Search

Despite the fact that accessible digital musical instruments can take into account the level of cognitive demands, previous studies have been conducted with patients with mild cognitive impairment (MCI), and it is not known whether they can be used by people with moderate to severe dementia or dementia with worsening behavioral and psychological symptoms of dementia (BPSD). The participant was an 88-year-old woman with vascular dementia (VaD) (Mini-Mental State Examination [MMSE] and Neuropsychiatric Inventory [NPI] scores: 8 and 20, respectively). Music therapy (MT) was provided twice a week for 15 min, and MT sessions spanned over 18 months. For the MT, we used the cyber musical instrument with score (Cymis), an accessible digital musical instrument; it could be played using a touch panel and switches. The cognitive function of the participant declined further, with MMSE scores of 4 after 1 year and 0 after 1.5 years. BPSD peaked with the NPI score of 54 at 1 year and declined thereafter, although only apathy remained. Despite these changes, during MT, she was able to play the accessible digital musical instrument and focus on the performance. These results suggest that even patients with severe VaD can play an accessible digital instrument and continue active music therapy even if their BPSD progress with cognitive decline.

We evaluated isolates obtained from children with Mycoplasma pneumoniae infection throughout Japan during 2008–2015. The highest prevalence of macrolide-resistant M. pneumoniae was 81.6% in 2012, followed by 59.3% in 2014 and 43.6% in 2015. The prevalence of macrolide-resistant M. pneumoniae among children in Japan has decreased.

It has been suggested that cytokines are associated with refractory Mycoplasma pneumoniae pneumonia, and steroid administration is reported to be effective in this situation. In order to elucidate the characteristics of refractory M. pneumoniae pneumonia, we analyzed five pediatric patients with refractory M. pneumoniae pneumonia, which was defined as showing prolonged fever and deterioration of clinical and radiological findings despite administration of appropriate antibiotics, compared with 15 pediatric patients with M. pneumoniae pneumonia who responded to treatment promptly (control group). Serum lactate dehydrogenase (LDH), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and interleukin (IL)-18 levels were significantly higher in the refractory group than in the control group at the initiation of corticosteroid use (LDH: 571 vs 292 IU/L, p = 0.0129; ALT: 25 vs 11 IU/L, p = 0.0143; AST: 41 vs 26 IU/L, p = 0.0404; IL-18: 579 vs 365 pg/mL, p = 0.0402). Significant correlation was found between serum values of IL-18 and LDH (r² = 0.504, p = 0.0433). The administration of corticosteroids to patients in the refractory group resulted in the rapid improvement of symptoms and decrease in serum LDH levels in all patients. A serum LDH level of ≥410 IU/L, which was calculated from receiver operating characteristic curve analysis, seemed to be an appropriate criterion for the initiation of steroid therapy. In conclusion, serum IL-18 and LDH levels can be used as parameters to determine which patients are candidates for corticosteroid therapy. In addition, serum LDH levels seem to be a useful marker for the evaluation of therapeutic efficacy in refractory M. pneumoniae pneumonia. [ABSTRACT FROM AUTHOR]