Download or read book Behavioural Investigation Into Whether L DOPA the Current gold Standard Pharmacotherapy for Parkinson s Disease Can be Improved by Optimising Its Treatment Strategies written by and published by . This book was released on 2014 with total page 608 pages. Available in PDF, EPUB and Kindle. Book excerpt: Long-term use of L-DOPA in Parkinson's disease results in motor complications and a progressive reduction in clinical efficacy. No new pharmacologic agents and treatment options have been able to deliver a more effective treatment than L-DOPA and therefore L-DOPA treatment strategies could offer improved clinical outcomes. This led to the hypothesis that L-DOPA, the current 'gold standard' pharmacotherapy for Parkinson's disease can be improved by optimising its treatment strategies. Using validated animal models of Parkinson's disease, behavioural studies were performed to test this hypothesis to evaluate if we could: (1) potentiate the clinical response of L-DOPA by maximising the efficiency of peripheral decarboxylase (DDC) inhibition, (2) enhance the clinical response of L-DOPA through prodrug delivery and (3) optimise LDOPA's clinical therapeutic window through combination therapy with dopamine agonists. Firstly, it was shown that the efficiency of DDC inhibition could improve the L-DOPA response particularly when L-alpha-methyl dopa (L-AMD) was utilised. Secondly, the novel L-DOPA prodrug PRX 1354, induced improvement in L-DOPA motor function in MPTP treated marmosets but did not have the same positive effect on dyskinesia expression. Lastly, in the MPTP-treated common marmosets, L-DOPA combined with the dopamine agonist pramipexole resulted in improved motor function and a reduction of dyskinesia. In conclusion, manipulating L-DOPA treatment strategies can improve motor function while reducing dyskinesia expression. These results suggest that optimizing the treatment of Parkinson's disease by improving L-DOPA treatment strategies could reduce the impact of dyskinesia in Parkinson's disease patients.
Download or read book Neurogenic Dysphagia written by Tobias Warnecke and published by Springer Nature. This book was released on 2021-03-05 with total page 416 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is a clinical manual that covers the whole spectrum of swallowing and its disorders. It starts with physiology of swallowing, pathophysiology of disordered deglutition, diagnostic methods (clinical and instrumental) and ends with an in-depth’s and up-to-date presentation of current treatment options. The clinically most relevant topics of dysphagia management on the stroke unit and the intensive care unit are dealt with in separate chapters. Also the closely intertwined issue of nutritional management is specifically addressed. Most importantly, the book covers all obligatory topics of the Flexible Endoscopic Evaluation of Swallowing (FEES)-curriculum, an educational initiative that started in Germany in 2014 and is currently being extended to other European and non-European countries. The book is richly illustrated and an online video section provides a number of typical patient cases. FEES is probably the most commonly chosen method for the objective assessment of swallowing and its disorders. It is used in stroke units, intensive care facilities, geriatric wards but also in rehabilitation clinics and within dedicated outpatient services. This book on neurogenic dysphagia therefore addresses a wide range of different medical disciplines, such as neurologists, geriatricians, intensive care physicians, rehabilitation physicians, gastroenterologists, otolaryngologists, phoniatrists and also speech-language pathologists.
Download or read book Sleep Disorders in Parkinson s Disease written by Chun-Feng Liu and published by Springer. This book was released on 2021-03-20 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book focuses on the sleep-related disorders in Parkinson's disease (PD), demonstrating that they are among the most common non-motor manifestations of PD and have a significant negative impact on quality of life. Sleep changes may also serve as markers to identify patients in the preclinical stage of PD. This book presents recent major breakthroughs related to sleep disorders in PD, such as REM sleep behavior disorder (RBD), insomnia, nocturia, restless legs syndrome and periodic limb movements, sleep disordered breathing, excessive daytime sleepiness, and circadian rhythm disorders. It also discusses the epidemiology, etiology, diagnosis, clinical implications, associated features, evaluation and management of these disorders and suggests some further research directions in these areas in order to develop neuroprotective therapies for PD. Focusing on Chinese PD patients, it addresses traditional Chinese Medicine, and compares the epidemiology and management of PD in China and Western countries to provide a frame of reference values for further studies. Further, it features numerous case reports to enable readers gain a better uderstanding of the subject matter. This comprehensive yet practical book is a valuable resource for scientists and clinicians.
Download or read book Occupational Therapy for People with Parkinson s Disease written by Ana Aragon and published by . This book was released on 2010 with total page 76 pages. Available in PDF, EPUB and Kindle. Book excerpt: These practice guidelines draw upon the widest relevant knowledge and evidence available to describe and inform contemporary best practice occupational therapy for people with Parkinson's disease. They include practical examples of interventions to allow occupational therapists to apply new treatments to their practice.
Download or read book Levodopa pharmacokinetics from stomach to brain written by Maria Nord and published by Linköping University Electronic Press. This book was released on 2019-01-07 with total page 81 pages. Available in PDF, EPUB and Kindle. Book excerpt: Parkinson’s disease (PD) is one of the most common neurodegenerative disorders and it is caused by a loss of dopamine (DA) producing neurons in the basal ganglia in the brain. The PD patient suffers from motor symptoms such as tremor, bradykinesia and rigidity and treatment with levodopa (LD), the precursor of DA, has positive effects on these symptoms. Several factors affect the availability of orally given LD. Gastric emptying (GE) is one factor and it has been shown to be delayed in PD patients resulting in impaired levodopa uptake. Different enzymes metabolize LD on its way from the gut to the brain resulting in less LD available in the brain and more side effects from the metabolites. By adding dopa decarboxylase inhibitors (carbidopa or benserazide) or COMT-inhibitors (e.g. entacapone) the bioavailability of LD increases significantly and more LD can pass the blood-brain-barrier and be converted to DA in the brain. It has been considered of importance to avoid high levodopa peaks in the brain because this seems to induce changes in postsynaptic dopaminergic neurons causing disabling motor complications in PD patients. More continuously given LD, e.g. duodenal or intravenous (IV) infusions, has been shown to improve these motor complications. Deep brain stimulation of the subthalamic nucleus (STN DBS) has also been proven to improve motor complications and to make it possible to reduce the LD dosage in PD patients. In this doctoral thesis the main purpose is to study the pharmacokinetics of LD in patients with PD and motor complications; in blood and subcutaneous tissue and study the effect of GE and PD stage on LD uptake and the effect of continuously given LD (CDS) on LD uptake and GE; in blood and cerebrospinal fluid (CSF) when adding the peripheral enzyme inhibitors entacapone and carbidopa to LD infusion IV; in brain during STN DBSand during oral or IV LD treatment. To conclude, LD uptake is more favorable in PD patients with less severe disease and GE is delayed in PD patients. No obvious relation between LD uptake and GE or between GE and PD stage is seen and CDS decreases the LD levels. Entacapone increases the maximal concentration of LD in blood and CSF. This is more evident with additional carbidopa and important to consider in avoiding high LD peaks in brain during PD treatment. LD in brain increases during both oral and IV LD treatment and the DA levels follows LD well indicating that PD patients still have capacity to metabolize LD to DA despite probable pronounced nigral degeneration. STN DBS seems to increase putaminal DA levels and together with IV LD treatment also increases LD in brain possibly explaining why it is possible to decrease LD medication after STN DBS surgery. Parkinsons sjukdom (PS) är en av de vanligaste s.k. neurodegenerativasjukdomarna och orsakas av förlust av dopamin(DA)producerande nervceller i hjärnan. Detta orsakar motoriska symptom såsom skakningar, stelhet och förlångsammade rörelser. Levodopa (LD) är ett ämne, som kan omvandlas till DA i hjärnan och ge symptomlindring och det är oftast förstahandsval vid behandling av patienter med PS. Flera faktorer påverkar tillgängligheten av LD, bl.a. den hastighet som magsäcken tömmer sig med och denna verkar förlångsammad hos personer med PS vilket ger sämre tillgänglighet av LD i blodet och därmed i hjärnan. LD bryts även ner i hög grad av olika enzym ute i kroppen vilket leder till mindre mängd LD som hamnar i hjärnan och till fler nedbrytningsprodukter som orsakar biverkningar. Tillägg av enzymhämmare leder till ökad mängd LD som kan nå hjärnan och omvandlas till DA. Det anses viktigt att undvika höga toppar av LD i hjärnan då dessa verkar bidra till utvecklandet av besvärliga motoriska komplikationer hos patienter med PS. Om LD ges mer kontinuerligt, exempelvis som en kontinuerlig infusion in i tarmen eller i blodet, så minskar dessa motoriska komplikationer. Inopererande av stimulatorer i vissa delar av hjärnan (DBS) har också visat sig minska dessa motoriska komplikationer och även resultera i att man kan minska LD-dosen. Huvudsyftet med den här avhandlingen är att studera LD hos patienter med PS; i blod och fettvävnad då LD ges i tablettform och se om det finns något samband med LD-upptag och hastigheten på magsäckstömningen (MT) och om kontinuerligt given LD påverkar LD-upptaget eller MT; i blod och i ryggmärgsvätska då enzymhämmarna entakapon och karbidopa tillsätts LD; i hjärna vid behandling med DBS och då LD ges både som tablett och som infusion i blodet. Sammanfattningsvis kan vi se att LD-upptaget är mer gynnsamt hos patienter med PS i tidigare skede av sjukdomens komplikationsfas. MT är förlångsammad hos patienter med PS och det är inget tydligt samband mellan LD-upptag och MT eller mellan MT och sjukdomsgrad. Kontinuerligt given LD minskar LDnivåerna. Enzymhämmaren entakapon ökar den maximala koncentrationen av LD i blod och ryggmärgsvätska och effekten är mer tydlig vid tillägg av karbidopa vilket är viktigt att ta i beaktande vid behandling av PS för att undvika höga toppar av LD i hjärnan. LD ökar i hjärnan då man behandlar med LD i tablettform och som infusion i blodet och DA-nivåerna i hjärnan följer LD väl vilket visar på att patienter med PS fortfarande kan omvandla LD till DA trots trolig uttalad brist av de DA-producerande nervcellerna i hjärnan. DBS verkar öka DA i vissa områden i hjärnan och tillsammans med LD-infusion i blodet verkar det även öka LD i hjärnan och det kan förklara varför man kan sänka LDdosen efter DBS-operation.
Download or read book Parkinson s Disease written by National Collaborating Centre for Chronic Conditions (Great Britain) and published by Royal College of Physicians. This book was released on 2006 with total page 243 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book An Essay on the Shaking Palsy written by James Parkinson and published by . This book was released on 1817 with total page 86 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Parkinson s Disease written by C. Warren Olanow and published by John Wiley & Sons. This book was released on 2011-07-18 with total page 916 pages. Available in PDF, EPUB and Kindle. Book excerpt: Parkinson's Disease has traditionally been seen as a movement disorder, and diagnosed by the development of tremor. However, we are beginning to understand that the disease manifests itself in many ways, and that earlier diagnosis might be possible through non-tremor symptoms. This textbook aims to tell the full story of non-motor and non-dopaminergic features of Parkinson's Disease.
Download or read book Pain Management and the Opioid Epidemic written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2017-09-28 with total page 483 pages. Available in PDF, EPUB and Kindle. Book excerpt: Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
Download or read book Non motor Parkinson s Disease written by Néstor Gálvez-Jiménez and published by Cambridge University Press. This book was released on 2022-03-10 with total page 271 pages. Available in PDF, EPUB and Kindle. Book excerpt: A comprehensive and practical manual describing the manifestations, pathophysiology and treatments for non-motor Parkinson's Disease. Topics covered in depth include autonomic and sexual dysfunction, mood disorders, sleep disturbances and drug-induced non-motor symptoms.
Download or read book Parkinson s Disease Management through ICT written by Joan Cabestany and published by CRC Press. This book was released on 2022-09-01 with total page 166 pages. Available in PDF, EPUB and Kindle. Book excerpt: Parkinson's Disease (PD) is a neurodegenerative disorder that manifests with motor and non-motor symptoms. PD treatment is symptomatic and tries to alleviate the associated symptoms through an adjustment of the medication. As the disease is evolving and this evolution is patient specific, it could be very difficult to properly manage the disease.The current available technology (electronics, communication, computing, etc.), correctly combined with wearables, can be of great use for obtaining and processing useful information for both clinicians and patients allowing them to become actively involved in their condition.Parkinson's Disease Management through ICT: The REMPARK Approach presents the work done, main results and conclusions of the REMPARK project (2011 – 2015) funded by the European Union under contract FP7-ICT-2011-7-287677. REMPARK system was proposed and developed as a real Personal Health Device for the Remote and Autonomous Management of Parkinson’s Disease, composed of different levels of interaction with the patient, clinician and carers, and integrating a set of interconnected sub-systems: sensor, auditory cueing, Smartphone and server. The sensor subsystem, using embedded algorithmics, is able to detect the motor symptoms associated with PD in real time. This information, sent through the Smartphone to the REMPARK server, is used for an efficient management of the disease.
Download or read book Guidelines for the Care and Use of Mammals in Neuroscience and Behavioral Research written by National Research Council and published by National Academies Press. This book was released on 2003-08-22 with total page 223 pages. Available in PDF, EPUB and Kindle. Book excerpt: Expanding on the National Research Council's Guide for the Care and Use of Laboratory Animals, this book deals specifically with mammals in neuroscience and behavioral research laboratories. It offers flexible guidelines for the care of these animals, and guidance on adapting these guidelines to various situations without hindering the research process. Guidelines for the Care and Use of Mammals in Neuroscience and Behavioral Research offers a more in-depth treatment of concerns specific to these disciplines than any previous guide on animal care and use. It treats on such important subjects as: The important role that the researcher and veterinarian play in developing animal protocols. Methods for assessing and ensuring an animal's well-being. General animal-care elements as they apply to neuroscience and behavioral research, and common animal welfare challenges this research can pose. The use of professional judgment and careful interpretation of regulations and guidelines to develop performance standards ensuring animal well-being and high-quality research. Guidelines for the Care and Use of Mammals in Neuroscience and Behavioral Research treats the development and evaluation of animal-use protocols as a decision-making process, not just a decision. To this end, it presents the most current, in-depth information about the best practices for animal care and use, as they pertain to the intricacies of neuroscience and behavioral research.
Download or read book Practical Psychopharmacology written by Joseph F. Goldberg and published by Cambridge University Press. This book was released on 2021-04-29 with total page 611 pages. Available in PDF, EPUB and Kindle. Book excerpt: A practical guide translating clinical trials findings, across major psychiatric disorders, to devise tailored, evidence-based treatments.
Download or read book Self management support to handle everyday life with Parkinson s disease written by Carina Hellqvist and published by Linköping University Electronic Press. This book was released on 2020-04-27 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Being diagnosed with Parkinson´s disease (PD) is a life-altering experience. The long-term condition requires continuous adjustments to the everyday life not only of the person affected, but also for care partners. There is still insufficient knowledge on how best to support this process of acceptance and adjustment to encourage self-management. Aims: The aim of this thesis is to enhance the knowledge and understanding of self-management for persons with PD (PwPD) and their care partners. Furthermore, to investigate whether the self-management intervention Swedish National Parkinson School can be used as a tool to support self-management, and how nurses specialised in the care of persons with Parkinson´s disease can tailor their support to encourage self-management in everyday life. Method and design: Both qualitative and quantitative designs and methods were used in the three studies included in this thesis. Participants included a total of 209 persons. Of these, 127 were persons with PD and 75 were care partners. Participants with PD were largely in the middle stages of the disease. The time since diagnosis ranged from less than one year to over 20 years, and most participants had lived with the disease for around five years. Participants were cared for at five separate outpatient clinics, both geriatric and neurological, in three county and two university hospitals across Sweden. Data collection included observations, interviews, self-reported questionnaires and audio-recordings of the National Parkinson School in clinical care. The overall results of this thesis were obtained using a qualitative approach, where the results of the three studies were analysed using qualitative thematic analysis as described by Braun and Clarke (2006). Results: In combining the results of the separate studies through thematic analysis three distinct but interrelated themes were evident. These described the processes and efforts of persons to accept, manage and adjust to everyday life with PD. The theme “A changed reality” involves participants´ descriptions of how life changed after the diagnosis of PD. For many this was a shock, and both the person affected and their care partners experienced a variety of emotions such as anger, denial and hopelessness. It changed their personal identities, their perception of themselves as individuals and as a couple. They worried about what the future would hold, and the uncertainty was hard to accept and handle. One strategy for processing and beginning to acknowledge the new situation involved speaking openly about the diagnosis. The second theme “Finding a new path”, involves a description of how, after accepting or at least acknowledging, their new reality, participants started to find ways of managing the impact of PD on everyday life, incorporating it into their current life and identity. Many felt new knowledge was needed and turned to books and websites on PD. An intervention which was appreciated in terms of providing tools for self-observation and self-knowledge was the Swedish National Parkinson School. Participants later used these techniques to communicate and observe symptoms and healthcare needs. Being an active participant in life and performing activities such as physical exercise or other activities they enjoyed were also used as a strategy to feel satisfaction in life. Participants frequently worked out self-care and compensatory strategies to handle everyday tasks. Another strategy they found comforting and helpful involved retaining a positive mind-set and believing that a good future lay ahead. In the third category “The companions”, the participants described self-management in everyday life as a task they performed together. Management of PD was considered the shared responsibility of the person affected and the care partner, but was also influenced by others such as family members and close friends. The Swedish National Parkinson School provided knowledge as a form of common ground for the person affected and the care partner. During the Swedish National Parkinson School, the social interaction involved in exchanging experiences and feeling support from others in the same situation was considered helpful and was much appreciated. Conclusions: Management of PD in everyday life involves both the person affected and the care partner. After the initial emotional reactions, alongside feelings of lost identity and an altered life, persons started to look to the future and were ready to find ways of handling the changed conditions of their everyday lives. Persons with PD and their care partners were now willing to learn more about PD and to find tools and strategies to help them manage its impact on their everyday lives. During this phase, they appreciated the support of the Swedish National Parkinson School intervention. In the intervention, they would meet others in the same situation to find support and exchange experiences. They also turn to healthcare for support in the process of self-management in everyday life. Nurses working specifically to support PwPD and their CP will need to tailor support taking into account the disease trajectory as well as the psychological processes involved in accepting and adjusting to PD to best fit the unique needs and wishes of every person with PD and their care partner.
Download or read book Parkinson s Disease Current and Future Therapeutics and Clinical Trials written by Néstor Gálvez-Jiménez and published by Cambridge University Press. This book was released on 2016-03-24 with total page 385 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book emphasizes treatment options for Parkinson's disease, providing the necessary clinical and scientific basis for the foundations of solid therapeutics.
Download or read book Principles and Practice of College Health written by John A. Vaughn and published by Springer Nature. This book was released on 2020-12-04 with total page 336 pages. Available in PDF, EPUB and Kindle. Book excerpt: This unique and comprehensive title offers state-of-the-art guidance on all of the clinical principles and practices needed in providing optimal health and well-being services for college students. Designed for college health professionals and administrators, this highly practical title is comprised of 24 chapters organized in three sections: Common Clinical Problems in College Health, Organizational and Administrative Considerations for College Health, and Population and Public Health Management on a College Campus. Section I topics include travel health services, tuberculosis, eating disorders in college health, and attention deficit hyperactivity disorder among college students, along with several other chapters. Subsequent chapters in Section II then delve into topics such as supporting the health and well-being of a diverse student population, student veterans, health science students, student safety in the clinical setting, and campus management of infectious disease outbreaks, among other topics. The book concludes with organizational considerations such as unique issues in the practice of medicine in the institutional context, situating healthcare within the broader context of wellness on campus, organizational structures of student health, funding student health services, and delivery of innovative healthcare services in college health. Developed by a renowned, multidisciplinary authorship of leaders in college health theory and practice, and coinciding with the founding of the American College Health Association 100 years ago, Principles and Practice of College Health will be of great interest to college health and well-being professionals as well as college administrators.
Download or read book Cancer Pain Relief written by World Health Organization and published by World Health Organization. This book was released on 1996 with total page 74 pages. Available in PDF, EPUB and Kindle. Book excerpt: The second edition of a guide, which introduced a simple, yet highly effective method for the relief of cancer pain. Thoroughly revised and updated, the new edition further refines the WHO method, which advocates the use of a small number of relatively inexpensive drugs, including morphine. Revisions draw on experiences with millions of patients around the world as well as new knowledge about the specific pain syndromes unique to cancer. Completely new are chapters describing the international system by which morphine and other opioids are made available for medical purposes. The book has two parts. Part one provides a practical guide to the relief of cancer pain, concentrating on drug treatment as the mainstay of pain management. The most extensive section sets out detailed guidelines for the selection and prescribing of non-opioid analgesics, opioid analgesics, drugs for neuropathic pain, and adjuvant drugs for the treatment of adverse effects, the enhancement of pain relief and the management of concomitant psychological disturbances. Information ranges from explanations of how specific drugs work, through the precautions to take in the presence of certain disorders, to a list of factors that influence the effectiveness of opioids. Concerning the use of opioids, readers are reminded that psychological dependence does not occur in cancer patients and that the only correct dose of morphine is the one that relieves the pain. Part two provides a guide to opioid availability. A discussion of the reasons why opioids continue to be underprescribed or difficult to obtain is followed by an explanation of the Single Convention on Narcotic Drugs.
