Music Therapy Benefits for Mild to Moderate Alzheimer’s Disease

One study conducted by Masayuki Satoh and colleagues focused on how music therapy could have potential psychomotor speed benefits for patients with mild to moderate Alzheimer’s Disease. Music therapy is a non-pharmaceutical intervention completed with a music therapist in an individual setting or group setting. It is meant to improve communication, relationships, learning, expression, and organization. The study had two groups of ten with one group given music therapy and one group that was not. Music therapy was done once a week for 6 months. Methods that were used to measure changes included neuropsychological assessment before and after the study, functional magnetic resonance imaging during performance, and other assessments.

Results of the study showed that the neuropsychological assessment time for the music therapy group decreased significantly in comparison to the control group. There was also sleep duration improvements in the music therapy group, and based on caregiver observation at home, there were improvements in personal will, emotion, and socialization. The fMRIs were more difficult to obtain due to resistance and some panicking from the patients. What this part of the study was able to demonstrate was increased activity in the right angular gyrus and left lingual gyrus for the patients that were able to complete the fMRIs.

The study was able to demonstrate that procedural memory is maintained in patients with mild to moderate Alzheimer’s, and psychomotor speed increased with this form of intervention. The team acknowledged that the study was limited based on the number of patients and that a longer study would need to be conducted to see the long term effects of music therapy on disease progression.

It’s interesting that the team acknowledged all of the limitations of the trial, but it is rewarding to see that the music therapy did have a positive effect on the patients. I would be interested to see how this could be implemented on a wide scale for patients facing dementia. As people become older, it is less likely for them to pick up something new. However, mental exercises could be a way to ensure cognition in the long run. What other options could be made available for patients dealing with degenerative diseases?

Satoh M, Yuba T, Tabej K, et al. Music Therapy Using Singing Training Improves Psychomotor Speed in Patients with Alzheimer’s Disease: A Neuropsychological and fMRI Study. Dement Geriatr Cogn Dis Extra. 2015; 5(3): 296-308.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608626/

Garcinia Cambogia Effect on Weight Loss in Rats

Obesity is a growing issue for many patients caused by an imbalance between consumption and expenditure of energy. With obesity, there is a higher risk for chronic disease and potentially disability. The excess lipids in fat cells can lead to production of inflammatory cytokines, insulin resistance, and potentially cause renal disease. In a study conducted by Ramalingam Sripradha and Sridhar Magadi, the primary focus how a supplement known as Garcinia Cambogia could help prevent obesity. Garcinia Cambogia contains hyroxycitruc acud which inhibits ATP-citrate lyase found in lipid formation. The study was conducted on five month old male Wistar rates. Two kinds of diets were given to the rats: standard rodent diet and a diet with 30% high fat. One group in each diet type was also given Garcinia Cambogia while the other group did not receive this.

To measure effects of the study, body weight, glucose tolerance, leptin, tumor necrosis factor-a, and renal function were measured. Results showed that there was weight gain in rats that were given a high fat diet while the group given a high fat diet and the Garcinia Cambogia had a decrease in weight gain. In the groups with a high fat diet, both higher levels of leptin (regulated food intake and energy expenditure) and weight gain were seen. The rats that had the Garcinia Cambogia along with a high fat diet had lower leptin levels and less weight gain. With Garcinia Cambogia, there were lower levels of cytokines being produced. Overall, renal function did not change dramatically but eventually the higher levels of lipids can cause renal damage. The study demonstrated that Garcinia Cambogia has potential for helping with weight gain.

This is an interesting study because many people are looking for ways to help manage weight. There are many fad diets and supplements in the market that are supposed to help. Garcinia Cambogia has some scientific evidence to support its purpose, but I wonder how results from rats would translate into humans. Even if this proves to be useful for weight management, people still need to adapt their habits and behaviors for weight loss or maintenance.

Sripradha R, Magadi S. Efficacy of Garcinia Cambogia on Body Weight, Inflammation, and Glucose Tolerance in High Fat Fed Male Wistar Rats. J Clin Diagn Res. 2015; 9(2): BF01-BF04.

http://www-ncbi-nlm-nih-gov.pitt.idm.oclc.org/pmc/articles/PMC4378731/

Cell Phone Use and Sleep

A major concern of the present communication age is the use of cell phones. In a self-reported study, Mehran Zarghami and colleagues looked into the surveys taken by 358 students at Mazandaran University in Iran. The study found that there was a relationship between cell phone use and energy loss for daily activities, tiredness, headache, and insomnia, but there was no relationship seen between cell phone use and sleep duration, waking time, sleep disturbance, and sleep efficiency. Over half of the students reported they use cell phones after lights are out to text. Calls were also made but to a lesser extent.  For future studies, more direct means of measure could be used to improve result reporting, and certain factors about the individual’s lifestyle should be taken into account (i.e. night shifts for work, compulsive phone use, etc.)

This is interesting because I feel many college students don’t realize how significant of an impact on being “connected” through cell phone use can have on overall energy. Society as a whole has become increasingly dependent on cell phones for communication in both business and socialization. People are always connected to others through cell phones, and it has become an expectation to respond quickly to others. I’m curious to see how cell phones impact people in other ways. A study with more direct observation may provide more definitive results on what cell phones can do to sleep.

Zarghami M, Khalilian A, Setareh J, Salehpour G. The Impact of Using Cell Phones After Lights-Out on Sleep Quality, Headache, Tiredness, and Distractibility Among Students of a University in North of Iran. Iran J Psychiatry Behav Sci. 2015; 9(4).

http://www.ncbi.nlm.nih.gov/pubmed/?term=The+Impact+of+Using+Cell+Phones+After+Lights-Out+on+Sleep+Quality%2C+Headache%2C+Tiredness%2C+and+Distractibility+Among+Students+of+a+University+in+North+of+Iran

Seasonal Affective Disorder and Methods for Treatment

In an article by Sherri Melrose, it is explained that seasonal affective disorder (SAD) is a recurrent form of depression during the fall and winter seasons. Common signs that someone is dealing with SAD includes sad mood, low energy, irritability, crying frequently, lethargy, abnormal sleep, decreased physical activity, carbohydrate craving, and withdrawal from social activity. Severity of symptoms is different in each patient and can include violent behavior. Women are more affected by SAD than men, and SAD begins to occur between 18 and 30 years of age.

Currently there are multiple ways to help those with SAD, including antidepressants, light therapy, vitamin D, and counseling. Antidepressants prevent the reuptake of serotonin and light therapy is a way to mimic the light that is produced from the sun. Vitamin D supplementation is important because the body is not as capable of producing vitamin D without light exposure. Counseling is another method for helping those with SAD because of the help and support that it can provide to the patient. It is helpful to limit sugar intake, increase exercise, manage stress, and avoid social withdrawal when symptoms are not sever. It is also helpful to patients to provide instruction about mindfulness, and enjoyable activities.

SAD is a serious problem that most people do not realize is the reason for a change in mood over the fall and winter seasons. It’s interesting how it is caused by small changes in the body, but it is very important for people to take care of themselves when onset occurs. I can understand how it can be difficult to diagnose, and it can be very difficult for the patient to understand what is happening. Treatment is important to start and continue throughout the darker months.

Melrose S. Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches. Depress Res Treat. 2015.

http://www-ncbi-nlm-nih-gov.pitt.idm.oclc.org/pmc/articles/PMC4673349/

Up and Coming Severe Asthma Medications

Severe asthma currently affects 5% of the total patients that are dealing with asthma. However, 50% of current costs of asthma come from treatments given to patients with severe asthma. This demonstrates the need for a more cost effective solution for patients with this form of asthma. According the World Health Organization, about 235 million people suffer from asthma, and there has been a 50% increase in asthma cases every decade. Asthma has one of the highest costs of chronic conditions including visits to the physician’s office and personal burdens. Though asthma is a common chronic disease, severe asthma can result from non-adherence. Proper education about asthma and cost effective prescriptions could help patients that suffer from severe asthma.

As of late, there have been four medications that have been studied for severe asthma. Tiotropium bromide is an anti-muscarinic agent and has shown to decrease asthma severity. Omalizumab is a recombinant IgG1 monoclonal anti-IgE antibody and is used for patients that have elevated IgE levels and react to one or more allergnes. This medication is given subcutaneously every two to four weeks. It has shown a great improvement in severe asthma but is one of the most expensive asthma medications. A third medication is Mepolizumab which is a humanized monoclonal antibody for interleukin 5. It is ment to prevent airway inflammation and is given intravenously every four weeks. It has shown to reduce asthma and lower blood and septum eosinophil counts. A fourth medication was mentioned. Thermoplasty is the newest method and is meant to reduce smooth muscle in airways of uncontrolled asthma. However, this is an invasive procedure and has yet to be made safe in the early stages after the procedure but has shown long term improvements over five years.

With asthma rates increasing, it is important to find cost effective ways to treat it. Not only will finding proper medications for patients would be helpful, but overall education about asthma would be useful to ensure that severe asthma does not happen. The future of these new severe asthma medications are promising though.

Al Efraij K, Fitzgerald JM. Current and emerging treatments for severe asthma. J Thorac Dis. 2015; 7(11).

Finding a Cheaper Way to Monitor HIV/AIDS

One of the most pressing conditions currently is HIV/AIDS. 36.9 million people live with HIV/AIDS, but 70% of the world’s burden is seen in sub-Saharan Africa. HIV/AIDS is something that should be monitored on a fairly regular basis after an antiretroviral therapy has been initiated. However, the lack of resources, monitoring capabilities, and trained professionals, testing is difficult to do. What this study was attempting to do was determine how effective a new qualitative viral failure assay (VFA) for HIV would be. This would be a lower cost option.

The study conducted included 496 pediatric and adult patients with HIV, and how well of an option the viral failure assay could be was explained in the results. Results of the VFA were compared to results of the standard. The VFA was more sensitive than the standard reference but was not as specific, and it was found that VFA worked better for the adult population in terms of sensitivity, specificity, and accuracy. However, the costs of the VFA would be lower than that of the reference. It is estimated that the cost of the VFA equipment would be about $22,000 in comparison to the $200,000 estimated cost of the standard. Also in terms of cost per run, the VFA would be $683.20 and the standard would be $2,105.80.

What can be seen from the study is that there are up and coming pieces of equipment that could potentially benefit populations with smaller economies. This would provide an option for patients to monitor their HIV/AIDS and to determine how well the therapy is working. Of course, there are issues with the effectiveness of the method, but it is a start to helping patients of all income levels. With this test, patients have the potential to live a more quality life.

Balinda SN, Ondoa P, Obuko EA, et al. Clinical Evaluation of an Affordable Qualitative Viral Failure Assay for HIV Using Dried Blood Spots in Uganda. PLoS One. 2016; 11(1).

 

Managing Sleep Disorders in Children with Neurodevelopmental Disorders

In a review conducted by Allison Beck Blackmer and colleagues, sleep disorder management for children with neurodevelopmental disorders were considered.  The article discussed the importance of sleep hygiene as a first-line intervention followed by pharmacological interventions. A majority of children affected by a neurodevelopmental disorder have a problem with sleep, but diagnosing a sleep disorder and providing a proper treatment for children is difficult. There is currently no FDA approved regimen for children. A brief overview was made for a variety of neurodevelopmental disorders, including autism, cerebral palsy, and Rett Syndrome among others. Some pharmacologic therapies that were considered were iron supplementation, melatonin, clonidine, and gabapentin to serve as FDA approved sleep disorder treatment. There were considerations for non-FDA approved medications such as atypical antipsychotics, antidepressants, antihistamines, and chloral hydrate. However, there is a lack of evidence to prove the benefits of these options. A major issue that comes with diagnosing treatment of sleep disorders is that is very individualized and few, if any, medications can be used in a widespread manner.

It’s interesting that there have been studies that have investigated this major problem that children with neurodevelopmental disorders face regularly. Studies a pediatric patients are harder to conduct due to restriction and safety, but having a foundation of solutions may benefit the patients long term. Sleep deprivation causes agitation and other frustrations for both the child and the family. If more studies could be done to determine the effectiveness of medications, then clinicians would be able to help families find an individualized regimen for their children.

Blackmer AB, Feinstein J. Management of Sleep Disorders in Children with Neurodevelopmental Disorders: A Review. Pharmacotherapy. 2016; 36(1): 84-98.

Genetics and Determination of Retinal Dystrophy Gene Mutations

In one study, Nicole Weisschuh and colleagues looked into how difference in genetics have a role in determining what retinal dystrophy patients may have. The idea behind the study was to use next generation sequencing to gain a better understanding of variability between patients and improve knowledge of what is causing the issue. The study used 89 independent cases and families with different forms of retinal dystrophy. There can be a lot of variability genetically that causes retinal dystrophy, and currently there are no cures. However, gene-replacement has become a promising direction. The study resulted in identification of mutations due to differences in sequences and found 39 new mutations. One issue with the study was that a gene could have been overlooked if it was not already identified as contributing to retinal dystrophy. In some of the cases, initial clinical diagnosis of the kind of retinal dystrophy had to be changed after the study.

I found this article to be interesting because with a better knowledge of what genetic mutations are causing retinal dystrophy, the better the chance of finding a treatment. If identification of genetic variability can be detected in retinal dystrophy, it could also likely be applied to other conditions. It would be a way to help identify what a patient will need to do or take to live a quality life.

Weisschuh N, Mayer A, Strom T, et al. Mutation Detection in Patients with Retinal Dystrophies Using Targeted Next Generation Sequencing. PLoS One. 2016; 11(1).

http://www-ncbi-nlm-nih-gov.pitt.idm.oclc.org/pubmed/26766544