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medical management of Parkinson

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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
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/29144565/rethinking-status-dystonicus
#6
REVIEW
Marta Ruiz-Lopez, Alfonso Fasano
Status dystonicus is a movement disorder emergency that has been a source of controversy in terms of terminology, phenomenology, and management since it was first described in 1982. Here we argue that the current use of the term status dystonicus falls well short of the precision needed for either clinical or academic use. We performed a critical review on this topic, describing possible pathophysiological mechanisms and areas of uncertainties. This review also addresses the problems derived by the extreme clinical heterogeneity of this condition, as the lack of an objective criterion useful for the definition, or the fact that status dystonicus may present not only in the context of a known dystonic syndrome...
November 16, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29144156/upmc-prescription-for-wellness-a-quality-improvement-case-study-for-supporting-patient-engagement-and-health-behavior-change
#7
Rebecca J Maners, Eric Bakow, Michael D Parkinson, Gary S Fischer, Geoffrey R Camp
Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system...
November 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29133106/considerations-for-general-anaesthesia-in-parkinson-s-disease
#8
REVIEW
Daniel P Roberts, Simon J G Lewis
Parkinson's disease is a common neurodegenerative disorder in the elderly which when present has a significant influence on surgical management. These patients necessitate additional perioperative and anaesthetic considerations across disease specific domains as well as in relation to the respiratory and cardiovascular systems. This brief review focuses on the factors which contribute to perioperative morbidity, including the use of medications that may exacerbate symptoms or adversely interact with treatments for Parkinson's disease...
November 10, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29127919/a-case-report-of-a-de-garengeot-hernia-in-a-nonagenarian-veteran
#9
Luis R Taveras, Sergio Huerta
INTRODUCTION: A hernia containing the vermiform appendix [de Garengeot hernia (DGH)] is an exceedingly rare event. Appendicitis occurring in this setting if further unusual. Most cases of DGH are made during inguinal exploration. In the present report, we discuss a patient who underwent an operation which revealed a DGH with appendicitis. PRESENTATION OF A CASE: A 94-year-old man with a past medical history significant for hypertension and Parkinson's disease was admitted to the hospital for the management of an event of CHF exacerbation...
November 3, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29095706/trunk-exercises-improve-gait-symmetry-in-parkinson-disease-a-blind-phase-ii-randomised-controlled-trial
#10
Ryan P Hubble, Geraldine Naughton, Peter A Silburn, Michael H Cole
OBJECTIVE: Deficits in step-to-step symmetry and trunk muscle activations have been linked to falls in Parkinson's disease (PD). Given such symptoms are poorly managed with anti-parkinsonian medications, alternate therapies are needed. This blind phase II randomised-controlled trial sought to establish whether exercise can improve step-to-step symmetry in PD. DESIGN: Twenty-four PD patients with a falls history completed baseline assessments of symptom severity, balance confidence, mobility and quality of life...
November 1, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29084313/safety-and-efficacy-of-focused-ultrasound-thalamotomy-for-patients-with-medication-refractory-tremor-dominant-parkinson-disease-a-randomized-clinical-trial
#11
Aaron E Bond, Binit B Shah, Diane S Huss, Robert F Dallapiazza, Amy Warren, Madaline B Harrison, Scott A Sperling, Xin-Qun Wang, Ryder Gwinn, Jennie Witt, Susie Ro, W Jeffrey Elias
Importance: Clinical trials have confirmed the efficacy of focused ultrasound (FUS) thalamotomy in essential tremor, but its effectiveness and safety for managing tremor-dominant Parkinson disease (TDPD) is unknown. Objective: To assess safety and efficacy at 12-month follow-up, accounting for placebo response, of unilateral FUS thalamotomy for patients with TDPD. Design, Setting, and Participants: Of the 326 patients identified from an in-house database, 53 patients consented to be screened...
October 30, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/29083328/current-trends-in-etiology-prognosis-and-therapeutic-aspects-of-parkinson-s-disease-a-review
#12
A J Jagadeesan, R Murugesan, S Vimala Devi, M Meera, G Madhumala, M Vishwanathan Padmaja, A Ramesh, A Banerjee, S Sushmitha, A N Khokhlov, F Marotta, Surajit Pathak
Parkinson's disease (PD) is a movement disorder, mainly affecting population consisting of the aged. PD occurs chiefly due to progressive loss of dopaminergic neurons in nigrostriatal pathway. Largely, PD patients suffer from non-motor symptoms, such as depression, anxiety, fatigue, and sleep disorders, that needs further investigation and addressing during PD research. Depression in PD is a predominant and complex symptom, and its pathology exists extrinsic to the nigrostriatal system. This disease can  ultimately be managed by a combination of regular physiotherapy and proper medication...
October 23, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29071698/-movement-disorders-units-and-management-of-motor-fluctuations-in-advanced-parkinson-s-disease
#13
O de Fabregues, A Gironell, D Rossello-Jimenez, E Regueras
INTRODUCTION: Advanced Parkinson's disease (PD) entails complications, such as motor fluctuations. In Spain, medical attention for such cases is often provided in movement disorder units (MDU). AIM: To gain further knowledge of the diagnostic resources and therapeutic approach of MDU. SUBJECTS AND METHODS: A descriptive cross-sectional study was conducted. The researchers designed an on-line questionnaire, addressed to neurologists from MDUs, containing 48 questions about the resources they have available, the number of patients with PD and motor fluctuations that have been attended to, as well as the therapeutic approach, according to the Hoehn and Yahr (HY) scale...
November 1, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/29043906/parkinson-s-disease-and-the-quest-for-preclinical-diagnosis-an-interview-with-professor-werner-poewe
#14
Werner Poewe
Werner Poewe speaks to Laura Dormer, Editorial Director: Professor Werner Poewe is Professor of Neurology and Director of the Department of Neurology at Innsbruck Medical University in Innsbruck, Austria. He held a Residency in Clinical Neurology and Psychiatry at the University of Innsbruck, Austria, from 1977 to 1984. From 1984 to 1985 he teamed up with Gerald Stern and Andrew Lees as a British Council Research Fellow at University College and Middlesex Hospital's Medical School in London to perform clinical studies into levodopa-induced dystonia and pharmacokinetics of levodopa in naive versus L-Dopa treated Parkinson's disease...
October 18, 2017: Neurodegenerative Disease Management
https://www.readbyqxmd.com/read/29039022/metformin-inhibits-the-development-of-l-dopa-induced-dyskinesia-in-a-murine-model-of-parkinson-s-disease
#15
Young-Kyoung Ryu, Hye-Yeon Park, Jun Go, Dong-Hee Choi, Yong-Hoon Kim, Jung Hwan Hwang, Jung-Ran Noh, Tae Geol Lee, Chul-Ho Lee, Kyoung-Shim Kim
Metformin is a medication that is widely prescribed for the management of type 2 diabetes. In addition to its anti-diabetic uses, metformin has been proposed as a therapeutically effective drug candidate in various central nervous system disorders, including Parkinson's disease (PD). PD is characterized by severe movement defects and is commonly treated with the dopamine (DA) precursor 3,4-dihydroxyphenyl-l-alanine (L-DOPA). However, prolonged use of L-DOPA can lead to the development of L-DOPA-induced dyskinesia (LID)...
October 16, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/29032347/vocalic-transitions-as-markers-of-speech-acoustic-changes-with-stn-dbs-in-parkinson-s-disease
#16
Vincent Martel-Sauvageau, Kris Tjaden
PURPOSE: Deep Brain Stimulation of the subthalamic nucleus (STN-DBS) effectively treats cardinal symptoms of idiopathic Parkinson's disease (PD) that cannot be satisfactorily managed with medication. Research is equivocal regarding speech changes associated with STN-DBS. This study investigated the impact of STN-DBS on vocalic transitions and the relationship to intelligibility. METHODS: Eight Quebec-French speakers with PD and eight healthy controls participated...
October 7, 2017: Journal of Communication Disorders
https://www.readbyqxmd.com/read/29020721/artefact-mimicking-torsades-treat-the-patient-not-the-ecg
#17
Una Bergin, Richard M Lynch
ECG interpretation is an essential skill in the management of the acutely unwell patient and in addition to history taking and physical examination has been shown to have a significant effect on referral patterns to cardiologists. One of the basic initial steps in ECG interpretation is assessment for the presence of artefact which if present can dramatically influence the diagnosis. The most common sources of artefact are tremor e.g. in Parkinson’s disease, loose skin electrodes and electromagnetic interference from other medical devices and mobile phones...
February 2017: Practitioner
https://www.readbyqxmd.com/read/29018160/dopamine-dysregulation-syndrome-in-parkinson-s-disease-a-systematic-review-of-published-cases
#18
Nicola Warren, Cullen O'Gorman, Alexander Lehn, Dan Siskind
OBJECTIVES: Dopamine dysregulation syndrome (DDS) is an uncommon complication of the treatment of Parkinson's disease, characterised by addictive behaviour and excessive use of dopaminergic medication. DDS may frequently go unrecognised or misdiagnosed. We aimed to clarify current understanding of presentation, risk factors, comorbidities and management of DDS. METHODS: Case reports were identified through a systematic search of databases (PubMed, Embase) with the following terms: dopaminergic dysregulation syndrome, hedonistic homeostatic dysregulation, dopamine/levodopa addiction...
October 10, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28990131/diagnosis-and-management-of-cognitive-and-behavioral-changes-in-dementia-with-lewy-bodies
#19
REVIEW
Babak Tousi
Proper diagnosis of dementia with Lewy bodies (DLB) in clinical practice remains suboptimal as many cases are misdiagnosed, usually as Alzheimer disease (AD) or Parkinson's disease (PD) and, in rare cases, psychosis. Therefore, it is important for patients with dementia to be thoroughly evaluated by a specialist who is familiar with current diagnostic tests and treatment options. New diagnostic criteria from the Dementia with Lewy Bodies Consortium have been developed to increase diagnostic sensitivity for DLB (Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB Consortium; McKeith et al...
October 9, 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28982489/palliative-care-in-neurology
#20
REVIEW
Maisha T Robinson, Robert G Holloway
Palliative medicine is a specialty that focuses on improving the quality of life for patients with serious or advanced medical conditions, and it is appropriate at any stage of disease, including at the time of diagnosis. Neurologic conditions tend to have high symptom burdens, variable disease courses, and poor prognoses that affect not only patients but also their families and caregivers. Patients with a variety of neurologic conditions such as Parkinson disease, dementia, amyotrophic lateral sclerosis, brain tumors, stroke, and acute neurologic illnesses have substantial unmet needs that can be addressed through a combination of primary and specialty palliative care...
October 2017: Mayo Clinic Proceedings
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