| Ventilation through an extraglottic tracheal tube: a technique for deep extubation and airway control |
Wed, 07 Jun 2017 05:57:03 +0000 |
| ,The parable of Buridan's ass |
| Wed, 07 Jun 2017 05:46:05 +0000 |
Notched Sound Therapy is an ongoing area of clinical research. With scientists examining its therapeutic potential in Germany, Italy, China and Korea, the research is occurring worldwide.
We’ve summarized some of these papers below:
In 2017, a group of Chinese researchers published the results of a randomized controlled trial of 43 patients evaluating the effectiveness of Tailor-Made Notched Sound Therapy. In this experiment, notched music was used. At one month of treatment, there was no significant difference between those who received notched music and those who received a placebo sound treatment. However, three months into the treatment program, a difference appeared: a significant decrease was found in the average tinnitus loudness for the notched music group, whereas there was no significant change in the placebo group.
Clinical Trial on Tonal Tinnitus with Tailor-Made Notched Music Training
The original German team that pioneered Tailor-Made Notched Music Therapy enrolled 100 patients in a clinical trial to evaluate the efficacy of this same treatment. Patients were randomized to either treatment (notched music therapy) or control (sham therapy) arms of the experiment and listened for 2 hours per day for 3 months. The notching process was slightly modified from the original method used with an intent to increase its effectiveness. After a three month duration, tinnitus loudness was found to be decreased in the treatment group, although more global measures of tinnitus distress did not show any relevant changes. The reduction in loudness was observed to be small, but persisted one month after the cessation of therapy (the original trials ran for 12 months duration).
A group of Korean researchers enrolled 26 patients who were chronically distressed by tinnitus as defined by the Tinnitus Handicap Inventory (THI). They were instructed to listen to tailor-made notched music through a smartphone application for 30 — 60 minutes a day and were also prescribed Ginkgo biloba for three months. Treatment outcome was evaluated using the THI, a visual analogue scale that measures the effects of tinnitus in terms of loudness, noticeable time, annoyance, and disruption of daily life. Chronic tinnitus patients who underwent smartphone application-derived notched music therapy and Gingko combined treatment showed improved THI scores, particularly the emotional score of the THI.
Music Therapy for Chronic Tinnitus: Variability of Tinnitus Pitch in the Course of Therapy
In general, tinnitus pitch has been observed to be variable across time for most patients experiencing tinnitus. Some tinnitus therapies relate to the dominant tinnitus pitch in order to adjust therapeutic interventions. A total of 175 adult patients experiencing chronic tinnitus served as participants. All patients had received a neuro-music therapy according to the “Heidelberg Model of Music Therapy for Chronic Tinnitus.” (this is not Notched Music, but is a type of sound therapy). During therapeutic interventions lasting for 5 consecutive days, the individual tinnitus frequency was assessed daily by means of a tinnitus pitch–matching procedure. Tinnitus pitch displayed a variability of approximately 3/5 to 4/5 octaves per day. Overall, the mean frequency declined in the course of the therapy. A frequent rechecking of tinnitus frequency is suggested during frequency-specific acoustic stimulation in order to train appropriate frequency bands.
Korean researchers implemented a variant of Tailor-Made Notched Sound Therapy delivered via a mobile app on the Android operating system. Experimental results indicated that tinnitus can be conveniently treated with such an application.
The German research group that originally pioneered Tailor-Made Notched Sound Therapy decided to determine whether or not transcranial direct current stimulation (tDCS) could amplify the therapeutic effects of Tailor-Made Notched Music Therapy (TMNMT). 32 patients with tonal tinnitus and without severe hearing loss were recruited, and were divided into three groups: sham (placebo) electrode + TMNMT, anodal electrode + TMNMT, and cathodal electrode + TMNMT. With respect to the music therapy, it was applied for 10 days at 2.5 hours of listening per day. To evaluate treatment outcome, tinnitus-related distress and perceived tinnitus loudness were assessed using standardized tinnitus questionnaires and a visual analogue scale. The results showed a significant treatment effect reflected in the Tinnitus Handicap Questionnaire that was largest after 5 days of treatment. This effect persisted at the end of follow-up 31 days after treatment cessation. Crucially, tDCS did not significantly affect the effectiveness of TMNMT- it did not make a difference whether anodal, cathodal, or sham tDCS was applied. It remains unclear why.
Late onset nonsyndromic deafness in a Dongxiang Chinese family is associated with the 593T>C variant in the mitochondrial tRNA(Phe) gene.
Mitochondrion. 2017 Jun 01;:
Authors: Chen X, Nie Z, Wang F, Wang J, Liu XW, Zheng J, Guo YF, Guan MX
Abstract
We report here the clinical, genetic, molecular and biochemical characterization of a four-generation Dongxiang Chinese pedigree with suggestively maternally transmitted non-syndromic hearing loss. Five of 10 matrilineal relatives exhibited variable severity and age at onset of sensorineural hearing loss. The average ages at onset of hearing loss in matrilineal relatives of this family were 29years. Molecular analysis of their mitochondrial genomes identified the tRNA(Phe) 593T>C variant belonging to Asian haplogroup G2a2a. The m.593T>C variant resided at the position 17 of DHU-loop, where the position is important for the structure and function of tRNA. It was anticipated that the m.593T>C variant altered the structure and function of tRNA(Phe). By using lymphoblastoid cell lines derived from the Chinese family, we showed a 46% decreases in the steady-state level of tRNA(Phe) in mutant cell lines. Western blotting analysis showed ∼35% reduction in the levels of mitochondrial translation in mutant cell lines carrying the m.593T>C variant. Impaired mitochondrial translation is apparently a primary contributor to the marked reduction in the rate of respiratory capacity. The respiratory deficiency lowed mitochondrial ATP production in the mutant cell lines. These data provide the evidence that mitochondrial dysfunctions caused by the m.593T>C variant lead to late-onset nonsyndromic deafness. Thus, our findings may provide the new insights into the understanding of pathophysiology and valuable information for management and treatment of maternally inherited hearing loss.
PMID: 28579530 [PubMed - as supplied by publisher]
