ABSTRACT
OBJECTIVE: For persons with Parkinson's disease (PD), secondary motor symptoms such as swallow impairment impact the quality of life and are major contributors to mortality. There is a present need for therapeutic interventions aimed at improving swallow function during the early stages of PD. The purpose of this pilot study was to examine the effects of a group therapeutic singing intervention on swallowing in persons with PD with no significant dysphagia symptoms. DESIGN: Cohort study. SETTING: University in the United States. PARTICIPANTS: Twenty-four participants with PD. INTERVENTION: Eight weeks of group therapeutic singing. MAIN OUTCOME MEASURES: Electromyography (EMG) was used to assess muscle activity associated with swallow pre and post the group singing intervention. Swallow quality of life (SWAL-QOL) and the Unified Parkinson's Disease Rating Scale (UPDRS) were also obtained pre- and post-intervention. RESULTS: Participants reported minimal difficulty with swallowing, yet results revealed a significant increase in EMG outcome measures, as well as significant improvement in UPDRS total and UPDRS motor scores. No significant differences were revealed for SWAL-QOL. CONCLUSION: Increases in EMG timing measures may suggest that group singing results in the prolongation of laryngeal elevation, protecting the airway from foreign material for longer periods of time during swallow. Combined with the improvement in UPDRS clinical measures, therapeutic singing may be an engaging early intervention strategy to address oropharyngeal dysphagia while also benefiting additional clinical symptoms of PD.
Subject(s)
Deglutition Disorders , Music Therapy/methods , Parkinson Disease , Singing , Aged , Cohort Studies , Deglutition , Deglutition Disorders/etiology , Deglutition Disorders/therapy , Early Intervention, Educational , Electromyography , Female , Humans , Male , Middle Aged , Parkinson Disease/complications , Parkinson Disease/therapy , Quality of LifeABSTRACT
Nine patients (11 eyes) with ocular cicatricial pemphigoid were treated with systemic azathioprine and a syngeneic nasal mucosa transplant from the inferior turbinate. Follow-up was 8-26 months (average 15 months). Grafting was successful in all cases. Treatment ameliorated the symptoms of pain in all patients and double vision in one. In 2 eyes in which simultaneous pannus resection had been performed, neither pannus nor corneal vascularization recurred. Late complications were recurrences with symblephara in two cases when azathioprine was stopped; in one patient with a serpiginous ulcer tectonic penetrating keratoplasty à chaud had to be performed; and in another a trophic ulcer was healed with a therapeutic contact lens.
Subject(s)
Azathioprine/administration & dosage , Conjunctivitis/surgery , Nasal Mucosa/transplantation , Pemphigoid, Benign Mucous Membrane/surgery , Aged , Aged, 80 and over , Combined Modality Therapy , Conjunctivitis/pathology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pemphigoid, Benign Mucous Membrane/pathology , RecurrenceABSTRACT
We report on a case of non-granulomatous bilateral iridocyclitis with tubulointerstitial nephritis in a 13-year-old girl. Complete recovery was achieved after treatment with systemic and topical corticosteroids.
