1
|
El-Demerdash AM, Hafez NG, Tanyous HN, Rezk KM, Shadi MS. Screening of voice and vocal tract changes in professional wind instrument players. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08755-1. [PMID: 38977470 DOI: 10.1007/s00405-024-08755-1] [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: 08/21/2023] [Accepted: 05/26/2024] [Indexed: 07/10/2024]
Abstract
PURPOSE Playing wind instruments is a strenuous task on the larynx, predisposing players to voice disorders. This study aims to evaluate potential vocal symptoms and vocal tract alterations in professional wind instrumentalists. METHODS In this cross-sectional study, 26 male military subjects were interviewed, completed the voice handicap index (VHI) -10 questionnaire, and subjected to auditory-perceptual assessment, neck examination, rigid laryngostroboscopy and flexible nasofiberoscopy both before and during instrument playing. RESULTS All participants had vocal fatigue symptoms, around one-quarter complained of voice change, one-quarter complained of shortness of breath while or after performing, and one-third complained of neck symptoms. The average score of VHI-10 was 16.2 ± 6.5, and approximately three-quarters of participants scored above the cut-off point. There were no significant correlations between age, years of instrument playing, average hours of daily practice, and VHI-10. Participants with neck symptoms had significantly higher VHI-10 scores. Those (around one-fifth) with an external neck swelling during Valsalva maneuver had a significantly higher VHI-10 score. Dysphonia, mainly mild and of strained, leaky quality, was detected in almost one-third of participants. While the instrument was being played, the vocal folds were somewhat adducted, and the vocal tract became more compressed as the task became more demanding. The most frequent observations in the vocal tract examination were hyperemia of the vocal folds or all over the laryngeal and pharyngeal mucosa, excessive secretions over the vocal folds, signs of hyperadduction, arytenoid edema, and phonatory waste. CONCLUSION Wind instrumentalists frequently experience voice disorders, which necessitate further care and investigation.
Collapse
Affiliation(s)
| | - Nirvana G Hafez
- Department of Otorhinolaryngology, Phoniatrics Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hanaa N Tanyous
- Higher Institute of the Conservatory, Academy of Arts, Cairo, Egypt
| | | | - Mariam S Shadi
- Department of Otorhinolaryngology, Phoniatrics Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| |
Collapse
|
2
|
Ashenefe Wassie B, Fantaw S, Mekonene Y, Teshale AM, Yitagesu Y, Tsige E, Getahun D, Tasew G, Abichu G, Moges B, Abate E, Abayneh T, Zeru T, Belay Z, Mor SM. First PCR Confirmed anthrax outbreaks in Ethiopia—Amhara region, 2018–2019. PLoS Negl Trop Dis 2022; 16:e0010181. [PMID: 35143510 PMCID: PMC8865639 DOI: 10.1371/journal.pntd.0010181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/23/2022] [Accepted: 01/18/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Anthrax is a disease that affects humans and animals. In Ethiopia, anthrax is a reportable disease and assumed to be endemic, although laboratory confirmation has not been routinely performed until recently. We describe the findings from the investigation of two outbreaks in Amhara region.
Methods
Following reports of suspected outbreaks in Wag Hamra zone (Outbreak 1) and South Gondar zone (Outbreak 2), multi-sectoral teams involving both animal and public health officials were deployed to investigate and establish control programs. A suspect case was defined as: sudden death with rapid bloating or bleeding from orifice(s) with unclotted blood (animals); and signs compatible with cutaneous, ingestion, or inhalation anthrax ≤7 days after exposure to a suspect animal (humans). Suspect human cases were interviewed using a standard questionnaire. Samples were collected from humans with suspected anthrax (Outbreak 1 and Outbreak 2) as well as dried meat of suspect animal cases (Outbreak 2). A case was confirmed if a positive test was returned using real-time polymerase chain reaction (qPCR).
Results
In Outbreak 1, a total of 49 cows died due to suspected anthrax and 22 humans developed symptoms consistent with cutaneous anthrax (40% attack rate), two of whom died due to suspected ingestion anthrax. Three people were confirmed to have anthrax by qPCR. In Outbreak 2, anthrax was suspected to have caused the deaths of two livestock animals and one human. Subsequent investigation revealed 18 suspected cases of cutaneous anthrax in humans (27% attack rate). None of the 12 human samples collected tested positive, however, a swab taken from the dried meat of one animal case (goat) was positive by qPCR.
Conclusion
We report the first qPCR-confirmed outbreaks of anthrax in Ethiopia. Both outbreaks were controlled through active case finding, carcass management, ring vaccination of livestock, training of health professionals and outreach with livestock owners. Human and animal health authorities should work together using a One Health approach to improve case reporting and vaccine coverage.
Collapse
Affiliation(s)
| | - Surafel Fantaw
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yonas Mekonene
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | | | | | - Geremew Tasew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Beyene Moges
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ebba Abate
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Taye Zeru
- Amhara Public Health Institute, Bahir Dar, Ethiopia
| | - Zewdu Belay
- Amhara Livestock Resource Development and Promotion Agency, Bahir Dar, Ethiopia
| | - Siobhan M. Mor
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- International Livestock Research Institute, Addis Ababa, Ethiopia
| |
Collapse
|
3
|
Wortsman X, Ferreira-Wortsman C. Ultrasound in Sports and Occupational Dermatology. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:1675-1692. [PMID: 33155699 DOI: 10.1002/jum.15550] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/06/2020] [Accepted: 10/12/2020] [Indexed: 06/11/2023]
Abstract
Chronic exposure to trauma, friction, or extreme conditions can generate cutaneous or ungual lesions in sports and certain occupations. Although some of these dermatologic conditions are diagnosed with a naked-eye examination, there are cases in which the provision of the underlying anatomic alterations can be helpful for the diagnosis and management. In comparison with computed tomography or magnetic resonance imaging, ultrasound has the highest axial resolution, which is critical for the observation of anatomic changes in the skin and nail. We review the ultrasound characteristics of frequent cutaneous and ungual lesions related to sports and occupations with a clinical correlation. The ultrasound features in some particular conditions such as "biker's and surfer's panniculitis," "fiddler's neck," piezogenic papules, and lipoatrophy semicircularis, among others, are discussed.
Collapse
Affiliation(s)
- Ximena Wortsman
- Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Santiago, Chile
- Department of Dermatology, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | | |
Collapse
|
4
|
Moore JE, Millar BC. Successful disinfection of trumpet mouthpieces using domestic steam disinfection. Lett Appl Microbiol 2020; 71:506-509. [PMID: 32745274 DOI: 10.1111/lam.13367] [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: 05/19/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 11/27/2022]
Abstract
There have been numerous reports in the literature describing the diversity of microbial flora isolated from woodwind and brass instruments, with potential infection risks for players, especially when such instruments are shared. Steam disinfection has become established as a trusted method of decontamination; however, there have been no reports on the employment of this technology to disinfect parts of musical instruments, hence it was the aim of this study to examine the fate of bacterial and yeast pathogens on artificially contaminated trumpet mouthpieces and to evaluate whether such disinfection is an effective method of disinfection for such instrument parts. Trumpet mouthpieces were artificially contaminated with 18 microbial strains (17 bacteria from four genera (Enterococcus, Escherichia, Staphylococcus and Streptococcus) and one yeast (Candida)), each at an inoculum density of approximately 1·5 × 107 colony forming units and subjected to a disinfection cycle. The experiment was repeated including 50% (v/v) sterile sputum as soil. No bacteria or yeast organisms were recovered post disinfection, including following recovery and with nonselective cultural enrichment techniques.
Collapse
Affiliation(s)
- J E Moore
- Northern Ireland Public Health Laboratory, Nightingale (Belfast City) Hospital, Belfast, UK.,School of Medicine, Dentistry and Biomedical Science, The Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, UK
| | - B C Millar
- Northern Ireland Public Health Laboratory, Nightingale (Belfast City) Hospital, Belfast, UK.,School of Medicine, Dentistry and Biomedical Science, The Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, UK
| |
Collapse
|
5
|
Franz L, Travan L, Isola M, Marioni G, Pozzo R. Facial Muscle Activity Patterns in Clarinet Players: A Key to Understanding Facial Muscle Physiology and Dysfunction in Musicians. Ann Otol Rhinol Laryngol 2020; 129:1078-1087. [PMID: 32486834 DOI: 10.1177/0003489420931553] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Facial muscle activity is crucial to controlling musical performance in wind instrument playing. Facial muscle dysfunctions are common in wind instrument players, dramatically affecting their professional musical activity and potentially leading to disabling symptoms.The aim of this pilot study on a cohort of healthy clarinetists was to use surface electromyography to identify the facial muscle activity patterns involved in stabilizing the mouthpiece, controlling emission and articulation during musical tasks in physiological conditions, also comparing muscle activity between less and more experienced clarinetists (students vs postgraduates/professionals). METHODS Surface electromyographic measures of the sternocleidomastoid, masseter, mentalis, mylohyoid and buccinator muscles were obtained from eight healthy clarinet players (four students and four postgraduates/professionals) performing two standardized musical tasks. RESULTS Overall, mean IEMG activity was significantly lower for the sternocleidomastoid than for the other muscles (P = .000), and for the mouthpiece-stabilizing muscles (masseter and mentalis) than for those directly involved in controlling emission and articulation (buccinator and mylohyoid muscles) (P = .000).Regardless of the musical task, the mean IEMG values were significantly higher in the students for the masseter (P = .0007), buccinator (P = .0001) and mylohyoid (0.000), while they were significantly higher in the postgraduates/professionals for the mentalis (P = .000). No significant differences emerged between the two groups for the sternocleidomastoid (P = .207). CONCLUSIONS These preliminary data reflect a significantly higher overall facial muscle activity in the less-experienced group, potentially resulting in an overload, whereas the more expert players had more optimized muscle activity patterns.
Collapse
Affiliation(s)
- Leonardo Franz
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy
| | - Luciana Travan
- Department of Medicine, Anatomy Section, University of Udine, Udine, Italy
| | - Miriam Isola
- Department of Medicine, Statistics Section, University of Udine, Udine, Italy
| | - Gino Marioni
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy
| | - Renzo Pozzo
- Department of Medicine, Exercise and Sport Science Section, University of Udine, Udine, Italy
| |
Collapse
|
6
|
Marwah V, Katoch CDS, Choudhary R, Bhati G. An unusual case of spontaneous pneumomediastinum secondary to tracheal tear in a trumpeter. Lung India 2020; 37:547-549. [PMID: 33154223 PMCID: PMC7879871 DOI: 10.4103/lungindia.lungindia_2_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Vikas Marwah
- Department of Pulmonary, Critical Care and Sleep Medicine, AICTS, Pune, Maharashtra, India
| | - C D S Katoch
- Department of Pulmonary, Critical Care and Sleep Medicine, AICTS, Pune, Maharashtra, India
| | - Robin Choudhary
- Department of Pulmonary, Critical Care and Sleep Medicine, AICTS, Pune, Maharashtra, India
| | - Gaurav Bhati
- Department of Pulmonary, Critical Care and Sleep Medicine, AICTS, Pune, Maharashtra, India
| |
Collapse
|
7
|
Kraft M, Schubert S, Geier J, Worm M. Contact dermatitis and sensitization in professional musicians. Contact Dermatitis 2019; 80:273-278. [DOI: 10.1111/cod.13191] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/31/2018] [Accepted: 11/26/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Magdalena Kraft
- Department of Dermatology and Allergology, Allergy-Centre-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - Steffen Schubert
- Information Network of Departments of Dermatology (IVDK) at the University of Göttingen; Göttingen Germany
| | - Johannes Geier
- Information Network of Departments of Dermatology (IVDK) at the University of Göttingen; Göttingen Germany
| | - Margitta Worm
- Department of Dermatology and Allergology, Allergy-Centre-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | | |
Collapse
|
8
|
Soumagne T, Reboux G, Metzger F, Roussel S, Lefebvre A, Penven E, De Vuyst P, Thaon I, Dalphin JC. Fungal contamination of wind instruments: Immunological and clinical consequences for musicians. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 646:727-734. [PMID: 30059932 DOI: 10.1016/j.scitotenv.2018.07.284] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/20/2018] [Accepted: 07/20/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Playing a wind instrument is an increasingly reported cause of hypersensitivity pneumonitis. However, current knowledge about contamination of wind instruments by fungi and specific fungal sensitization is scarce. Therefore, we aimed: (i) to assess the current prevalence and type of fungal contamination of wind instruments, (ii) to identify potential risk factors associated with instrument contamination, and (iii) to evaluate the prevalence of sensitization to these fungi among musicians. MATERIAL AND METHODS Musicians from music schools in eastern France and who played a wind instrument were prospectively recruited (NCT01487850). The mouthpiece and the reed of their instrument were sampled to quantify the magnitude and type of fungi. Each subject had a physical examination, a mycological analysis of saliva and a blood sample in search of serum precipitins against the most frequent fungi isolated from instruments. The results were compared with those of 40 healthy non-exposed controls. RESULTS Forty musicians playing a wind instrument (bassoon, clarinet, oboe, saxophone) were included. (i) 95% of wind instruments were colonized by fungi, mainly with Phoma spp., Penicillium spp. and Rhodotorula mucilaginosa; (ii) absence of systematic drying of the instrument was a main contributing factor; (iii) serum precipitins were significantly more present in the musicians' sera than in control sera and were consistent with the fungi present in their instrument. CONCLUSION This study reveals a constant and specific fungal contamination among wind reed instruments with a significant sensitization among musicians, pleading in favour of regular instrument cleaning. Physicians should be aware of this possible source of antigenic exposure.
Collapse
Affiliation(s)
- Thibaud Soumagne
- Service de Pneumologie, Centre Hospitalier Universitaire de Besançon, Besançon, France; Service de Physiologie-Explorations Fonctionnelles, Centre Hospitalier Universitaire de Besançon, Besançon, France.
| | - Gabriel Reboux
- UMR-CNRS 6249 Chrono-environnement, Université de Franche-Comté, Besançon, France; Laboratoire de Mycologie, Centre Hospitalier Universitaire Jean Minjoz, Besançon, France
| | - Flora Metzger
- Service de Pneumologie, Centre Hospitalier de Colmar, Colmar, France
| | - Sandrine Roussel
- UMR-CNRS 6249 Chrono-environnement, Université de Franche-Comté, Besançon, France
| | - Annick Lefebvre
- Service d'Hygiène Hospitalière, Centre Hospitalier Universitaire de Reims, Reims, France
| | - Emmanuelle Penven
- Université de Lorraine, CHRU-Nancy, Centre de Consultations de Pathologies Professionnelles, Nancy, France
| | - Paul De Vuyst
- Service de Pneumologie, Université Libre de Bruxelles, Brussels, Belgium
| | - Isabelle Thaon
- Université de Lorraine, CHRU-Nancy, Centre de Consultations de Pathologies Professionnelles, Nancy, France; Université de Lorraine, APEMAC, Nancy, France
| | - Jean-Charles Dalphin
- Service de Pneumologie, Centre Hospitalier Universitaire de Besançon, Besançon, France; UMR-CNRS 6249 Chrono-environnement, Université de Franche-Comté, Besançon, France
| |
Collapse
|
9
|
Barros A, Mendes J, Moreira A, Vardasca R, Pais Clemente M, Pinhão Ferreira A. Thermographic Study of the Orofacial Structures Involved in Clarinetists Musical Performance. Dent J (Basel) 2018; 6:E62. [PMID: 30388769 PMCID: PMC6313761 DOI: 10.3390/dj6040062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/15/2018] [Accepted: 10/22/2018] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Wind instrumentalists like clarinetists, may present a muscular hyperactivity on certain groups of the cranio-cervico-mandibular complex, due to their musical activity. Therefore, the use of infrared thermography can be used to assess and characterize the orofacial structures involved in clarinet performance. AIM The objective of this study was to analyze and record the thermal patterns using the thermographic camera Flir® E60sc to evaluate anatomically and physiologically certain orofacial structures of the cranio-cervical-mandibular complex, such as the masticatory muscles and the region of the temporomandibular joint. METHODOLOGY A sample of 30 clarinetists completed an individual questionnaire composed of two components (musical and clinical history of the participant), and were subjected to a clinical examination. Four thermographic images were taken of the cranio-cervical-mandibular complex at a rest position with frontal, right lateral, left lateral and anterior dentoalveolar components views. Each musician performed a piece of music for an uninterrupted period of 10 min. New thermographic images were captured with the same incidences, after the performance, respecting the same protocol. RESULTS There were statistically significant differences in the areas corresponding to the left temporal muscle, the orbicularis muscle (labial component), the left and right perioral teguments, as well as in the upper central incisors. There was also statistical evidence regarding the initial and final temperature asymmetries regarding temporal muscle and orbicular muscles (labial and marginal components). CONCLUSION Infrared thermography has been shown to be an effective complementary diagnostic tool in the monitorization of the cranio-cervical-mandibular complex of clarinetists.
Collapse
Affiliation(s)
- Ana Barros
- Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal.
| | - Joaquim Mendes
- INEGI-LAETA, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal.
| | - André Moreira
- Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal.
| | - Ricardo Vardasca
- INEGI-LAETA, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal.
| | | | - Afonso Pinhão Ferreira
- Department of Orthodontics, Faculty of Dental Medicine; University of Porto, 4200-393 Porto, Portugal.
| |
Collapse
|