Receptive music interventions improve apathy and depression in elderly patients with dementia

Individuals with dementia and their families often experience poor quality of life due to patient's behavioral and psychological symptoms. Increasing evidence has mounted on the potential role of music in improving social, emotional and cognitive skills. In the present study we aim to investigate whether a receptive music intervention might reduce apathy and depression in elderly patients with Alzheimer's disease (AD) or vascular dementia (VaD) and improve their caregivers' burden. Among patients attending to a Memory Clinic, we have enrolled 48 AD or VaD elderly subjects. They were divided into two groups on the basis of family agreement to musictherapy. The experimental group (n=15) was asked to listen to a 80-minute audio CD, for at least 15 minutes per day, at least once a week, for three months. The overall sample was evaluated at baseline, at week 4 and at week 12 through the Mini Mental State Examination (MMSE), the Cornel- Brown Scale QoL in Dementia (CBSQoLD) and the Apathy Evaluation Scale (AES); caregiver stress was assessed using the Caregiver Burden Inventory (CBI). Apathy and depression were significantly improved among patients treated with music interventions compared to control group (treatment effect =43.667; P<0.001 and treatment effect =61.238; P<0.001 respectively). Caregiver burden was significantly reduced after three months of receptive music approach (treatment effect =15.759; P<0.001). The results of this study are consistent with the efficacy of receptive music interventions on improving apathy and depression in AD or VaD elderly patients and lowering associated caregiver's burden

Musical hallucinations in elderly patients with visuospatial impairment: two case reports

Musical hallucinations are an uncommon type of auditory hallucinations, they widely occur in elderly. Our group analyzed medical history, pharmacological therapy, neuropsychological pattern, audiometric testing, electroencephalogram, cerebral magnetic resonance and cerebral fludeoxyglucose-positron emission tomography (FDG-PET) of two patients. FDGPET showed in both patients hypometabolism pronounced in posterior regions. In particular the medial-inferior temporal cortex and the occipital associative areas were affected. Moreover, neuropsychological pattern suggested a visuospatial-executive deficit, conformed to the occipital involvement. Our reported cases might suggest that musical hallucinations have been arisen from a combination of peripheral and central dysfunction. A further explanation might be that musical hallucinations result from multiple white matter lacunar lesions due to small vascular events. A question is whether musical hallucinations might be primarily associated with occipital areas hypometabolism and visuospatial alterations typically associated with Levy body dementia (LBD)

Efficacy of Doll thErapy compared with standard treatment in the control of behavioral and psychologic Symptoms and CaRegIver Burden in dEmentia: DESCRIBE a randomized, controlled study

Behavioral and psychologic symptoms of dementia (BPSD) are frequent and represent a burden for patients and caregivers; in particular, the presence of agitation and aggression (A/A) has an important impact on patients’ quality of life. As psychotropic drugs can induce severe collateral effects, the use of a first line non-pharmacologic approach is highly recommended. Here we evaluate the effect of doll therapy (DT) on A/A in geriatric patients with moderate to severe dementia hospitalized in an acute geriatric unit. We enrolled fifty-two acute in-patients with dementia and A/A. Subjects were randomized to DT (26) or standard treatment (ST, 26), we measured agitation and caregiver burden with standard clinical scales at baseline and during treatment. In order to evaluate the effect of DT withdrawal, we carried out a telephonic follow-up interview after 1 and 4 weeks from hospital discharge. DT is more effective than ST in the control of agitation, but not in reducing the professional caregiver burden. The use of pro re nata psychotropic drugs was reduced in patients treated with DT. After DT withdrawal, A/A progressively increased. In conclusion we show that DT may be more effective than ST in the control of A/A in acute geriatric in-patients affected by dementia. Our results suggest that, in patients affected by severe to moderate forms of dementia with A/A, DT may be used as a first line treatment, not only in nursing home residents, but also in acute care geriatric in-patients

Altered tetrahydrobiopterin metabolism in patients with phenylalanine hydroxylase deficiency

The tetrahydrobiopterin (BH4) cofactor is essential for the activity of various enzymes, including phenylalanine (Phe) hydroxylase. In phenylketonuria (PKU) patients, who are chronically exposed to high Phe levels, high urinary excre- tion of BH4 metabolites neopterin and biopterin is observed. The aim of this longitudinal study was to investigate consistence and variability of the urinary excretion of pterins (neopterin and biopterin) in PKU patients in relation to age and concomitant blood Phe and tyrosine levels. The study was based on the result of 274 pterin examinations (3–13 exams per subject) performed in 47 PKU patients (aged 6 days to 37 years). Multivariate analysis showed that urinary biopterin and neopterin excretion was affected by age and concomitant blood Phe concentration. The influence of blood Phe on both biopterin and neopterin levels was greater in patients younger than 4 months. Later on, interindividual variability was higher than intraindividual variability for both biopterin and neopterin

Chemico-physical and antifungal properties of poly(butylene succinate)/cavoxin blend: Study of a novel bioactive polymeric based system

This manuscript describes antifungal, structural, thermal and morphological properties of a novel, eco-friendly bioplastic film, based on poly(butylenesuccinate) and cavoxin, a chalcone phytopathogenic metabolite, isolated from cultures by the fungus Phoma cava and included inside the biodegradable polymeric matrix. The antagonistic activity of the film explored against two fungal food contaminants Penicilliumroqueforti and Aspergillusniger, highlighted that cavoxin was fungicide at MIC concentrations. The chemico-physical analysis were performed on films before and after antifungal activity. Thermal analysis evidenced both the higher thermal stability of poly(butylenesuccinate) and cavoxin blend and the sharp nucleating action of cavoxin on the polymer. Infrared spectroscopy highlighted the presence of physical interaction between the polar groups of the blend components, whereas gel permeation chromatography highlighted that the hydrolytic effect of cavoxin on poly(butylenesuccinate) was responsible for the diffusion and releasing of the biomolecule from the matrix and UV–Vis spectroscopy provided quantitative information of release kinetics. Finally, morphological analysis confirmed both the polymeric surface hydrolysis exerted by cavoxin, and the adhesion of fungal spores on films after contact occurred during the antifungal assay

Exploiting Potential Biotechnological Applications of Poly-γ-glutamic Acid Low Molecular Weight Fractions Obtained by Membrane-Based Ultra-Filtration

Since the potentialities of applications of low molecular weight poly-γ-glutamic acid (γ-PGA) chains have been so far only partially explored, the separation of diverse molecular families of them, as well as their characterization for potential bioactivity and ability to form films, were investigated. Two different approaches based on organic solvent precipitation or on ultra- and nano-filtration membrane-based purification of inexpensive commercial material were employed to obtain size-specific γ-PGA fractions, further characterized by size exclusion chromatography equipped with a triple detector array and by ultra-high-performance liquid chromatography to assess their average molecular weight and their concentration. The γ-PGA low molecular weight fractions, purified by ultra-filtration, have been shown both to counteract the desiccation and the oxidative stress of keratinocyte monolayers. In addition, they were exploited to prepare novel hydrocolloid films by both solvent casting and thermal compression, in the presence of different concentrations of glycerol used as plasticizer. These biomaterials were characterized for their hydrophilicity, thermal and mechanical properties. The hot compression led to the attainment of less resistant but more extensible films. However, in all cases, an increase in elongation at break as a function of the glycerol content was observed. Besides, the thermal analyses of hot compressed materials demonstrated that thermal stability was increased with higher γ-PGA distribution po-lymer fractions. The obtained biomaterials might be potentially useful for applications in cosmetics and as vehicle of active molecules in the pharmaceutical field

INVESTIGATION OF BIOFILM FORMATION AND ITS ASSOCIATION WITH BIOFILM ASSOCIATED FACTORS OF FOOD-RELATED METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS STRAINS

Microbial biofilm formed on food contact surfaces can lead to significant hygiene and food safety issues. Both methicillin-sensitive and methicillin-resistant Staphylococcus aureus (MSSA and MRSA) have the ability to form biofilms on various food industry surfaces (Mirani et al., 2013). The aim of this study, was to investigated the relationship between biofilm associated factors and the ability of food-derived MRSA strains to form biofilm. Twentytwo MRSA strains and 3 reference strains (S.aureus ATCC 35556, S. aureus ATCC 12600 and S. epidermidis ATCC 12228) were tested for the detection of some genetic markers associated to the biofilm production, by PCR (Shopsin et al., 2003; Graber et al., 2009); furthermore, the strains were tested for the biofilm production on polystyrene and stainless steel using a previously described method (Di Ciccio et al., 2015). Majority of MRSA isolates (90%) showed similar distribution of adhesion genes (icaA, icaD, cna, fnbA and fnbB), toxin genes (hla and hlb), and staphylococcal regulators (sarA). Majority of biofilm producers isolates (66.7%) were found to carry agr type III whereas most of (87.5%) of the biofilm negative isolates were found to carry agr type I. All MRSA strains were found icaA, icaD, hla positive and fnbB negative. Biofilm formation was observed in the 27.2% of the isolates, of which two strains formed strong biofilms, two moderate biofilms and two formed weak biofilms. The biofilm formation by MRSA strains occurred preferentially on polystyrene (27.2%) compared to stainless steel (9%). In conclusion, this study underline the ability of some genotypes of food related MRSA strains to form biofilm on surfaces largely used in the food industry and the need of carefully control their spread for preventing food safety concern

Spray-by-spray in situ cross-linking alginate hydrogels delivering a tea tree oil microemulsion

In this paper we propose an in situ forming ionically cross-linked alginate (Alg) hydrogel delivering a Tea Tree Oil microemulsion (MeTTO) and potentially useful as an advanced dressing for infected wounds. Alg hydrogels were prepared by a spray-by-spray deposition method with the aim to minimize the discomforts during application. From pseudoternary phase diagrams, it was found that proper combination of TTO, water, polysorbate 80 and ethanol gave stable spherical MeTTO with good antimicrobial activity. On this basis, MeTTO at 20% TTO was selected for further inclusion in an Alg hydrogel prepared by alternating sprays of Alg/MeTTO and calcium chloride solutions. Homogeneous dispersion of MeTTO inside cross-linked Alg was assessed by different macroscopic and microscopic methods demonstrating the superior propensity of MeTTO to be integrated in the water-based hydrogel as compared to TTO. Antimicrobial effect of Alg/MeTTO hydrogels on Escherichia Coli strains was remarkable, highlighting the potential of the system as bioactive wound dressing