The strength of exercise

Spina bifida is a birth defect which is caused in vitro improper formation of the spinal cord and spine. This birth defect is common within the United States and leads to lifelong complications, it is reported that 7 of every 10,000 children have this condition. The limitations range from mobility to system complications such as cardiovascular complications. Due to the severe limitation and complication it is often extremely difficult to live active lifestyles. This can further cause a significant impact on their quality of life and mental wellbeing. 

The article took adult with spina bifida and did a comparison analysis based off different factions such as age, fitness level, and impairments or limitations. They found that adults who regularly exercised had a lower risk of cardiovascular disease, high cholesterol, and bone density. All of which highly impact spina bifida. 

With early intervention of physical therapy and low impact exercise many patient with Spina bifida have found a improvement in their quality of life. During my internship in physical therapy we had one patient who also had spina bifida and had previously as an infant undergone many surgeries and procedures. Standard exercises were too aggressive and dangerous for him. We chose an alternative route to more aerobic treatment with manual therapy. During my 4 month internship the improvement this patient showed was significant. He first would only use the elevator to our clinic and by the end of my time he had started using the stairs. He also informed us that with the exercise and diet he was able to manage his glucose levels better and was no longer pre-diabetic (about 16 months after start of treatment). By making treatments more accessible and catered to individual needs we were able to showcase beneficence. By catering to his needs we impacted not only his lifestyle but also learned a lot about inclusivity and catering to individual needs. Exercise may not look the same for all but by making slight adjustments the impact may be greater than one could imagine.

Crytzer, Theresa M., et al. “Physical activity, exercise, and health‐related measures of fitness in adults with spina bifida: A review of the literature.” PM&R, vol. 5, no. 12, Dec. 2013, pp. 1051–1062, https://doi.org/10.1016/j.pmrj.2013.06.010. 

Rocky Mountain High Could Cause Psychosis

    As a native of Colorado, who grew up during the legalization of marijuana, I have been fed numerous ideas about the drug. Some say that it will make you go crazy, while others claim that marijuana has no adverse side effects. After all, you can’t overdose on it, right? This smokey cloud of confusion led me to investigate the psychological effects of marijuana, and the results were mixed.

    It turns out that all the wild propaganda of the late 20^th century, depicting marijuana users as losing their minds, is not entirely false. Consistent users of marijuana are twice as likely to develop psychosis, and heavy users are 4 times as likely. The good news is that the psychosis is likely not permanent. A study with 35 patients found that after a psychotic episode, patients who did not continue to use marijuana did not relapse, whereas, patients that continued using the drug saw higher rates of relapse and worse outcomes. It is also worth noting that marijuana use has been found to increase the risk of developing schizophrenia and increase the severity of symptoms for those who already have the disease.

    So we should go back to banning marijuana, right? The answer is not definitive, as it is worth noting that, despite the increased risk, most people who use marijuana will never develop psychosis or schizophrenia. These disorders are genetically linked, and the risk of developing these disorders from marijuana use probably lessens after adolescence. CBD from marijuana has also shown great benefits in helping chemotherapy patients manage symptoms and has been used in other medicinal products. So is that Rocky Mountain High going to give you a psychological disorder? It probably won’t, but there is definitely an increased risk.

Source

Urits, I., Gress, K., Charipova, K., Li, N., Berger, A. A., Cornett, E. M., Hasoon, J., Kassem, H.,     Kaye, A. D., & Viswanath, O. (2020). Cannabis Use and its Association with Psychological     Disorders. Psychopharmacology bulletin, 50(2), 56–67.

Count Meow-t

 Cat scratch Disease

Transmission? Vector born as in the bacteria Bartonella henselae was first expelled by a flea which infected a cat which then can infect a human by scratches bites or even liking a wound. Cats are also often asymptomatic so it is difficult to know a cat is infected prior to your infection. 

How does the disease progress? There is a large latency period of 3 to 10 days for loss of appetite, fatigue, swelling, redness of skin and pus from the natural immune response. 

Close lymph nodes near the infected area can be swollen and infected in one to three weeks. Rarely it can also cause breast masses, endocarditis, osteomyelitis, Neuroretinitis (eye pain) or hepatosplenomegaly. Another study found it caused cysts in the lung and kidneys. 

While generally the bacterial infection can be fought by the body's own natural defenses some risk factors for the more severe complications are age and immunocompromising conditions like HIV. 

Diagnosis- Metagenomic next-generation sequencing can inform a practitioner of the exact bacteria but because the latency period is so long they often have to look for unilateral lymph node enlargement and take a detailed history. They can also test the lymph for the bacteria, 

Doxycycline and azithromycin are effective medications for this bacterial infection if you are having trouble fighting the infection. 

Knowledge of this disease is essential because an insignificant scratch can cause weeks of issues all of which are hard to diagnose if one interaction with a cat if forgotten about. Children and elderly are also at risk so it's important to know their safety at rick when new animals are brought into the home as well. 

Cleveland Clinic. (NA). Cat Scratch Fever. https://my.clevelandclinic.org/health/diseases/23537-cat-scratch-fever

Klotz, S., Ianas, V., & Elliott, S. (2011, January 15). STEPHEN A. KLOTZ, MD, VOICHITA IANAS,. Cat-scratch Disease. https://www.aafp.org/pubs/afp/issues/2011/0115/p152.html

Zhou, T., Zheng, Y., Zhang, H., & Liu, Y. (2024, January 14). A case report of diagnosis of cat-scratch disease using metagenomic next-generation sequencing. Frontiers. https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2023.1322651/full

Ketamine for Treatment Resistant Depression

When I first heard about Ketamine as a potential option for treatment resistant major depressive disorder, I was shocked. I first heard about ketamine as a an anesthetic that had psychoactive and hallucinogenic properties. I had never imagined it as being a real and viable treatment option for depression. Esketamine, a nasal spray consisting of the S enantiomer of ketamine, has been FDA approved in the treatment for treatment resistant depression. Tt is often associated with high efficacy under the careful dosage and supervision of a psychiatrist.

A ketamine trial consisting of 25 individuals affected by major depression, were given an IV injection of ketamine hydrochloride (Mandal et al., 2019). The dosage was given right below the anesthetic dose at 0.5 mg/kg. The patients baselines were recorded before the treatment, one hour after treatment, after 2 weeks, and then after 1 month of treatment. This study concluded that patients had a significant rapid improvement of depressive symptoms, after ketamine treatment.

Ketamine treatment may be a fast and a seemingly efficient treatment for depression. Depression is truly an serious and can be a lifelong disease, but hope must never be lost when fighting against it. More research still needs to be done on how Ketamine and its dissociative effects play a role in treating depression. Other drugs such as psilocybin and other psychedelics are being studied to learn about their effectiveness in treating psychiatric disorders. How do you feel about these, once illicit drugs, being used for treatment? Do you feel like the risks outweigh the benefits? This new field opens a very unknown field of consciousness, and there are many ethical concerns about the field. However, I feel like this is still a very good start to discovering our identities and the very essence of being human.

Mandal, S., Sinha, V., & Goyal, N. (2019). Efficacy of ketamine therapy in the treatment of depression. Indian Journal of Psychiatry, 61(5), 480. https://doi.org/10.4103/psychiatry.indianjpsychiatry_484_18

Do Violent Video Games Lead to Increased Aggression ?!

There’s been a long term debate and a lot of buzz about whether playing violent video games really makes people more aggressive. A recent study by Kühn et al. (2018) dives into this topic, and I found it pretty eye-opening.

The researchers looked at how playing a violent game, Grand Theft Auto V, compared to a non-violent game, The Sims 3, over two months affected players' behavior. They divided participants into three groups, one group played the violent game, another played the non-violent game, and the last group didn’t play any games at all. This setup was designed to see if long-term gameplay had any real impact on aggression and other psychological factors.

What’s interesting is that while some earlier studies showed that playing violent games could lead to short bursts of aggressive thoughts, this new research suggests those effects don’t stick around. The researchers found that after two months of gameplay, there were no significant changes in aggression levels among the players. This challenges the idea that violent video games automatically lead to aggressive behavior.

To measure aggression, the study used various tests, including word completion tasks. Surprisingly, most of these tests didn’t show any major differences between the groups. This makes me think that the connection between violent gaming and aggression might not be as clear-cut as we often hear. The study also pointed out that many previous studies focused on short gaming sessions, which might not reflect real-life situations. By looking at longer gameplay, the researchers found that continuous gaming didn’t lead to the expected increases in aggression or negative social interactions.

In the end, this research suggests that while violent video games are often blamed for aggressive behavior, the reality is much more complicated. It's worth considering that potential biases in past studies could have significant ethical implications. If researchers selectively report findings that support the idea that violent games lead to aggression, it can misinform the public. This could lead to unnecessary stigma against gamers. It’s crucial for future research to be transparent and comprehensive to ensure that published work is based on accurate and balanced evidence.

Kühn, S., Kugler, D. T., Schmalen, K., Weichenberger, M., Witt, C., & Gallinat, J. (2018). Does playing violent video games cause aggression? A longitudinal intervention study. Molecular Psychiatry, 24(8), 1220–1234. https://doi.org/10.1038/s41380-018-0031-7 

The Healing Power of Music

I’ve recently been diving into the fascinating world of music therapy, and I’m amazed by its potential to impact mental health. Unlike other music interventions, often led by healthcare professionals, music therapy involves a curative process between patient and therapist and allows individuals to connect with music in a way that feels personal and expressive. It’s all about exploring emotions and finding a voice through sound.

One of the coolest things I’ve learned is how music can really change our mood and behavior. For people dealing with disabilities, injuries, or mental health issues, music therapy offers a unique way to communicate feelings that might be hard to put into words. It’s like music speaks a language of its own, breaking down barriers and helping people express themselves. However, it's not just about feelings, as there are some impressive physiological benefits too. Research shows that engaging with music can improve heart rate, motor skills, and even boost our immune system. When we listen to or create music, our brains release dopamine, the “feel-good” chemical. This not only lifts our spirits but also contributes to our overall health.

Of course, it’s important to remember that not all music has a positive effect. Some studies point out that certain lyrics, especially those that are misogynistic, can lead to aggressive behavior in men toward women. This really highlights how crucial it is to choose the right music in therapy settings. Music therapy can be applied in so many different environments, from hospitals to community centers. Whether it’s in a group setting or one-on-one, the use of music can create a supportive space for healing and self-exploration.

Overall, music therapy is a powerful approach to mental health that combines emotional expression with real physiological benefits. As I continue to learn more about the connection between music and health, it’s clear that music is more than just entertainment…it’s a vital tool for enhancing our mental and physical well-being.

Rebecchini, L. (2021). Music, mental health, and immunity. Brain, Behavior, & Immunity - Health, 18, 100374. https://doi.org/10.1016/j.bbih.2021.100374 

Diabetic Neuropathy 101

 Burning, stabbing, shooting pain are all common symptoms of someone with DPN or Diabetic peripheral neuropathy. Having DPN can significantly impact ones daily activities and lifestyle. DPN is a complication of diabetes which is presented in many different forms and often being referred as diabetic sciatic pain. Diabetes affects over 11% of the US population and of which over 40% develop DPN. Being that this disease is so prevalent within our society and community it is essential to understand what preventative measures or treatments are available for those within our communities. 

This study focuses on manual therapy and exercises with a focus on lower limbs of patients with DPN. Various different intervention methods were used such as aerobics or gait training all of which encompass the idea of exercises for patients with limited mobility or limited impact. Pedro scale was used to help determine the results of the study of which it was found that after 12 weeks of exercise various nerves such as the motor tibial or peroneal nerve have improved the neuropathic conduction velocity. Patients described this as lower frequency of pain and or discomfort. In this study it is important to note that along with the change in exercise patterns overall lifestyle and diet changes were also made. 

While working at my local clinic I was fortunate enough to work with a patient with DPN. This patient had been experiencing these pains for years before being diagnosed with diabetes. Multiple different medications were tried, none with much success. I found myself working with this patient once again at this summer's internship at a Physical therapy clinic. This patient had significant weight loss 250lb to under 200lb. I learned that with the weight loss and exercise treatments he had been receiving he has felt a significant decrease in the frequency of his DPN pain. He explained that when he would take a traditional exercise route of walking or weight lifting he would experience sharp pain especially after working. Via water aerobics he was able to decrease the impact on his joints and feet resulting in a decrease in pain frequency. 

This study had many confounding variables which was further highlighted with my patient in which many of these studies do not account for variables such as economic status or lifestyle. I questioned about, How these studies cater more to the main population affected while also taking into account the various lifestyles and limitations? It essential to explore more deeply into these differences in order to be able to better help various communities. 

Sharma, Jyoti, et al. “Effects of exercises and manual therapy on nerve conduction studies of lower limb in patients with diabetes and diabetic peripheral neuropathy: A systematic review.” International Journal of Diabetes in Developing Countries, vol. 44, no. 2, 23 Oct. 2023, pp. 241–264, https://doi.org/10.1007/s13410-023-01258-5.