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https://www.readbyqxmd.com/read/28196947/cohort-profile-the-welsh-geriatric-registrar-led-research-network-wegen-rationale-design-and-description
#1
Benjamin Jelley, Sara Long, John Butler, Jonathan Hewitt
PURPOSE: Medical trainees are required to undertake audit and quality improvement projects. They must also have an understanding of the principles of research and are encouraged to participate in research projects. However, the constraints of time, a lack of formal training and rotation between different training posts create barriers to audit cycle completion and pursuing research. This leads to trainees being reluctant to undertake research, facilitates poor quality research and risks incomplete audit...
February 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28168537/hyperkinetic-movement-disorder-emergencies
#2
REVIEW
Giovanni Cossu, Carlo Colosimo
A movement disorder emergency has been defined by Fahn and Frucht as "any neurological disorder evolving acutely or subacutely, in which the clinical presentation is dominated by a primary movement disorder, and in which failure to accurately diagnose and manage the patient may result in significant morbidity or even mortality." In this review, we discuss the most common situations in which hyperkinetic movement disorders, including chorea, ballism, dystonia, myoclonus, tics, as well as psychogenic disorders, can present as emergencies...
January 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28159316/-de-novo-consultation-evaluation-of-an-outpatient-s-clinic-dedicated-to-early-diagnosis-of-parkinsonian-syndromes
#3
J Ruggeri, L-L Mariani, S Aix, A-M Bonnet, F Cormier, J-C Corvol, P Dodet, D Grabli, A Hartmann, C Hubsch, L Lacomblez, E Roze, M-L Welter, Y Worbe, M Vidailhet, B Degos
INTRODUCTION: In the absence of specific clinical signs, imaging or biomarkers, the differential diagnosis of degenerative parkinsonian syndromes may be difficult at early stages of the disease. To reduce the risk of misdiagnosis or delayed diagnosis and referral to multiple medical centers at disease onset, easier access to expert centers should be available. To improve the initial care of parkinsonian patients, the Parkinson's disease Expert Center (PEC) at Pitié-Salpêtrière Academic Hospital has set up a specific outpatients clinic with short waiting times dedicated to the diagnosis of early Parkinson's disease and related disorders...
January 31, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28126343/management-of-impulse-control-disorders-with-deep-brain-stimulation-a-double-edged-sword
#4
REVIEW
Chayut Kasemsuk, Genko Oyama, Nobutaka Hattori
Deep brain stimulation (DBS) is a surgical option for advanced Parkinson's disease. Although DBS is used to treat motor fluctuation, DBS may affect non-motor symptoms including mood disorders, cognitive dysfunction, and behavior problems. Impulse control disorders (ICDs) are abnormal behaviors with various manifestations such as pathological gambling, hypersexuality, compulsive shopping, and binge eating, which can affect the quality of life in patients with Parkinson's disease. The effect of DBS on ICD is controversial...
March 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28116784/management-of-sleep-disorders-in-parkinson-s-disease-and-multiple-system-atrophy
#5
REVIEW
Aleksandar Videnovic
Parkinson's disease (PD) and multiple system atrophy (MSA) are disorders associated with α synuclein-related neurodegeneration. Nonmotor symptoms are common hallmarks of these disorders, and disturbances of the sleep-wake cycle are among the most common nonmotor symptoms. It is only recently that sleep disturbances have received the attention of the medical and research community. Significant progress has been made in understanding the pathophysiology of sleep and wake disruption in alphasynucleinopathies during the past few decades...
January 24, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/28116120/distant-delivery-of-a-mindfulness-based-intervention-for-people-with-parkinson-s-disease-the-study-protocol-of-a-randomised-pilot-trial
#6
A Bogosian, C S Hurt, D Vasconcelos E Sa, J V Hindle, L McCracken, P Cubi-Molla
BACKGROUND: Psychological difficulties, especially depression and anxiety, are the most prevalent non-motor symptoms in Parkinson's disease. Pharmacological treatments for these conditions appear relatively ineffective in Parkinson's disease. Mindfulness courses are increasingly popular and recognised as effective for managing emotional states, and there is growing evidence for the effectiveness of mindfulness courses for people with long-term medical conditions. With this exploratory pilot trial, we want to assess the feasibility of the procedures and processes, including recruitment, most appropriate outcome measure(s), acceptability of type and number of measures, potential nocebo effects, and potential effectiveness and cost-effectiveness of a specially adapted distance-delivered mindfulness-based intervention in people affected by Parkinson's disease...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28115853/the-role-and-structure-of-the-multidisciplinary-team-in-the-management-of-advanced-parkinson-s-disease-with-a-focus-on-the-use-of-levodopa-carbidopa-intestinal-gel
#7
REVIEW
Stephen W Pedersen, Martin Suedmeyer, Louis W C Liu, Dirk Domagk, Alison Forbes, Lars Bergmann, Koray Onuk, Ashley Yegin, Teus van Laar
A multidisciplinary team (MDT) approach is increasingly recommended in Parkinson's disease (PD) treatment guidelines, but no standard of care exists for such an approach, and the guidelines do not provide clarification on how it should be implemented. This paper reviews evidence of MDT interventions in people with PD and provides expert clinical perspectives for an MDT approach, with a focus on advanced PD and levodopa-carbidopa intestinal gel (carbidopa-levodopa enteral suspension in the USA). The key recommendations are to enable the best possible treatment of people with PD locally by facilitating a close structured collaboration of different health care professionals working in a fixed network structure; to refer people with PD to established MDT centers in a timely manner; to establish regular meetings for the MDT enabling interdisciplinary exchange and learning; to optimize individual treatment and carefully evaluate available treatment options; to ensure treatment decisions are agreed jointly between people with PD, their caregivers, family, and health care professional; and to include specialists outside of neurology from adjuvant medical departments as necessary when implementing advanced therapies...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28108265/palliative-care-and-parkinson-s-disease-meeting-summary-and-recommendations-for-clinical-research
#8
REVIEW
Benzi M Kluger, Siobhán Fox, Suzanne Timmons, Maya Katz, Nicholas B Galifianakis, Indu Subramanian, Julie H Carter, Miriam J Johnson, Edward W Richfield, David Bekelman, Jean S Kutner, Janis Miyasaki
INTRODUCTION: Palliative care is an approach to caring for patients and families affected by serious illnesses that focuses on the relief of suffering through the management of medical symptoms, psychosocial issues, advance care planning and spiritual wellbeing. Over the past decade there has been an emerging clinical and research interest in the application of palliative care approaches to Parkinson's disease (PD) and outpatient palliative care services are now offered by several movement disorders centers...
January 11, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28106066/the-psychosis-spectrum-in-parkinson-disease
#9
REVIEW
Dominic H Ffytche, Byron Creese, Marios Politis, K Ray Chaudhuri, Daniel Weintraub, Clive Ballard, Dag Aarsland
In 2007, the clinical and research profile of illusions, hallucinations, delusions and related symptoms in Parkinson disease (PD) was raised with the publication of a consensus definition of PD psychosis. Symptoms that were previously deemed benign and clinically insignificant were incorporated into a continuum of severity, leading to the rapid expansion of literature focusing on clinical aspects, mechanisms and treatment. Here, we review this literature and the evolving view of PD psychosis. Key topics include the prospective risk of dementia in individuals with PD psychosis, and the causal and modifying effects of PD medication...
February 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/28074748/possible-parkinson-s-disease-induced-by-chronic-manganese-supplement-ingestion
#10
Michael J Schuh
OBJECTIVE: The objective is to report a case of possible neurotoxicity resulting from an incorrect dietary supplement for osteoporosis taken at a toxic dose. SUMMARY: The case study examined here is a 37-year-old African-American female who consumed excessive manganese over a period of years, resulting in Parkinson's disease (PD). This patient was referred to the pharmacist pharmacotherapy service by a neurology physician. PD has been shown in the medical literature to be caused by chronic exposure to high levels of manganese...
December 1, 2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28073650/the-utilisation-of-one-district-hospital-emergency-department-by-people-with-parkinson-s-disease
#11
Marion Harris, Margaret Fry
BACKGROUND: Parkinson's disease (PD) is the second most common neurodegenerative disorder in Australia and the economic burden is more than $8.3 billion a year and predicted to escalate. However, little is known of the trends and characteristics of people with Parkinson's disease presenting to emergency departments (ED). METHOD: The study design was a 12 month retrospective medical record audit. The study was conducted in one metropolitan 300 bed district hospital in an outer suburb of Sydney...
January 7, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28063683/diphasic-dyskinesias-during-levodopa-carbidopa-intestinal-gel-lcig-infusion-in-parkinson-s-disease
#12
Meloni Mario, Solla Paolo, Mascia Mario Marcello, Marrosu Francesco, Cannas Antonino
OBJECTIVES: Levodopa-carbidopa intestinal gel infusion (LCIG) is indicated in patients with advanced levodopa-responsive Parkinson's disease (PD) for the treatment of motor fluctuations and dyskinesias. Here we describe 4 PD patients who developed disabling diphasic dyskinesias after LCIG initiation. METHODS: The clinical data of 33 PD patients consecutively treated with LCIG therapy were obtained through direct clinical observation and detailed review of medical records...
December 31, 2016: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28028671/anesthesia-considerations-for-patients-with-an-implanted-deep-brain-stimulator-undergoing-surgery-a-review-and-update
#13
Tze Yeng Yeoh, Pirjo Manninen, Suneil K Kalia, Lashmi Venkatraghavan
PURPOSE: Deep brain stimulation (DBS) can be an effective treatment option for patients with essential tremor and Parkinson's disease. This review provides an overview on the functioning of neurostimulators and recent advances in this technology and presents an updated guide on the anesthetic management of patients with an implanted neurostimulator undergoing surgery or medical intervention. SOURCE: A search was conducted on MEDLINE®, EMBASE™, and Cochrane Database of Systematic Reviews databases to identify studies published in English from 1974 to December 2015...
March 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28027343/recommendations-for-the-treatment-of-patients-with-parkinson-disease-during-ramadan
#14
Philippe Damier, Jasem Al-Hashel
Importance: Every year, Ramadan fasting is practiced by many Muslim individuals. In cases of chronic disease, religious texts allow fasting to be broken. However, many believers still want to fast even at the risk of damaging their health. To our knowledge, there are no published recommendations on the medical management of Parkinson disease (PD) during Ramadan. Effective treatments exist in PD and usually require several daily drug intakes. Apart from worsening symptoms, interrupting PD treatment might lead to a severe withdrawal syndrome...
February 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28007002/physical-therapy-and-occupational-therapy-in-parkinson-s-disease
#15
Danielle L M Radder, Ingrid H Sturkenboom, Marlies van Nimwegen, Samyra H Keus, Bastiaan R Bloem, Nienke M de Vries
Current medical management is only partially effective in controlling the symptoms of Parkinson's disease. As part of comprehensive multidisciplinary care, physical therapy and occupational therapy aim to support people with Parkinson's disease in dealing with the consequences of their disease in daily activities. In this narrative review, we address the limitations that people with Parkinson's disease may encounter despite optimal medical management, and we clarify both the unique and shared approaches that physical therapists and occupational therapists can apply in treating these limitations...
December 22, 2016: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28000926/virtual-reality-for-rehabilitation-in-parkinson-s-disease
#16
REVIEW
Kim Dockx, Esther Mj Bekkers, Veerle Van den Bergh, Pieter Ginis, Lynn Rochester, Jeffrey M Hausdorff, Anat Mirelman, Alice Nieuwboer
BACKGROUND: Parkinson's disease (PD) is a neurodegenerative disorder that is best managed by a combination of medication and regular physiotherapy. In this context, virtual reality (VR) technology is proposed as a new rehabilitation tool with a possible added value over traditional physiotherapy approaches. It potentially optimises motor learning in a safe environment, and by replicating real-life scenarios could help improve functional activities of daily living. OBJECTIVES: The objective of this review was to summarise the current best evidence for the effectiveness of VR interventions for the rehabilitation of people with PD in comparison with 1) active interventions, and 2) passive interventions...
21, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27942720/assessment-of-safety-and-efficacy-of-safinamide-as-a-levodopa-adjunct-in-patients-with-parkinson-disease-and-motor-fluctuations-a-randomized-clinical-trial
#17
Anthony H V Schapira, Susan H Fox, Robert A Hauser, Joseph Jankovic, Wolfgang H Jost, Christopher Kenney, Jaime Kulisevsky, Rajesh Pahwa, Werner Poewe, Ravi Anand
Importance: Although levodopa remains the most effective oral pharmacotherapy for Parkinson disease (PD), its use is often limited by wearing off effect and dyskinesias. Management of such complications continues to be a significant challenge. Objective: To investigate the efficacy and safety of safinamide (an oral aminoamide derivative with dopaminergic and nondopaminergic actions) in levodopa-treated patients with motor fluctuations. Design, Setting, and Participants: From March 5, 2009, through February 23, 2012, patients from academic PD care centers were randomized (1:1 ratio) to receive double-blind adjunctive safinamide or placebo for 24 weeks...
February 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/27932224/unmet-needs-in-parkinson-s-disease-new-horizons-in-a-changing-landscape
#18
K Ray Chaudhuri, Roongroj Bhidayasiri, Teus van Laar
The success of levodopa and other classes of drugs have meant that most people with Parkinson's disease enjoy a good quality of life for many years. However, despite the availability of several drugs and formulations that can be used as monotherapy and in combination, there are a number of disease features that the current therapies are unable to address. The disease continues to progress despite treatment, patients suffer from a myriad of motor and non-motor symptoms, and a neuroprotective therapy is urgently required...
December 2016: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/27926449/the-role-of-dopamine-in-the-pathophysiology-and-treatment-of-apathy
#19
T T-J Chong, M Husain
Disorders of diminished motivation, such as apathy, are common and prevalent across a wide range of medical conditions, including Parkinson's disease, Alzheimer's dementia, stroke, depression, and schizophrenia. Such disorders have a significant impact on morbidity and quality of life, yet their management lacks consensus and remains unsatisfactory. Here, we review laboratory and clinical evidence for the use of dopaminergic therapies in the treatment of apathy. Dopamine is a key neurotransmitter that regulates motivated decision making in humans and other species...
2016: Progress in Brain Research
https://www.readbyqxmd.com/read/27911342/impulsive-and-compulsive-behaviors-in%C3%A2-parkinson-s-disease-the-norwegian-parkwest-study
#20
Aleksander H Erga, Guido Alves, Jan Petter Larsen, Ole Bj Rn Tysnes, Kenn Freddy Pedersen
BACKGROUND: Impulsive and compulsive behaviors (ICBs) are frequent in Parkinson's disease (PD), but data from population-based cohorts is lacking. OBJECTIVES: To determine the frequency and associated demographic, clinical, neuropsychiatric and cognitive features of ICBs in a population-based PD cohort. METHODS: This cross-sectional study included 125 patients with PD and 159 age- and gender-matched normal controls recruited from the Norwegian ParkWest study...
November 30, 2016: Journal of Parkinson's Disease
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