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medical management of Parkinson

Jacob Taylor, William S Anderson, Jason Brandt, Zoltan Mari, Gregory M Pontone
Although Parkinson disease (PD) is defined clinically by its motor symptoms, it is increasingly recognized that much of the disability and worsened quality of life experienced by patients with PD is attributable to psychiatric symptoms. The authors describe a model of multidisciplinary care that enables these symptoms to be effectively managed. They describe neuropsychiatric complications of PD itself and pharmacologic and neurostimulation treatments for parkinsonian motor symptoms and discuss the management of these complications...
September 3, 2016: American Journal of Geriatric Psychiatry
Kevin Ita
With the increasing proportion of the global geriatric population, it becomes obvious that neurodegenerative diseases will become more widespread. From an epidemiological standpoint, it is necessary to develop new therapeutic agents for the management of Alzheimer's disease, Parkinson's disease, multiple sclerosis and other neurodegenerative disorders. An important approach in this regard involves the use of the transdermal route. With transdermal drug delivery systems, it is possible to modulate the pharmacokinetic profiles of these medications and improve patient compliance...
October 5, 2016: Journal of Drug Targeting
Cindy Canivet, Nadège Costa, Fabienne Ory-Magne, Céline Arcari, Christine Mohara, Laure Pourcel, Hélène Derumeaux, Emilie Bérard, Robert Bourrel, Laurent Molinier, Christine Brefel-Courbon
BACKGROUND: Parkinson's disease (PD) is characterized by its impact on quality of life, constituting a substantial economic burden on society. Education programs implicating patients more in the management of their illness and complementing medical treatment may be a beneficial adjunct in PD. This study assessed the impact of an education program on quality of life and its cost-effectiveness in PD patients. METHODS: This single-center, prospective, randomized study assessed an education program consisting of individual and group sessions over a 12-month period...
2016: PloS One
Amit Batla, Natalie Tayim, Mahreen Pakzad, Jalesh N Panicker
Urogenital dysfunction is commonly reported in Parkinson's disease (PD), and history taking and a bladder diary form the cornerstone of evaluation. The assessment of lower urinary tract (LUT) symptoms include urinalysis, ultrasonography, and urodynamic studies and help to evaluate concomitant urological pathologies such as benign prostate enlargement. Antimuscarinic medications are the first line treatment for overactive bladder (OAB) symptoms and solifenacin has been specifically studied in PD. Antimuscarininc drugs may exacerbate PD-related constipation and xerostomia, and caution is advised when using these medications in individuals where cognitive impairment is suspected...
October 2016: Current Treatment Options in Neurology
Umer Akbar, Arlet G Kurkchubasche, Joseph H Friedman
Guidelines for the management of Parkinson's disease (PD) patients in the perioperative setting are lacking. Areas covered: Here we review potential problems that may arise when PD patients are undergoing an operation. We also review the literature, where available, and provide our expert opinion and recommendations based on experience. Expert commentary: Elderly patients with PD are especially prone to complications in the perioperative setting. Extreme caution must be used to ensure appropriate medication administration, transition to non-oral agents, if indicated, and early mobilization to achieve rapid recovery after surgery...
October 3, 2016: Expert Review of Neurotherapeutics
Alfonso Fasano, Silke Appel-Cresswell, Mandar Jog, Mateusz Zurowkski, Sarah Duff-Canning, Melanie Cohn, Marina Picillo, Christopher R Honey, Michel Panisset, Renato Puppi Munhoz
In this review, we have gathered all the available evidence to guide medication management after deep brain stimulation (DBS) in Parkinson's disease (PD). Surprisingly, we found that almost no study addressed drug-based management in the postoperative period. Dopaminergic medications are usually reduced, but whether the levodopa or dopamine agonist is to be reduced is left to the personal preference of the treating physician. We have summarized the pros and cons of both approaches. No study on the management of cognitive problems after DBS has been done, and only a few studies have explored the pharmacological management of such DBS-resistant symptoms as voice (amantadine), balance (donepezil) or gait disorders (amantadine, methylphenidate)...
September 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Md Asiful Islam, Fahmida Alam, Mohammad Amjad Kamal, Kah Keng Wong, Teguh Haryo Sasongko, Siew Hua Gan
Neurological manifestations or disorders associated with central nervous system (CNS) are one of the most common as well as important clinical characteristics of antiphospholipid syndrome (APS). Although in the last updated (2006) classification criteria of APS its neurological manifestations encompassed only transient ischemic attack (TIA) and stroke, diverse 'non-criteria' neurological disorders or manifestations (headache, migraine, bipolar disorder, transverse myelitis, dementia, chorea, epileptic seizures, multiple sclerosis, psychosis, cognitive impairment, Tourette's syndrome, parkinsonism, dystonia, transient global amnesia, obsessive compulsive disorder and leukoencephalopathy) have been observed in APS patients...
September 20, 2016: CNS & Neurological Disorders Drug Targets
Kangdi Zhu, Jacobus J van Hilten, Johan Marinus
INTRODUCTION: Insomnia is a debilitating symptom in Parkinson's disease (PD) that has been scarcely investigated in a longitudinal design. Knowledge of factors associated with occurrence of insomnia may provide clues for an increased understanding of underlying pathophysiology and facilitate early detection. The objective of this study is to examine the course and factors associated with longitudinal changes in insomnia severity in patients with PD. METHODS: Analyses were performed in data of the SCOPA-PROPARK cohort, a 5-year longitudinal cohort study (2003-2011) of 421 PD patients who have been examined annually...
September 9, 2016: Parkinsonism & related Disorders
Oluwadamilola O Ojo, Hubert H Fernandez
Psychosis in Parkinson's disease (PD) is one of the greatest determinants of nursing home placement and caregiver stress. Traditionally associated with medications with dopaminergic effect, it has now been linked to other medications and other stressors e.g. systemic illnesses. The development of hallucinations in a PD patient can herald the onset of dementia and usually predicts increased mortality risk. Medication reduction in PD psychosis usually reduces the symptoms; however, this comes at the cost of worsening motor function...
October 2016: Current Psychiatry Reports
Aileen Chen, Erwin J Loquias, Ramesh Roshan, Richard Levene, Raymond Zelhof, Terry Hickey, Gail Austin Cooney, Faustino Gonzalez
BACKGROUND: Diphenhydramine (DPH) is most commonly used via oral, topical, intramuscular (IM) and intravenous (IV) routes for the palliation of pruritus, treatment of extrapyramidal symptoms, management of parkinsonism and for allergic reactions. However, many hospice patients are unable to take oral medications and/or do not have IV access. Moreover, topical administration has a relatively slow rate of absorption. For this reason, in the hospice setting it is not uncommon for diphenhydramine to be administered via the subcutaneous (SC) route secondary to its ease of access, low infection rates and its low levels of discomfort...
September 13, 2016: American Journal of Hospice & Palliative Care
Annette Hand, William K Gray, Lloyd L Oates, Megan Woolford, Anna Todd, Elizabeth Bale, Catherine Jones, Brian H Wood, Richard W Walker
BACKGROUND: People with Parkinson's disease (PD) and parkinsonism living in care homes (residential or nursing care) in the UK represent around 10-15% of all people with PD and 3-5% of all care home residents. There are few previous data on medication use in those living in care homes with PD. In this study we aimed to compare medication use in a representative cohort of people with PD living in care homes in north-east England with those living in their own homes. METHOD: All people with late stage (Hoehn and Yahr III-V) idiopathic PD, PD dementia, or atypical parkinsonian syndromes under the care of the Northumbria Healthcare NHS Foundation Trust PD service on 1st January 2015 were identified...
September 2, 2016: Parkinsonism & related Disorders
Blaine Reeder, Alexandria David
INTRODUCTION: Smart watches have the potential to support health in everyday living by: enabling self-monitoring of personal activity; obtaining feedback based on activity measures; allowing for in-situ surveys to identify patterns of behavior; and supporting bi-directional communication with health care providers and family members. However, smart watches are an emerging technology and research with these devices is at a nascent stage. METHODS: We conducted a systematic review of smart watch studies that engaged people in their use by searching PubMed, Embase, IEEE XPlore and ACM Digital libraries...
September 6, 2016: Journal of Biomedical Informatics
Hee Jin Kim, Beomseok Jeon, Sun Ju Chung
The practice of complementary and alternative medicine (CAM) is not, at present, considered an integral part of conventional medicine. As the popularity of CAM grows and access to information about CAM increases through the media and internet where CAMs are often promoted, patients are at risk of exposure unvalidated information. Therefore, there is a need for physicians to examine objectively the efficacy and safety of CAM, compare it with current medications, and become actively involved in the CAM treatment with patients...
October 19, 2016: Journal of Parkinson's Disease
Ana Lígia Silva de Lima, Tim Hahn, Nienke M de Vries, Eli Cohen, Lauren Bataille, Max A Little, Heribert Baldus, Bastiaan R Bloem, Marjan J Faber
BACKGROUND: Long-term management of Parkinson's disease does not reach its full potential because we lack knowledge about individual variations in clinical presentation and disease progression. Continuous and longitudinal assessments in real-life (ie, within the patients' own home environment) might fill this knowledge gap. OBJECTIVE: The primary aim of the Parkinson@Home study is to evaluate the feasibility and compliance of using multiple wearable sensors to collect clinically relevant data...
2016: JMIR Research Protocols
Namyata Pathak-Gandhi, Ashok D B Vaidya
ETHNOPHARMACOLOGICAL RELEVANCE: Medicinal plants like Mucuna pruriens L.(DC) and Withania somnifera L.(Dunal) have been used in traditional Ayurvedic medicine to manage neurodegenerative diseases like Parkinson's disease. AIM: The aim of this review is to share the role of Ayurveda's insights, traditional usage and contemporary investigations for translational, integrative applications to manage Idiopathic Parkinson's Disease. MATERIALS AND METHODS: High impact journals for Parkinson's diseases, traditional textbooks from Ayurveda as well as relevant clinical and para clinical studies with botanicals are selectively incorporated to evolve the aforesaid translational application...
August 17, 2016: Journal of Ethnopharmacology
C Clark, D Thomas, F Warren, D Llewellyn, L Ferrucci, J Campbell
OBJECTIVE: Over three million people aged over 65 fall each year in the UK. Postural hypotension (PH) is a risk factor for falls. It is associated with excess mortality, and may affect cognition. PH is not routinely checked for in UK clinical practice. We studied the InCHIANTI dataset to derive and validate a simple prediction tool designed to facilitate identification of subjects to be checked for PH. DESIGN AND METHOD: InCHIANTI is a population-based study of ageing...
September 2016: Journal of Hypertension
Chien-Chia Huang, Wei-Lung Chen, Chien-Chin Hsu, Hung-Jung Lin, Shih-Bin Su, How-Ran Guo, Chien-Cheng Huang, Pi-Ching Chen
Backgrounds and Aim. Taiwan's population is gradually aging; however, there are no comparative data on emergency medical services (EMS) use between the elderly and nonelderly. Methods. We analyzed the emergency calls dealt with between January 1 and April 4, 2014, by EMS in one city in Taiwan. All calls were divided into two groups: elderly (≥65 years) and nonelderly (<65 years). Nontransport and transport calls were compared between the groups for demographic characteristics, transport time, reasons for calling EMS, vital signs, and emergency management...
2016: BioMed Research International
Themistocles S Protopsaltis, Anthony J Boniello, Frank J Schwab
A wide range of neuromuscular diseases, including Parkinson disease, cerebral palsy, multiple sclerosis, and myopathy, are associated with spinal deformities. The most common postural deformities include anterocollis, Pisa syndrome (pleurothotonus), scoliosis, and camptocormia. Nonsurgical management of spinal deformity in patients with neuromuscular disease centers on maximizing the medical management of the underlying neurodegenerative pathology before surgical intervention is contemplated. Surgical management can include decompression alone, or decompression and fusion with short or long fusion constructs...
September 2016: Journal of the American Academy of Orthopaedic Surgeons
Tamlyn J Watermeyer, John V Hindle, Julie Roberts, Catherine L Lawrence, Anthony Martyr, Huw Lloyd-Williams, Andrew Brand, Petra Gutting, Zoe Hoare, Rhiannon Tudor Edwards, Linda Clare
Alongside the physical symptoms associated with Parkinson's disease dementia and dementia with Lewy bodies, health services must also address the cognitive impairments that accompany these conditions. There is growing interest in the use of nonpharmacological approaches to managing the consequences of cognitive disorder. Cognitive rehabilitation is a goal-orientated behavioural intervention which aims to enhance functional independence through the use of strategies specific to the individual's needs and abilities...
2016: Parkinson's Disease
Fumin Jia, Hongwei Hao, Fangang Meng, Yi Guo, Shizhong Zhang, Jianguo Zhang, Luming Li
PURPOSE/AIM OF THE STUDY: Rechargeable deep brain stimulation (DBS) system with longer battery life has become available for treating movement disorders. However, little information exists about the safety and management after implantation. Therefore, there is an urgent need to evaluate the recharging performance through long-term observations. MATERIALS AND METHODS: Fifty-three Parkinson's disease (PD) patients were implanted with a new rechargeable device (G102R, PINS Medical)...
November 2016: International Journal of Neuroscience
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