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medical management of Parkinson

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https://www.readbyqxmd.com/read/29444973/eight-hours-adaptive-deep-brain-stimulation-in-patients-with-parkinson-disease
#1
Mattia Arlotti, Sara Marceglia, Guglielmo Foffani, Jens Volkmann, Andres M Lozano, Elena Moro, Filippo Cogiamanian, Marco Prenassi, Tommaso Bocci, Francesca Cortese, Paolo Rampini, Sergio Barbieri, Alberto Priori
OBJECTIVES: To assess the feasibility and clinical efficacy of local field potentials (LFPs)-based adaptive deep brain stimulation (aDBS) in patients with advanced Parkinson disease (PD) during daily activities in an open-label, nonblinded study. METHODS: We monitored neurophysiologic and clinical fluctuations during 2 perioperative experimental sessions lasting for up to 8 hours. On the first day, the patient took his/her daily medication, while on the second, he/she additionally underwent subthalamic nucleus aDBS driven by LFPs beta band power...
February 14, 2018: Neurology
https://www.readbyqxmd.com/read/29419682/acupuncture-for-management-of-lower-urinary-tract-symptoms-in-parkinson-s-disease-a-protocol-for-the-systematic-review-of-randomized-controlled-trials
#2
Jong-In Kim, Tae-Young Choi, Ji Hee Jun, Hee Kang, Myeong Soo Lee
BACKGROUND: Acupuncture is claimed to improve the lower urinary tract symptoms (LUTS). Currently, no systematic reviews are performed for acupuncture on LUTS in patients with Parkinson's diseases (PD). This review aims to evaluate the current evidence on the efficacy of acupuncture for the management of LUTS in PD. METHODS AND ANALYSES: Eleven databases will be searched from their inception. These include PubMed, AMED, EMBASE, the Cochrane Library, 6 Korean medical databases, and 1 Chinese medical database...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29396576/lingual-pressure-as-a-clinical-indicator-of-swallowing-function-in-parkinson-s-disease
#3
Laura L Pitts, Sarah Morales, Julie A G Stierwalt
Purpose: Swallowing impairment, or dysphagia, is a known contributor to reduced quality of life, pneumonia, and mortality in Parkinson's disease (PD). However, the contribution of tongue dysfunction, specifically inadequate pressure generation, to dysphagia in PD remains unclear. Our purpose was to determine whether lingual pressures in PD are (a) reduced, (b) reflect medication state, or are (c) consistent with self-reported diet and swallowing function. Method: Twenty-eight persons with idiopathic PD (PwPD) and 28 age- and sex-matched controls completed lingual pressure tasks with the Iowa Oral Performance Instrument...
February 2, 2018: Journal of Speech, Language, and Hearing Research: JSLHR
https://www.readbyqxmd.com/read/29361810/-clinical-course-of-percutaneous-endoscopic-gastrostomy-a-single-center-observational-study
#4
Jihyun Lee, Ki Nam Shim, Kang Hoon Lee, Ko Eun Lee, Ji Young Chang, Chung Hyun Tae, Chang Mo Moon, Seong Eun Kim, Hye Kyung Jung, Sung Ae Jung
Background/Aims: Percutaneous endoscopic gastrostomy (PEG) is a widely used method for long-term tube feeding. This study aimed to investigate the clinical characteristics and outcomes of patients who utilized long-term feeding tube via PEG. Methods: The medical records of 137 patients who underwent PEG tube insertion at Ewha Womans University Mokdong Hospital between January 2002 and December 2013 were reviewed. Results: PEG was indicated most frequently for cerebrovascular accidents (66 patients, 48...
January 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29356826/globus-pallidus-interna-or-subthalamic-nucleus-deep-brain-stimulation-for-parkinson-disease-a-review
#5
Adolfo Ramirez-Zamora, Jill L Ostrem
Importance: Selection of the best deep brain stimulation (DBS) target-subthalamic nucleus (STN) or globus pallidus interna (GPi)-for treatment of motor complications in Parkinson disease remains a matter of debate. Observations: Increasing evidence from randomized clinical trials indicates that motor benefit is similar between both targets, including an effect on dyskinesia and improvement in quality of life. Deep brain stimulation of the STN offers consistently greater dopaminergic medication reduction, possible mild benefit in nonmotor domains, and potential economic advantage...
January 22, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29336905/getting-a-good-night-sleep-the-importance-of-recognizing-and-treating-nocturnal-hypokinesia-in-parkinson-s-disease
#6
REVIEW
Roongroj Bhidayasiri, Claudia Trenkwalder
When Parkinson's disease (PD) patients are asked about the quality of their sleep, their answers are dominated by difficulties associated with impaired mobility in bed, medically referred to as nocturnal hypokinesia. Nocturnal hypokinesia is symptomatic from the mid-stage of the disease, affecting up to 70% of PD patients, and contributes to poor sleep quality, and increased carer burden. Here we explore four areas of nocturnal hypokinesia that are relevant to clinical practice, namely: manifestations and definition; clinical assessment and objective monitoring; etiologies and contributing factors; and evidence-based therapeutic approaches...
January 5, 2018: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/29332072/medical-management-of-movement-disorders
#7
Marina Picillo, Renato P Munhoz
Pharmacological treatment is the cornerstone in the management of movement disorders. Although most available treatment options have no impact on the underlying process of each movement disorder, symptomatic therapies can significantly improve patient's quality of life and level of disability. Here, we review the current knowledge on clinical symptomatic management of Parkinson's disease (both early and advanced stages), essential tremor, dystonia, and chorea. Ideally, treatment should be carried out by specialists with reasonable experience in movement disorders, as it needs to be tailored for each patient depending on several appraisals, including but not limited to patients' needs, compliance issues, potential side effects, caregiver support, and presence of comorbidities...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332071/clinical-presentation-and-prognosis-of-common-movement-disorders
#8
Jennifer Han, Samay Jain
Great progress has been made in expanding our understanding of the natural history of movement disorders, leading to impressive advancements in their medical and surgical management. Movement disorders are a diverse group of diseases, varying widely in clinical characteristics and evolution. Some are monosymptomatic while others have associated motor and nonmotor features. Some are static while others follow a progressive course. This chapter will review common primary and secondary movement disorders: Parkinson disease and other forms of Parkinsonism, essential tremor and its differential diagnoses, dystonia and tic disorders...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29318592/falls-in-cognitively-impaired-older-adults-implications-for-risk-assessment-and-prevention
#9
Manuel Montero-Odasso, Mark Speechley
OBJECTIVES: To provide an overview of the role of cognition in falls, with potential implications for managing and preventing falls in older adults. DESIGN: Review. SETTING: Observational and interventional studies addressing the role of cognition on falls. PARTICIPANTS: Community-dwelling older adults (65 years and older). MEASUREMENTS: The relationship between gait and cognition in aging and neurodegeneration was reviewed in the medical literature to highlight the role of brain motor control deficits in fall risk...
January 10, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29305084/poor-nighttime-sleep-is-positively-associated-with-dyskinesia-in-parkinson-s-disease-patients
#10
Cheng-Jie Mao, Ya-Ping Yang, Ju-Ping Chen, Fen Wang, Jing Chen, Jin-Ru Zhang, Hui-Jun Zhang, Sheng Zhuang, Yi-Tong Xiong, Chen-Chen Gu, Wen Yuan, Juan-Ying Huang, Alexander Fay, Chong-Ke Zhong, Chun-Feng Liu
BACKGROUND: Dyskinesia is a troublesome complication of long-term dopaminergic medications in Parkinson's disease (PD) patients. Many factors are reported to be associated with dyskinesia in PD. OBJECTIVE: To investigate the association between sleep quality and dyskinesia in patients with PD. METHODS: Four hundred twenty-five patients with PD were enrolled in this study. Demographic information was collected. Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn and Yahr (H-Y) stage scale were also performed...
December 21, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/29303679/teleneurology-for-veterans-in-a-major-metropolitan-area
#11
Steven S Schreiber
BACKGROUND: The recent growth in telehealth has been facilitated by the need to deliver healthcare to patients living in remote or rural areas. In contrast, the role of telehealth in more urban settings is less clear. A teleneurology program was established in 2011 at the Tibor Rubin VA Medical Center (TRVAMC) in Long Beach, California. A review of teleneurology encounters was conducted to assess the feasibility of applying this telehealth modality to patients with chronic neurological disorders living in an urban setting...
January 5, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29276766/challenges-to-ethically-managing-parkinson-disease-an-interview-study-of-patient-perspectives
#12
Shelagh T Shaw, Pirashanthie Vivekananda-Schmidt
This study investigated the current ethical issues in relation to recognizing and managing Parkinson disease (PD) from the patient's perspective. Methods: Twelve patients living with PD who were from the medical school's Patients as Educators program were recruited. Semistructured interviews were conducted to record patient experiences in order to identify potential ethical issues in relation to recognizing and managing PD. Thematic analysis was applied to the interview transcripts. Results: Four key themes emerged from the interviews...
December 2017: Journal of Patient Experience
https://www.readbyqxmd.com/read/29274834/espen-guideline-clinical-nutrition-in-neurology
#13
Rosa Burgos, Irene Bretón, Emanuele Cereda, Jean Claude Desport, Rainer Dziewas, Laurence Genton, Filomena Gomes, Pierre Jésus, Andreas Leischker, Maurizio Muscaritoli, Kalliopi-Anna Poulia, Jean Charles Preiser, Marjolein Van der Marck, Rainer Wirth, Pierre Singer, Stephan C Bischoff
Neurological diseases are frequently associated with swallowing disorders and malnutrition. Moreover, patients with neurological diseases are at increased risk of micronutrient deficiency and dehydration. On the other hand, nutritional factors may be involved in the pathogenesis of neurological diseases. Multiple causes for the development of malnutrition in patients with neurological diseases are known including oropharyngeal dysphagia, impaired consciousness, perception deficits, cognitive dysfunction, and increased needs...
September 22, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29246470/effectiveness-and-costs-of-specialised-physiotherapy-given-via-parkinsonnet-a-retrospective-analysis-of-medical-claims-data
#14
Jan H L Ypinga, Nienke M de Vries, Lieke H H M Boonen, Xander Koolman, Marten Munneke, Aeilko H Zwinderman, Bastiaan R Bloem
BACKGROUND: Parkinson's disease is a complex condition that is best managed by specialised professionals. Trials show that specialised allied health interventions are cost-effective, as compared with usual care. We aimed to study the long-term benefits of specialised physiotherapy using the ParkinsonNet approach in real-world practice. METHODS: We did an observational study, retrospectively analysing a database of health insurance claims that included a representative population of Dutch patients with Parkinson's disease, who were followed for up to 3 years (Jan 1, 2013, to Dec 31, 2015)...
December 12, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/29242256/manual-review-of-electronic-medical-records-as-a-reference-standard-for-case-definition-development-a-validation-study
#15
Tyler Williamson, Rebecca C Miyagishima, Janeen D Derochie, Neil Drummond
BACKGROUND: The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) previously carried out a validation study of case definitions for 8 chronic diseases (diabetes mellitus, hypertension, osteoarthritis, depression, dementia, chronic obstructive pulmonary disease, parkinsonism and epilepsy) using direct review of "raw" electronic medical record data. Although effective, this method is time-consuming and can present methodological and organizational challenges. We aimed to determine whether the processed and standardized data contained with the CPCSSN database might function as a reference standard for case definition validation...
December 11, 2017: CMAJ Open
https://www.readbyqxmd.com/read/29229347/post-operative-stridor-and-acute-respiratory-failure-after-parkinson-s-disease-deep-brain-stimulator-placement-a-case-report-and-review-of-literature
#16
Mi Wang, Wael Saasouh, Thomas Botsford, Allen Keebler, Andrew Zura, Michael S Benninger, Rafi Avitsian
BACKGROUND: Parkinson's disease (PD), a neurodegenerative disorder characterized by loss of dopaminergic neurons in the substantia nigra of the midbrain is commonly thought of as a motion disorder, but it can have significant effect on the respiratory system. Respiratory failure is the most common cause of death in these patients, but it can also affect laryngeal function causing dysphonia, dysphagia, and dysarthric speech.. Acute upper airway obstruction is a very rare finding in PD, especially in the perioperative settings...
December 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29203153/focused-ultrasound-subthalamotomy-in-patients-with-asymmetric-parkinson-s-disease-a-pilot-study
#17
Raul Martínez-Fernández, Rafael Rodríguez-Rojas, Marta Del Álamo, Frida Hernández-Fernández, Jose A Pineda-Pardo, Michele Dileone, Fernando Alonso-Frech, Guglielmo Foffani, Ignacio Obeso, Carmen Gasca-Salas, Esther de Luis-Pastor, Lydia Vela, José A Obeso
BACKGROUND: Ablative neurosurgery has been used to treat Parkinson's disease for many decades. MRI-guided focused ultrasound allows focal lesions to be made in deep brain structures without skull incision. We investigated the safety and preliminary efficacy of unilateral subthalamotomy by focused ultrasound in Parkinson's disease. METHODS: This prospective, open-label pilot study was done at CINAC (Centro Integral de Neurociencias), University Hospital HM Puerta del Sur in Madrid, Spain...
December 1, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/29183419/south-african-guideline-on-deep-brain-stimulation-for-parkinson-s-disease
#18
D G Anderson, R Van Coller, J Carr
BACKGROUND: Parkinson's disease (PD) is a common neurodegenerative disease, associated with severe impairment of quality of life. Although the motor aspects of the illness are typically successfully treated with medications acting on the dopaminergic system, a number of patients encounter progressive difficulties associated with their medical treatment. RECOMMENDATIONS: Carefully selected patients will benefit from deep brain stimulation (DBS) treatment for their PD...
November 6, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29160144/parkinson-s-disease-psychosis-presentation-diagnosis-and-management
#19
Ruth B Schneider, Julia Iourinets, Irene H Richard
Parkinson's disease is a neurodegenerative disorder characterized by motor and nonmotor symptoms. Psychosis is a common feature of Parkinson's disease. Parkinson's disease psychosis (PDP) encompasses minor phenomena (illusions, passage hallucinations and presence hallucinations), visual and nonvisual hallucinations and delusions. PDP is associated with reduced function and quality of life. The initial management approach should focus on identification and treatment of any contributory medical factors, reduction or discontinuation of medications with potential to induce or worsen psychosis, nonpharmacological strategies and consideration of acetylcholinesterase inhibitor treatment in the setting of dementia...
November 21, 2017: Neurodegenerative Disease Management
https://www.readbyqxmd.com/read/29150873/survival-in-patients-with-parkinson-s-disease-after-deep-brain-stimulation-or-medical-management
#20
Frances M Weaver, Kevin T Stroupe, Bridget Smith, Beverly Gonzalez, Zhiping Huo, Lishan Cao, Dolores Ippolito, Kenneth A Follett
OBJECTIVE: Deep brain stimulation has been shown to have a significant long-term beneficial effect on motor function. However, whether it affects survival is not clear. In this study, we compared survival rates for Parkinson's disease (PD) patients who underwent deep brain stimulation (DBS) with those who were medically managed. METHODS: A retrospective analysis of Veterans Affairs and Medicare administrative data of veterans with PD who received DBS and were propensity score matched to a cohort of veterans with PD who did not receive DBS between 2007-2013...
November 18, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
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