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medical management of Parkinson

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https://www.readbyqxmd.com/read/29677942/insights-into-pharmacotherapy-management-for-parkinson-s-disease-patients-using-wearables-activity-data
#1
Vincent Nguyen, Holger Kunz, Paul Taylor, Dionisio Acosta
We investigate what supervised classification models using clinical and wearables data are best suited to address two important questions about the management of Parkinson's Disease (PD) patients: 1) does a PD patient require pharmacotherapy or not, and 2) whether therapies are having an effect. Currently, patient management is suboptimal due to using subjective patient reported episodes to answer these questions. METHODOLOGY: Clinical and real environment sensor data (memory, tapping, walking) was provided by the mPower study (6805 participants)...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29668839/prognostic-factors-of-functional-outcome-after-hip-fracture-surgery-a-systematic-review
#2
K J Sheehan, L Williamson, J Alexander, C Filliter, B Sobolev, P Guy, L M Bearne, C Sackley
Objective: this systematic review aimed to identify immutable and modifiable prognostic factors of functional outcomes and their proposed mechanism after hip fracture surgery. Design: systematic search of MEDLINE, Embase, CINAHL, PEDRO, OpenGrey and ClinicalTrials.gov for observational studies of prognostic factors of functional outcome after hip fracture among surgically treated adults with mean age of 65 years and older. Study selection, quality assessment, and data extraction were completed independently by two reviewers...
April 12, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29623455/managing-gait-balance-and-posture-in-parkinson-s-disease
#3
REVIEW
Bettina Debû, Clecio De Oliveira Godeiro, Jarbas Correa Lino, Elena Moro
PURPOSE OF REVIEW: Postural instability and gait difficulties inexorably worsen with Parkinson's disease (PD) progression and become treatment resistant, with a severe impact on autonomy and quality of life. We review the main characteristics of balance instability, gait disabilities, and static postural alterations in advanced PD, and the available treatment strategies. RECENT FINDINGS: It remains very difficult to satisfactorily alleviate gait and postural disturbances in advanced PD...
April 6, 2018: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/29608802/king-s-parkinson-s-disease-pain-scale-for-assessment-of-pain-relief-following-deep-brain-stimulation-for-parkinson-s-disease
#4
Marisa DiMarzio, Julie G Pilitsis, Lucy Gee, Sophia Peng, Julia Prusik, Jennifer Durphy, Adolfo Ramirez-Zamora, Era Hanspal, Eric Molho, Sarah E McCallum
OBJECTIVE: Pain is a prevalent and debilitating nonmotor symptom of Parkinson's disease (PD) that is often inadequately managed. Deep brain stimulation (DBS) has been shown to relieve pain in PD but an effective method of identifying which types of PD pain respond to DBS has not been established. We examine the effects of DBS on different types of PD pain using the King's Parkinson's disease pain scale (KPDPS), the only validated scale of PD pain. METHODS: We prospectively followed 18 PD patients undergoing subthalamic nucleus (STN) or Globus pallidus interna (GPi) DBS...
April 2, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29570862/medical-and-surgical-management-of-advanced-parkinson-s-disease
#5
REVIEW
Angelo Antonini, Elena Moro, Clecio Godeiro, Heinz Reichmann
Advanced Parkinson's disease is characterized by the presence of motor fluctuations, various degree of dyskinesia, and disability with functional impact on activities of daily living and independence. Therapeutic management aims to extend levodopa benefit while minimizing motor complications and includes, in selected cases, the implementation of drug infusion and surgical techniques. In milder forms of motor complications, these can often be controlled with manipulation of levodopa dose and the introduction of supplemental therapies such as catechol-O-methyl transferase inhibitors, monoamine oxidase B inhibitors, and dopamine agonists including apomorphine...
March 23, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29569570/behavioral-and-psychological-symptoms-in-lewy-body-disease-a-review
#6
Lucie Jurek, Mathieu Herrmann, Mathilde Bonze, Sophie Brunet, Catherine Padovan, Jean-Michel Dorey
Dementia with Lewy bodies (DLB) is a common neurodegenerative disease, second in terms of prevalence after Alzheimer's disease (AD). DLB may be suspected according to three core features which are cognitive and motor fluctuations, early visual hallucinations and parkinsonism; and more recently, according to the new criteria, REM sleep behavior disorder (RBD). Behavorial and psychological symptoms associated with DLB are more frequent, more severe and appear earlier than those found in other neurodegenerative diseases...
March 1, 2018: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/29503325/parkinson-s-disease-a-review
#7
REVIEW
Divya M Radhakrishnan, Vinay Goyal
Parkinson's disease is a common movement disorder seen in neurological practice, but the diagnosis and management is challenging. The diagnosis is clinical and sometimes difficult, considering a large number of motor and non-motor symptoms in PD patients. The medical management of PD patients is difficult, as choices of drugs are limited and levodopa is the mainstay of treatment. However, levodopa-induced dyskinesia (LID) is commonly seen in Parkinson's disease patients treated with levodopa. This side effect is usually encountered after a long duration of treatment, but occasionally, this may be seen even after a few days or months of treatment...
March 2018: Neurology India
https://www.readbyqxmd.com/read/29483867/ethnopharmacological-approaches-for-dementia-therapy-and-significance-of-natural-products-and-herbal-drugs
#8
REVIEW
Devesh Tewari, Adrian M Stankiewicz, Andrei Mocan, Archana N Sah, Nikolay T Tzvetkov, Lukasz Huminiecki, Jarosław O Horbańczuk, Atanas G Atanasov
Dementia is a clinical syndrome wherein gradual decline of mental and cognitive capabilities of an afflicted person takes place. Dementia is associated with various risk factors and conditions such as insufficient cerebral blood supply, toxin exposure, mitochondrial dysfunction, oxidative damage, and often coexisting with some neurodegenerative disorders such as Alzheimer's disease (AD), Huntington's disease (HD), and Parkinson's disease (PD). Although there are well-established (semi-)synthetic drugs currently used for the management of AD and AD-associated dementia, most of them have several adverse effects...
2018: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/29480230/cardiovascular-risk-factor-burden-in-veterans-and-non-veterans-with-parkinson-disease
#9
Vikas Kotagal, Roger L Albin, Martijn L T M Müller, Nicolaas I Bohnen
BACKGROUND: Medical comorbidities, including cardiovascular risk factors such as hypertension and diabetes, influence disease progression in Parkinson disease (PD) and may be variably present in different clinical populations. OBJECTIVE/METHODS: We conducted a retrospective nested case-control study of 29 Veterans with PD and 29 non-Veteran PD controls. The groups were matched for age, gender, and disease duration. Both groups underwent clinical and imaging testing as part of their participation in a larger cross-sectional PD observational study at our research center...
2018: Journal of Parkinson's Disease
https://www.readbyqxmd.com/read/29480225/what-is-functional-mobility-applied-to-parkinson-s-disease
#10
Raquel Bouça-Machado, Walter Maetzler, Joaquim J Ferreira
Although yet poorly defined and often misused, the concept of functional mobility has been used in research studies as a more global and ecological outcome of patients' health status. Functional mobility is a person's physiological ability to move independently and safely in a variety of environments in order to accomplish functional activities or tasks and to participate in the activities of daily living, at home, work and in the community. Parkinson's disease (PD) has a direct impact on patients' motor control and on mobility in general...
2018: Journal of Parkinson's Disease
https://www.readbyqxmd.com/read/29444973/eight-hours-adaptive-deep-brain-stimulation-in-patients-with-parkinson-disease
#11
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
#12
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
#13
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 15, 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
#14
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
#15
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...
March 1, 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
#16
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
#17
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
#18
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
#19
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...
February 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
#20
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...
March 2018: Parkinsonism & related Disorders
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