Parkinson-kórban szenvedő betegek perioperatív ellátása. Irodalmi összefoglaló

2015 ◽  
Vol 156 (34) ◽  
pp. 1355-1359
Author(s):  
Béla Fülesdi ◽  
Calin Mitre ◽  
Csilla Molnár
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Life Expectancy ◽  
Statistical Data ◽  
Perioperative Complications ◽  
Management Strategies ◽  
Perioperative Period ◽  
Interdisciplinary Cooperation ◽  
Surgical Interventions ◽  
Proper Strategy

Similarly to an increase in life expectancy, the incidence of Parkinson’s disease increases as well. In parallel with this, more patients with Parkinson’s disease undergo elective or urgent surgical interventions. According to recent statistical data, more than half of the patients with Parkinson’s disease are not properly managed when they are hospitalized for surgical interventions. It is also clear that properly managed Parkinson’s disease patients have an approximately 50% lower rate for perioperative complications. The authors aimed to summarize the most important complications, the updated peri- and intraoperative treatment and management strategies of patients with Parkinson’s disease. They intended to underline that interdisciplinary cooperation and knowledge of the proper strategy may result in more successful treatment of Parkinson’s disease patients during the perioperative period. Orv. Hetil., 2015, 156(34), 1355–1359.

scholarly journals Present and Future of Parkinson’s Disease in Spain: PARKINSON-2030 Delphi Project

2021 ◽  
Vol 11 (8) ◽  
pp. 1027
Author(s):  
Diego Santos García ◽  
Marta Blázquez-Estrada ◽  
Matilde Calopa ◽  
Francisco Escamilla-Sevilla ◽  
Eric Freire ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
New Technologies ◽  
Management Strategies ◽  
Multidisciplinary Teams ◽  
Modified Delphi ◽  
Advanced Stages ◽  
Diagnostic Capacity ◽  
Socio Economic Impact

Parkinson’s disease (PD) is a chronic progressive and irreversible disease and the second most common neurodegenerative disease worldwide. In Spain, it affects around 120.000–150.000 individuals, and its prevalence is estimated to increase in the future. PD has a great impact on patients’ and caregivers’ lives and also entails a substantial socioeconomic burden. The aim of the present study was to examine the current situation and the 10-year PD forecast for Spain in order to optimize and design future management strategies. This study was performed using the modified Delphi method to try to obtain a consensus among a panel of movement disorders experts. According to the panel, future PD management will improve diagnostic capacity and follow-up, it will include multidisciplinary teams, and innovative treatments will be developed. The expansion of new technologies and studies on biomarkers will have an impact on future PD management, leading to more accurate diagnoses, prognoses, and individualized therapies. However, the socio-economic impact of the disease will continue to be significant by 2030, especially for patients in advanced stages. This study highlighted the unmet needs in diagnosis and treatment and how crucial it is to establish recommendations for future diagnostic and therapeutic management of PD.

scholarly journals Spectrum of impulse control behaviours in Parkinson’s disease: pathophysiology and management

2020 ◽  
Vol 91 (7) ◽  
pp. 703-711
Author(s):  
Mark John Kelly ◽  
Fahd Baig ◽  
Michele Tao-Ming Hu ◽  
David Okai
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Impulse Control ◽  
Association Studies ◽  
Management Strategies ◽  
Brain Regions ◽  
Vulnerability Factors ◽  
Pharmacological Management ◽  
Functional Changes

Impulse control behaviours (ICBs) are a range of behaviours linked by their reward-based, repetitive natures. They can be precipitated in Parkinson’s disease (PD) by dopamine replacement therapy, often with detrimental consequences for patients and caregivers. While now a well-recognised non-motor feature of treated PD, much remains unknown about the influence of risk factors, pathophysiological mechanisms, vulnerability factors for specific types of behaviour and the optimal management strategies. Imaging studies have identified structural and functional changes in striatal and prefrontal brain regions, among others. Gene association studies indicate a role for genetic predisposition to PD-ICB. Clinical observational studies have identified potential modifiable and non-modifiable risk factors. Psychological studies shed light on the neurocognitive domains implicated in PD-ICBs and identify psychosocial determinants that may perpetuate the cycle of impulsive and harm-avoidance behaviours. Based on these results, a range of pharmacological and non-pharmacological management strategies have been trialled in PD-ICBs with varying success. The purpose of this review is to update clinicians on the evidence around the pathophysiology of PD-ICB. We aim to translate our findings into an interpretable biopsychosocial model that can be applied to the clinical assessment and management of individual cases of PD-ICB.

Parkinson’s disease: etiopathogenesis and treatment

2020 ◽  
Vol 91 (8) ◽  
pp. 795-808 ◽  
Author(s):  
Joseph Jankovic ◽  
Eng King Tan
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Innovative Drug ◽  
Gene Target ◽  
Surgical Interventions ◽  
Disease Modifying Drugs ◽  
Protein Clearance ◽  
Pathogenic Genes ◽  
The Rich ◽  
Future Outcomes

The concept of ‘idiopathic’ Parkinson’s disease (PD) as a single entity has been challenged with the identification of several clinical subtypes, pathogenic genes and putative causative environmental agents. In addition to classic motor symptoms, non-motor manifestations (such as rapid eye movement sleep disorder, anosmia, constipation and depression) appear at prodromic/premotor stage and evolve, along with cognitive impairment and dysautonomia, as the disease progresses, often dominating the advanced stages of the disease. The key molecular pathogenic mechanisms include α-synuclein misfolding and aggregation, mitochondrial dysfunction, impairment of protein clearance (associated with deficient ubiquitin-proteasome and autophagy-lysosomal systems), neuroinflammation and oxidative stress. The involvement of dopaminergic as well as noradrenergic, glutamatergic, serotonergic and adenosine pathways provide insights into the rich and variable clinical phenomenology associated with PD and the possibility of alternative therapeutic approaches beyond traditional dopamine replacement therapies.One of the biggest challenges in the development of potential neuroprotective therapies has been the lack of reliable and sensitive biomarkers of progression. Immunotherapies such as the use of vaccination or monoclonal antibodies directed against aggregated, toxic α-synuclein.as well as anti-aggregation or protein clearance strategies are currently investigated in clinical trials. The application of glucagon-like peptide one receptor agonists, specific PD gene target agents (such as GBA or LRRK2 modifiers) and other potential disease modifying drugs provide cautious optimism that more effective therapies are on the horizon. Emerging therapies, such as new symptomatic drugs, innovative drug delivery systems and novel surgical interventions give hope to patients with PD about their future outcomes and prognosis.

Impact of Parkinson’s disease on perioperative complications and hospital cost in multilevel spine fusion: A population-based analysis

2017 ◽  
Vol 35 ◽  
pp. 88-91 ◽  
Author(s):  
Shearwood McClelland ◽  
Joseph F. Baker ◽  
Justin S. Smith ◽  
Breton G. Line ◽  
Thomas J. Errico ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Hospital Cost ◽  
Perioperative Complications ◽  
Population Based ◽  
Spine Fusion

MORTALITY IN PARKINSON'S DISEASE AND ATYPICAL PARKINSONIAN DISORDERS

2015 ◽  
Vol 86 (11) ◽  
pp. e4.88-e4
Author(s):  
Angus Macleod ◽  
Carl Counsell
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Life Expectancy ◽  
Median Survival ◽  
Lewy Body Dementia ◽  
Mortality Data ◽  
Kaplan Meier ◽  
Central Register ◽  
Population Mortality ◽  
Incident Cohort

BackgroundWe evaluated the mortality associated with Parkinson's disease (PD), Lewy body dementia (LBD), progressive supranuclear palsy (PSP), multiple system atrophy (MSA), and vascular parkinsonism (VP) using a community-based incident cohort.MethodsAll incident parkinsonism cases identified over 4.5 years (2002-4, 2006-9) were tagged to the NHS central register for regular death notifications. Kaplan-Meier survival probabilities were plotted. Standardised mortality ratios (SMRs) and life expectancy, adjusted for age, sex and calendar year, were calculated using regional mortality data.ResultsUntil June 2014, 90 deaths occurred in 198 PD patients, and 107 deaths in 117 patients with other syndromes. Median survival in PD, LBD, PSP, MSA, and VP was 7.8 (6.7–9.4), 3.3 (2.3–4.1), 2.6 (1.1–3.8), 5.1 (1.3–NA), 2.1 (1.5–3.4) years, respectively. SMRs were 1.5 (1.2–1.9), 4.2 (3.0–5.9), 3.8 (2.6–5.5), 1.8 (0.9–3.4), 4.2 (3.0–6.0) respectively. In PD, median survival was lower than life expectancy, but more so in under 65s.ConclusionsMortality in PD was increased by 50% over expected population mortality. Younger patients have proportionally more to lose. Survival was much poorer in other syndromes.

Projections of prevalence, lifetime risk, and life expectancy of Parkinson's disease (2010-2030) in France

2018 ◽  
Vol 33 (9) ◽  
pp. 1449-1455 ◽  
Author(s):  
Mathilde Wanneveich ◽  
Frédéric Moisan ◽  
Hélène Jacqmin-Gadda ◽  
Alexis Elbaz ◽  
Pierre Joly
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Life Expectancy ◽  
Lifetime Risk
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