among groups. Results The positive yield of allergy testing in patients with primary laryngeal indications was 51.8%, 63.3% for rhinitis, 60.9% for sinusitis, and 33.3% for otitis media. The odds ratio of having a positive test was not statistically different for patients with laryngeal symptoms, rhinitis, or sinusitis. Patients with chronic laryngeal symptoms and positive allergy testing were most often sensitized to dust mites (63%) and least often sensitized to molds (1.3%). Conclusions Allergy testing in patients with chronic laryngeal symptoms yields positive results in equivalent proportion to patients with other common presenting symptoms. Dust mites sensitization is the most common sensitization in patients with allergic laryngitis.
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Affiliation(s)
| | | | - Stephen Reese
- Boston University Medical Center, Boston, Massachusetts, USA
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Brook C, Noordzij JP, Russell K, Aliphas A, Platt M. Predictive findings of allergic disease in fiberoptic nasolaryngoscopy. Laryngoscope 2014; 125:286-90. [DOI: 10.1002/lary.24880] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 07/09/2014] [Accepted: 07/16/2014] [Indexed: 11/05/2022]
Affiliation(s)
- Christopher Brook
- Department of Otolaryngology-Head and Neck Surgery; Boston University School of Medicine; Boston Massachusetts U.S.A
| | - J. Pieter Noordzij
- Department of Otolaryngology-Head and Neck Surgery; Boston University School of Medicine; Boston Massachusetts U.S.A
| | - Kimberly Russell
- Department of Otolaryngology-Head and Neck Surgery; Boston University School of Medicine; Boston Massachusetts U.S.A
| | - Avner Aliphas
- Department of Otolaryngology-Head and Neck Surgery; Boston University School of Medicine; Boston Massachusetts U.S.A
| | - Michael Platt
- Department of Otolaryngology-Head and Neck Surgery; Boston University School of Medicine; Boston Massachusetts U.S.A
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Roth DF, Abbott KV, Carroll TL, Ferguson BJ. Evidence for primary laryngeal inhalant allergy: a randomized, double-blinded crossover study. Int Forum Allergy Rhinol 2012; 3:10-8. [PMID: 23129179 DOI: 10.1002/alr.21051] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Despite anecdotal reports, no controlled studies to date link allergen exposure with a change in vocal function or dysphonia. The aim of this study was to determine whether allergen exposure in susceptible individuals impairs vocal function. METHODS The study was a prospective, double-blind, placebo-controlled study in which subjects serve as their own controls. The participants were 5 inhalant allergic adults with suspected dysphonia from allergies, without evidence of reactive lower airways based on methacholine challenge. All subjects were exposed to 2 experimental conditions in which they were challenged with (1) orally inhaled diluent placebo on 1 day, and (2) orally inhaled allergen on another day. Conditions were randomly ordered across subjects and separated by at least 48 hours. Phonatory threshold pressure (PTP) at the 80th percentile pitch was measured prior to diluent and allergen challenge, and 15 and 60 minutes postchallenge to assess potential change in vocal function after challenge testing. RESULTS A repeated measures ANOVA revealed a significant main effect for treatment (allergen vs placebo, p = 0.013) with greater PTP required post-allergen challenge compared to placebo and an effect size of 0.821. CONCLUSION A primary causal relationship between allergen exposure and impaired vocal function, as assessed by PTP, was observed in adults with documented allergy independent of asthma or nasal exposure. The current design establishes a safe model for laryngeal inhalant allergen challenge.
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Affiliation(s)
- Douglas F Roth
- University of Pittsburgh, School of Health and Rehabilitation Sciences, Department of Communication Science and Disorders, Pittsburgh, PA 15213, USA
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Reflux and aerodigestive tract diseases. Eur Arch Otorhinolaryngol 2012; 270:417-23. [PMID: 22773190 DOI: 10.1007/s00405-012-2085-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2012] [Accepted: 06/05/2012] [Indexed: 02/08/2023]
Abstract
Gastroesophageal reflux disease can present with a wide variety of extraesophageal symptoms. In particular, the type of disease characterized predominately by laryngopharyngeal reflux may be difficult to diagnose because of the absence of regurgitation or heartburn. The available battery of diagnostic tools is often insufficient to confirm a diagnosis of reflux, so the diagnosis is often made by elimination. In many cases, treatment with proton pump inhibitors will relieve symptoms and respiratory complications, despite the persistence of non-acidic reflux. Such treatment is often employed to "confirm" the diagnosis, as measured by patient response. Many diseases have been related to this condition in the literature. The authors review knowledge about these manifestations and their relationship with refluxed gastric content. Physiopathology, symptoms and treatment are reviewed in order to clarify our understanding of laryngopharyngeal reflux diseases and related manifestations.
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Cohen SM, Pitman MJ, Noordzij JP, Courey M. Management of Dysphonic Patients by Otolaryngologists. Otolaryngol Head Neck Surg 2012; 147:289-94. [DOI: 10.1177/0194599812440780] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective To investigate common treatment approaches of general otolaryngologists for adult dysphonic patients without obvious laryngeal anatomic abnormalities. Study Design Cross-sectional survey. Setting General otolaryngology community. Subjects and Methods One thousand randomly chosen American Academy of Otolaryngology—Head and Neck Surgery general otolaryngologists were mailed a survey. Results The response rate was 27.8%. Mean years in practice was 19.5. The most common treatments were proton pump inhibitor (PPI), referral to speech pathology, and stroboscopy. Muscle tension dysphonia, vocal fold nodules, and dysphonia of uncertain etiology were the most common reasons for voice therapy referral. Various forms of supraglottic compression and tender extralaryngeal muscles were identified as findings of muscle tension dysphonia. Response to once-daily PPI, laryngeal signs, and throat symptoms were the most common determinants for laryngopharyngeal reflux. When patients failed initial treatment, 58.2% refer for voice therapy, 46.9% obtain stroboscopy, and 33.3% extend or increase duration of PPI treatment. Conclusions Varied treatment approaches to adult dysphonic patients were identified. How practice patterns vary from best practice guidelines, affect patient outcome, and influence health care costs needs examination.
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Affiliation(s)
- Seth M. Cohen
- Duke Voice Care Center, Division of Otolaryngology–Head & Neck Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Michael J. Pitman
- Voice and Swallowing Institute, Department of Otolaryngology–Head & Neck Surgery, New York Eye and Ear Infirmary, New York, New York, USA
| | - J. Pieter Noordzij
- Department of Otolaryngology–Head & Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Mark Courey
- UCSF Voice Center, Department of Otolaryngology–Head & Neck Surgery, University of California–San Francisco, San Francisco, California, USA
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Abstract
Hoarseness is a common symptom that can result from a wide spectrum of underlying causes ranging from the common cold to a malignancy. A framework for diagnostic evaluation is presented based on categorizing the myriad of causes by how they interfere with the voice production mechanism. Triaging of cases by necessity or urgency of laryngoscopy is assisted by forming a global index of suspicion based on targeted history taking. Laryngoscopy is required in most cases to obtain a diagnosis for the hoarseness. Treatments commonly prescribed for hoarseness are critically examined in this article. To listen to audio clips of patients with different types of hoarseness, please visit our website, www.medical.theclinics.com.
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Affiliation(s)
- Ted Mau
- Clinical Center for Voice Care, Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA.
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Vocal allergy: recent advances in understanding the role of allergy in dysphonia. Curr Opin Otolaryngol Head Neck Surg 2010; 18:176-81. [DOI: 10.1097/moo.0b013e32833952af] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Current World Literature. Curr Opin Otolaryngol Head Neck Surg 2010; 18:191-4. [DOI: 10.1097/moo.0b013e32833ad4c9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Judd O. Re: Hoarse voice in adults: an evidence-based approach to the 12 minute consultation. Clin Otolaryngol 2009; 34:266-7. [DOI: 10.1111/j.1749-4486.2009.01928.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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