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PubMed2006

Songs composed for use in music therapy: a survey of original songwriting practices of music therapists.

While researchers have documented the efficacy of clinical songwriting in music therapy, limited research has been conducted on songs composed by music therapists that address clinical goals. The purpose of this research was to examine the original songwriting practices of music therapists. Professional music therapists (N = 1,364) received a 14-question survey via email asking each to identify client populations and clinical goals addressed by original songs, their length of time in clinical practice, and specifics about their acquisition of songwriting skills. The data collected from 302 completed surveys revealed that respondents who used original songs were most likely to work with children and adolescents in schools or the developmental disability field and wrote songs in order to individualize treatment. Music therapists working with persons over 65 years of age in long term care or assisted living programs were the least likely to use original songs in clinical practice, opting for interventions utilizing the client's familiar music. Most music therapists found songwriting generally easy, but only 37% indicated that they acquired this skill during their undergraduate degree. Additional research on the clinical efficacy of original songs and therapist's compositional processes is needed to identify best practices models for strategic songwriting.

Adolescent↗
PubMed2005

Phylogenomic analysis identifies red algal genes of endosymbiotic origin in the chromalveolates.

Endosymbiosis has spread photosynthesis to many branches of the eukaryotic tree; however, the history of photosynthetic organelle (plastid) gain and loss remains controversial. Fortuitously, endosymbiosis may leave a genomic footprint through the transfer of endosymbiont genes to the "host" nucleus (endosymbiotic gene transfer, EGT). EGT can be detected through comparison of host genomes to uncover the history of past plastid acquisitions. Here we focus on a lineage of chlorophyll c-containing algae and protists ("chromalveolates") that are postulated to share a common red algal secondary endosymbiont. This plastid is originally of cyanobacterial origin through primary endosymbiosis and is closely related among the Plantae (i.e., red, green, and glaucophyte algae). To test these ideas, an automated phylogenomics pipeline was used with a novel unigene data set of 5,081 expressed sequence tags (ESTs) from the haptophyte alga Emiliania huxleyi and genome or EST data from other chromalveolates, red algae, plants, animals, fungi, and bacteria. We focused on nuclear-encoded proteins that are targeted to the plastid to express their function because this group of genes is expected to have phylogenies that are relatively easy to interpret. A total of 708 genes were identified in E. huxleyi that had a significant Blast hit to at least one other taxon in our data set. Forty-six of the alignments that were derived from the 708 genes contained at least one other chromalveolate (i.e., besides E. huxleyi), red and/or green algae (or land plants), and one or more cyanobacteria, whereas 15 alignments contained E. huxleyi, one or more other chromalveolates, and only cyanobacteria. Detailed phylogenetic analyses of these data sets turned up 19 cases of EGT that did not contain significant paralogy and had strong bootstrap support at the internal nodes, allowing us to confidently identify the source of the plastid-targeted gene in E. huxleyi. A total of 17 genes originated from the red algal lineage, whereas 2 genes were of green algal origin. Our data demonstrate the existence of multiple red algal genes that are shared among different chromalveolates, suggesting that at least a subset of this group may share a common origin.

Algal Proteins↗
PubMed1982

The chromosomal origin of replication (oriC) of Erwinia carotovora.

The chromosomal DNA replication origin (oriC) of the plant pathogen Erwinia carotovora has been isolated and sequenced. The minimal E. carotovora oriC regional functional in Escherichia coli is a 374 base pair region located on a 7.9 kilobase pair SalI fragment which also contains a functional asnA gene. Differences between the nucleotide sequence of the minimal origin regions of E. carotovora and those of E. coli and Salmonella typhimurium are clustered nucleotide substitutions, with regions of complete homology, up to 19 base pairs long, between the three origins. Nine GATC sites are found in the minimal origin, and all are conserved. In contrast, the region toward asnA from the minimal origin shows little clustering and the differences occur mainly every third nucleotide, suggesting that this region is a protein coding region.

Base Sequence↗
PubMed1989

Binding of the herpes simplex virus type 1 UL9 gene product to an origin of viral DNA replication.

The binding of a herpes simplex virus type 1 (HSV-1) encoded polypeptide to a viral origin of DNA replication has been studied by using a gel retardation assay. Incubation of nuclear extract from HSV-1 infected cells with a labelled origin-containing fragment resulted in the formation of a specific retarded complex, the migration of which was further reduced in the presence of an antibody reactive with the UL9 gene product. Introduction of an additional copy of the UL9 gene, under the control of an immediate early (IE) promoter, conferred the ability to express origin binding activity at the non-permissive temperature upon an HSV-1 ts mutant blocked at the IE stage of infection. Endogenous or exogenous proteolytic activity revealed the presence of a relatively protease-resistant domain which retained sequence-specific DNA binding activity. The C-terminal 317 amino acids of the UL9 gene expressed as a fusion protein in Escherichia coli also bound to the origin. Our results demonstrate that the UL9 gene product binds to a viral origin and that sequence specific recognition and binding are specified by the C-terminal 37% of the polypeptide.

Animals↗
PubMed1980

The nucleotide sequence surrounding the replication origin of the cop3 mutant of the bacteriocinogenic plasmid Clo DF13.

The nucleotide sequence from about 100 base-pairs downstream to about 600 base pairs upstream the CloDF13 replication origin has been determined. A comparison of this sequence with the corresponding ColE1 origin sequence reveals that: The sequence at the origin of replication is conserved. There are large differences in the nucleotide sequence downstream the replication origin, whereas there is a large homology in the region of about 410 base-pairs upstream the replication origin. This conserved region might code for a largely homologous basic, arginine rich polypeptide of about 45 amino-acids, for both ColE1 and CloDF13. Although there are large differences in the primary structure of the region coding for the 100 nucleotide RNA, the secondary structure of this region seems to be conserved.

Base Composition↗
PubMed1989

Retrospective versus original information on cigarette smoking. Implications for epidemiologic studies.

This study was conducted to evaluate the agreement between retrospective information on cigarette smoking and original information obtained six years previously. A questionnaire on smoking habits was answered by 94% of a random sample of the adult Swedish population in 1963 (original information). Of the 10,356 subjects aged 40-59 years who reported that they had ever smoked regularly, 9,394 answered a second questionnaire in 1969. Information was obtained on present smoking habits as well as on smoking habits in 1963 (retrospective information). Cigarette consumption was divided into four categories: 0, 1-7, 8-15, and 16+ cigarettes per day. In relation to the original information on smoking, retrospective information showed a strong tendency to overestimate previous cigarette consumption among subjects who had increased their cigarette smoking (69%), and to underestimate previous cigarette consumption among subjects who had decreased their cigarette smoking (49%). Subjects with unchanged cigarette consumption showed a high level of agreement between original and retrospective information (89%). Age, sex, income, and occupational status also had some impact on the agreement between retrospective and original information on cigarette consumption. Consequences for epidemiologic studies based on retrospective smoking information are discussed. The use of retrospective information may introduce considerable differential misclassification when cases and noncases differ with regard to changes in smoking habits.

Adult↗
PubMed1992

Differences in the prevalence of hypertension by ethnic origin and age at immigration in a cohort of 5,146 Israelis.

Marked ethnic differences in hypertension prevalence have been described in Jewish immigrants to Israel. The extent to which this phenomenon has persisted after a long period of living in the same country, and whether native-born descendants exhibit similar patterns, is not clear. The aim of this study was to determine the prevalence of hypertension in immigrants to Israel and native-born Israelis by region of origin and age at immigration. Complete data were available for 5,146 subjects (3,607 men and 1,539 women) aged 20-64 years who were employed in Israeli industries and were examined during 1985-1987. In both sexes, Jews originating in the West (Europe and the Americas) had higher blood pressures and a significantly higher prevalence of hypertension than those from northern Africa or Asia, particularly in the age group 20-44 years (17% vs. 9% and 8% in men, respectively, and 9% vs. 3% and 5% in women). There was a significant positive association between the prevalence of hypertension and age at immigration (p less than 0.001) in both sexes, and this finding was present in all ethnic groups. In multiple logistic regression analysis, the associations of hypertension with ethnic origin and age at immigration were only partly explained by variations in body mass index, after controlling for other potentially confounding variables. These findings suggest that despite these subjects' having shared a relatively similar physical environment for many years, ethnic differences in the prevalence of hypertension persist. Immigration at an older age was associated with a higher prevalence of hypertension for both subjects originating in industrialized countries and those originating in nonindustrialized countries, suggesting that the process of immigration itself may adversely affect blood pressure.

Adult↗
PubMed1997

Out-of-hospital cardiac arrests of non-cardiac origin. Epidemiology and outcome.

AIMS: The aim of the study was to determine the epidemiology of out-of-hospital cardiac arrests of non-cardiac origin and survival following resuscitation, using the Utstein method of data collection. METHODS AND RESULTS: The study was of prospective cohort design and was conducted in a middle-sized urban city (population 525000) served by a single emergency medical services system. Consecutive out-of-hospital cardiac arrests of non-cardiac origin occurring between 1 January 1994 and 31 December 1995 were included. Survival from cardiac arrest to hospital discharge, and factors associated with survival were considered as main outcome measures. Of the 809 patients, 276 (34.1%) had a cardiac arrest of non-cardiac origin. The mean (SD) age of the patients was 49.8 (20.9) years. Resuscitation was attempted in 204 cases, 82 of whom (40.2%) were hospitalized alive and 23 (11.3%) were discharged. Thirteen (56.5%) of the survivors were discharged neurologically intact or with mild disability (overall performance category I or II). The survivors, during the study period, who suffered an out-of-hospital cardiac arrest of non-cardiac origin comprised 19.2% of all out-of-hospital cardiac arrest survivors. Trauma (62), non-traumatic bleeding (36), intoxication (31), near drowning (22) and pulmonary embolism (18) were the most common aetiologies, comprising 61.2% of cases. The non-cardiac aetiology was suspected pre-hospital in 176 (63.8%) cases; in the remaining cases, the aetiology was revealed only after in-hospital investigations or autopsy. In a logistic regression model, time interval to first responding unit, collapse outside the home, and aetiologies of near-drowning, airway obstruction, intoxication and convulsions were associated with survival. CONCLUSIONS: These results indicate that sudden out-of-hospital cardiac arrest more often has a non-cardiac cause than previously believed. Although survival is not as likely as from cardiac arrest of cardiac origin, since non-cardiac-cause survivors comprise one fifth of all out-of-hospital cardiac arrest survivors, resuscitation efforts are worthwhile.

Adolescent↗
PubMed1996

Nuclear-encoded rDNA group I introns: origin and phylogenetic relationships of insertion site lineages in the green algae.

Group I introns are widespread in eukaryotic organelles and nuclear-encoded ribosomal DNAs (rDNAs). The green algae are particularly rich in rDNA group I introns. To better understand the origins and phylogenetic relationships of green algal nuclear-encoded small subunit rDNA group I introns, a secondary structure-based alignment was constructed with available intron sequences and 11 new subgroup ICI and three new subgroup IB3 intron sequences determined from members of the Trebouxiophyceae (common phycobiont components of lichen) and the Ulvophyceae. Phylogenetic analyses using a weighted maximum-parsimony method showed that most group I introns form distinct lineages defined by insertion sites within the SSU rDNA. The comparison of topologies defining the phylogenetic relationships of 12 members of the 1512 group I intron insertion site lineage (position relative to the E. coli SSU rDNA coding region) with that of the host cells (i.e., SSU rDNAs) that contain these introns provided insights into the possible origin, stability, loss, and lateral transfer of ICI group I introns. The phylogenetic data were consistent with a viral origin of the 1512 group I intron in the green algae. This intron appears to have originated, minimally, within the SSU rDNA of the common ancestor of the trebouxiophytes and has subsequently been vertically inherited within this algal lineage with loss of the intron in some taxa. The phylogenetic analyses also suggested that the 1512 intron was laterally transferred among later-diverging trebouxiophytes; these algal taxa may have coexisted in a developing lichen thallus, thus facilitating cell-to-cell contact and the lateral transfer. Comparison of available group I intron sequences from the nuclear-encoded SSU rDNA of phycobiont and mycobiont components of lichens demonstrated that these sequences have independent origins and are not the result of lateral transfer from one component to the other.

Base Sequence↗
PubMed1993

Genetic affinities of inbred mouse strains of uncertain origin.

Phylogenetic analyses of genetic data arising from 144 gene loci are used to describe the interrelationships among 24 widely used inbred strains of mice. An unordered-parsimony analysis gives a cladogram that is virtually identical to the known genealogy of the mouse strains. A loss-parsimony analysis is used to evaluate the hypothesis that the observed patterns of genetic divergence among these 24 strains can be explained by the segregation of residual heterozygosity arising from a small population of highly heterozygous mice. The loss-parsimony cladogram is very similar to both the unordered-parsimony cladogram and the known genealogy of the mice. The phylogenetic analyses of these 144 loci are integrated with data on the type and origin of the Y chromosome. Inclusion of the Y-chromosome data provides additional insights into the genetic composition of several of the original stocks used to produce the current inbred strains of mice. Ten strains of uncertain origin are contained in these analyses, including AKR, BUB, CE, I, NZB, P, RF, SJL, ST, and SWR. SJL is hypothesized to have been derived from the same Swiss albino stock previously used to produce SWR. The BUB strain appears to have had a complex origin and shows closest genetic similarity to SWR and ST. AKR and RF are shown to be closely related, while the I strain shows greatest genetic similarity to DBA/2 for the 144 loci. However, I and DBA possess different types of Y chromosome. The NZB strain shows genetic similarity to several stocks of both U.S. and European origins. The power of the genetic data used in these analyses reiterates that inbred strains of mice can be a valuable paradigm for studies in evolutionary biology.

Animals↗
PubMed1995

Use of spectral analysis to test hypotheses on the origin of pinnipeds.

The evolutionary origin of the pinnipeds (seals, sea lions, and walruses) is still uncertain. Most authors support a hypothesis of a monophyletic origin of the pinnipeds from a caniform carnivore. A minority view suggests a diphyletic origin with true seals being related to the mustelids (otters and ferrets). The phylogenetic relationships of the walrus to other pinniped and carnivore families are also still particularly problematic. Here we examined the relative support for mono- and diphyletic hypotheses using DNA sequence data from the mitochondrial small subunit (12S) rRNA and cytochrome b genes. We first analyzed a small group of taxa representing the three pinniped families (Phocidae, Otariidae, and Odobenidae) and caniform carnivore families thought to be related to them. We inferred phylogenetic reconstructions from DNA sequence data using standard parsimony and neighbor-joining algorithms for phylogenetic inference as well as a new method called spectral analysis (Hendy and Penny) in which phylogenetic information is displayed independently of any selected tree. We identified and compensated for potential sources of error known to lead to selection of incorrect phylogenetic trees. These include sampling error, unequal evolutionary rates on lineages, unequal nucleotide composition among lineages, unequal rates of change at different sites, and inappropriate tree selection criteria. To correct for these errors, we performed additional transformations of the observed substitution patterns in the sequence data, applied more stringent structural constraints to the analyses, and included several additional taxa to help resolve long, unbranched lineages in the tree. We find that there is strong support for a monophyletic origin of the pinnipeds from within the caniform carnivores, close to the bear/raccoon/panda radiation. Evidence for a diphyletic origin was very weak and can be partially attributed to unequal nucleotide compositions among the taxa analyzed. Subsequently, there is slightly more evidence for grouping the walrus with the eared seals versus the true seals. A more conservative interpretation, however, is that the walrus is an early, but not the first, independent divergence from the common pinniped ancestor.

Algorithms↗
PubMed1992

The evolution of the mitochondrial D-loop region and the origin of modern man.

The origin of modern man is a highly debated issue that has recently been tackled by using mitochondrial DNA sequences. The limited genetic variability of human mtDNA has been explained in terms of a recent common genetic ancestry, thus implying that all modern-population mtDNAs originated from a single woman who lived in Africa less than 0.2 Mya. This divergence time is based on both the estimation of the rate of mtDNA change and its calibration date. Because different estimates of the rate of mtDNA evolution can completely change the scenario of the origin of modern man, we have reanalyzed the available mitochondrial sequence data by using an improved version of the statistical model, the "Markov clock," devised in our laboratory. Our analysis supports the African origin of modern man, but we found that the ancestral female from which all extant human mtDNAs originated lived in a time span of 0.3-0.8 Mya. Pushing back the date of the deepest root of the human implies that the earliest divergence would have been in the Homo erectus population.

Animals↗
PubMed2002

Variation in the glenoid origin of the anteroinferior glenohumeral capsulolabrum.

Restoration of the anteroinferior capsulolabrum, including the labrum and origin of the anterior band of the inferior glenohumeral ligament is crucial during Bankart repair. The purpose of the current study was to describe variations in this anatomy near the glenoid. The histologic and gross anatomy were studied in 10 fresh-frozen glenohumeral joints from adult cadavers. Each joint was placed in the apprehension position of abduction, external rotation, and horizontal abduction because anterior dislocation occurs in this shoulder position. The joints then were sectioned serially in the transverse plane from cephalad to caudad. Three glenohumeral joints were embedded in Techovit 7200 resin, polymerized, and then mounted onto an acrylic slide. Ground sections were prepared by attaching a microscope slide to the face of each and cutting 200 microm-thick sections. The thin sections were ground to a thickness of 30 microm. Finally, sections were stained with 1% toluidine blue zero in 1% sodium tetraborate for light microscopic examination. The other seven glenohumeral joints were frozen in the apprehension position and held with a custom jig while sectioned serially at 3-mm intervals. The surfaces then were recorded with a tabletop computer and a scanning device. Two distinct patterns of the anteroinferior capsulolabrum attachment to the glenoid were identified. In eight joints (80%) it had its major origin from the labrum with some fibers extending onto the glenoid neck, a Type I origin. In two joints (20%), it emanated solely from the glenoid neck, a Type II origin. Failure to repair the glenoid origin of the anteroinferior capsulolabrum, the location of the anterior band of the inferior glenohumeral ligament, because of variations in its anatomy may be a reason for failure after Bankart repair.

Humans↗
PubMed2004

Origin of nasal polyps: an endoscopic autopsy study.

OBJECTIVES/HYPOTHESIS: To further elucidate the natural history, etiology, and pathogenesis of nasal polyps, the present study of their anatomical site of origin was undertaken. The possibility for preferred areas or certain patterns in the places of origin was also considered. STUDY DESIGN: Autopsies were examined consecutively. METHODS: Endoscopic examination of the nasal cavity and paranasal sinuses, including endoscopic sinus surgery, was performed in 69 autopsies. The place of origin and attachment of each polyp was meticulously described. Polyps were photographically documented in situ and removed, together with the corresponding mucosa, for later histological examination. The cause of death of the patients was either cardiopulmonary disease or malignant diseases. Median age was 73 years (age range, 47-94 y). RESULTS: Nasal polyps were found in 22 of the 69 autopsies, corresponding to a frequency of 32%. In all, 54 polyps were found. Thirty-nine polyps were small (length, 2-5 mm), 10 were medium-sized, and 5 were large. No complaints of symptoms from the nasal polyps were registered. Most of the polyps (40 of 54 [74%]) originated in relation to sinus outlets. Most of these (34 of 54 [63%]) were found in the middle or superior meatus (13 of 54 [24%]). CONCLUSION: The results seemed to indicate that the frequency of nasal polyps is high and that most of the polyps originate from the mucosa of the ostia, clefts, and recesses in the ostiomeatal complex where the initial stage of sinonasal polyposis seems to take place. Continuous postmortem studies in autopsy materials and systematic endoscopic examinations for "silent," asymptomatic nasal polyps in various groups of patients will lead to a better understanding of the natural history of nasal polyps.

Aged↗
PubMed1998

Volume maintenance of onlay bone grafts in the craniofacial skeleton: micro-architecture versus embryologic origin.

The superior volume maintenance of membranous over endochondral bone has been shown in several studies and provides the basis for its preferred clinical use as an onlay grafting material in the craniofacial skeleton. The scientific rationale for this seeming embryologic advantage, however, has never been proven. Our hypothesis is that the pattern of onlay bone graft resorption is primarily determined by a graft's micro-architecture (relative cortical and cancellous composition) rather than its embryologic origin (membranous versus endochondral). Twenty-five adult New Zealand, White rabbits were used for this study. Eight animals were killed at 3 weeks, eight animals at 8 weeks, and nine animals at 16 weeks. Three graft types were placed onto each rabbit cranium: cortical bone graft of membranous origin and cortical and cancellous bone graft of endochondral origin. Fluorochrome markers were injected into all living rabbits at 1, 6, and 14 weeks. Microcomputed tomography scanning was performed on all of the bone grafts to determine postsacrifice volumes and to obtain detailed information regarding the bone graft's trabecular architecture. In addition, specimens were examined histologically. Volume analysis showed a statistically greater resorption rate in the cancellous endochondral bone graft than in either the endochondral or membranous cortical bone grafts (p < 0.05) for all time points. In addition there was no significant difference in the resorption rates between the endochondral and membranous cortical bone grafts. A post-test power analysis (alpha = 5 percent) of the volume data comparing the two types of cortical bone grafts showed that a difference in resorption of 8.9 percent would be detected with a 90-percent probability. Previous studies, which have shown a seeming superiority of membranous over endochondral bone grafts, used composite grafts composed of both cortical and cancellous portions. By separating these components, we have shown that cortical bone grafts maintain their volumes significantly better than cancellous bone grafts. In addition, we found no statistical difference in the resorption rates between the two cortical onlay bone grafts of different embryologic origins, a finding that has never been previously published. From our results, we believe cortical bone to be a superior onlay grafting material, independent of its embryologic origin. We believe these results challenge the currently accepted theories of bone graft dynamics and may lead to a change in the way clinicians approach bone graft selections for craniofacial surgery.

Animals↗
PubMed2005

Comparison of the original Amsler grid with the modified Amsler grid: result for patients with age-related macular degeneration.

PURPOSE: To compare the sensitivity of the original Amsler grid presenting white lines on a black background with that of the modified standard version of the grid presenting black lines on a white background in the detection of visual disturbances. PATIENTS AND METHODS: One hundred eighty-two patients (182 eyes) with dry and exudative age-related macular degeneration and a history of metamorphopsia were instructed to use an Amsler grid. None of the patients were familiar with an Amsler grid or had used it previously. If the disease was present in both eyes, one eye was chosen as the study eye by randomization. Both grid types were presented and used for documentation of central visual field changes. The sequence of presentation of the respective grid was also chosen by randomization. Original Amsler grid questions were used for grading ("metamorphomas" and "scotomas"). Visual acuity of patients ranged from 0.1 to 0.7. Subgroup analysis was performed based on the visual acuity levels. RESULTS: For the overall study population, the original Amsler grid provided significantly better results than the modified version. Evaluation of data for the different subgroups showed no significant difference between patients with visual acuity ranging from 0.1 to 0.3. For patients with visual acuity of 0.5 or better, the original Amsler grid was significantly more informative and reliable than the modified version. CONCLUSION: For patients with macular diseases, use of the original Amsler grid (white lines on a black background) should be recommended. This is particularly important for patients with visual acuity of 0.5 or better.

Aged↗
PubMed2002

Smooth-muscle progenitor cells of bone marrow origin contribute to the development of neointimal thickenings in rat aortic allografts and injured rat carotid arteries.

This study indicates that circulating progenitors of bone marrow origin give rise to cells with smooth muscle-like properties during formation of neointimal thickenings in the arterial wall after allotransplantation and after balloon injury. A segment of abdominal aorta was transplanted from female F344 to male LEW rats, and the grafts were analyzed for male cells by using the gene as a marker. Immunostaining demonstrated that CD45-positive leukocytes made up 35-45% of the neointimal cells during the 8-week period examined. Concurrently, up to 70% of the neointimal cells were of host origin, as shown by real-time polymerase chain reaction for the gene (Y chromosome). This suggests that the neointima contained host cells also of noninflammatory character. Accordingly, many cells positive for smooth-muscle alpha-actin were detected in this layer. To explore the possible bone marrow origin of allograft cells, female LEW rats were irradiated and substituted with bone marrow from male LEW rats. Subsequently, the animals received an aortic transplant from female F344 rats or were exposed to a balloon injury of the carotid artery. Immunostaining and real-time polymerase chain reaction confirmed the above findings, but the fractions of leukocytes and -positive cells were lower in the carotids than in the allografts. Combined primed in situ labeling and immunostaining verified that not only inflammatory but also smooth muscle-like cells of male origin appeared in the vessel wall in both situations. These observations suggest that the smooth-muscle cells that participate in the development of neointimal lesions during vascular disease may, in part, originate from circulating progenitors.

Animals↗
PubMed2003

Derivation and identification of questions that act as predictors of abdominal pain of musculoskeletal origin.

OBJECTIVE: Although most causes of abdominal pain have a visceral origin, the musculoskeletal system must be considered when the cause is not obvious. This prospective study aimed to identify questions that would aid the diagnosis of patients with abdominal pain of musculoskeletal origin. DESIGN: Assessment of consecutive patients with abdominal pain recruited from gastroenterological outpatient clinics to develop diagnostic pointers to identify abdominal pain arising from musculoskeletal disorders. PARTICIPANTS: Subjects with benign abdominal pain, with or without a change in bowel habit, were recruited from gastroenterological clinics. Patients with inflammatory or neoplastic disease were excluded. SETTING: The study was conducted in the Physiotherapy Department, Addenbrooke's NHS Trust Hospital, Cambridge. MAIN OUTCOME MEASURES: A set of questions developed to indicate a musculoskeletal cause of a patient's abdominal symptoms. RESULTS The questions 'Does taking a deep breath aggravate your symptoms?' and 'Does twisting your back aggravate your symptoms?' had a significant positive indication of abdominal symptoms of musculoskeletal origin. The questions 'Has there been any change in bowel habit since onset of your symptoms?', 'Does eating foods aggravate your symptoms?' and 'Has there been any weight change since onset of symptoms?' had a significant negative indication for abdominal symptoms not of musculoskeletal origin. A combination of these questions gave 96% specificity and 67% sensitivity. CONCLUSION: These questions may help with the early identification of patients with abdominal pain of musculoskeletal origin and will be tested in further studies.

Abdominal Pain↗