scholarly journals The impact of a COVID-19 pandemic-related interruption of regular physical rehabilitation on functional abilities in a patient with two chronic neurological diseases: a case report

2020 ◽  
Author(s):  
Tobias Braun ◽  
Raphael Weidmann ◽  
Jens Carsten Möller ◽  
Anissa Ammann ◽  
Detlef Marks
Keyword(s):  
Multiple Sclerosis ◽  
Parkinson’S Disease ◽  
Case Report ◽  
Physical Functioning ◽  
Neurological Disorders ◽  
Neurological Diseases ◽  
Inpatient Rehabilitation ◽  
Outpatient Rehabilitation ◽  
Rehabilitation Service ◽  
Functional Abilities

Abstract Background: Regular outpatient rehabilitation is prescribed for many patients with chronic neurological disorders, such as Parkinson's disease or Multiple Sclerosis, to constantly support patients and their proxies in disease management. Due to the COVID-19 pandemic, federal institutions and governments worldwide have directed local or nationwide lockdowns. During these times, the provision of regular outpatient rehabilitation service is drastically limited, making it actually impossible for community-dwelling patients with neurological disorders to receive prescribed rehabilitation interventions.Case presentation: A 67-year-old man with two chronic neurological diseases, Parkinson's disease and Multiple Sclerosis, underwent a 4-week inpatient rehabilitation in our hospital. The patient gained significant functional improvements that he maintained over the following months, supported by the continuation of physiotherapy in the domestic environment. Due to a COVID-19 pandemic related interruption of the regular ambulatory rehabilitation for several weeks, the patient’s functional abilities decreased significantly. Thus, the patient was again referred to our hospital for intensive inpatient rehabilitation to regain his physical functioning and mobility capacity. At hospital discharge, the patient improved most of his physical functioning to a pre-pandemic level.Conclusions: The interruption of a rehabilitation service due to a pandemic-related lockdown can significantly impact the functional abilities of patients with chronic neurological diseases. This case report supports the claim for continuous access to rehabilitation services for all people with rehabilitation needs.

scholarly journals The impact of a coronavirus disease 2019 pandemic-related interruption of regular physical rehabilitation on functional abilities in a patient with two chronic neurological diseases: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Tobias Braun ◽  
Raphael Weidmann ◽  
Jens Carsten Möller ◽  
Anissa Ammann ◽  
Detlef Marks
Keyword(s):  
Multiple Sclerosis ◽  
Parkinson’S Disease ◽  
Case Report ◽  
Physical Functioning ◽  
Neurological Disorders ◽  
Neurological Diseases ◽  
Inpatient Rehabilitation ◽  
Outpatient Rehabilitation ◽  
Rehabilitation Service ◽  
Functional Abilities

Abstract Background Regular outpatient rehabilitation is prescribed for many patients with chronic neurological disorders, such as Parkinson’s disease or multiple sclerosis, to constantly support patients and their proxies in disease management. Due to the coronavirus disease 2019 pandemic, federal institutions and governments worldwide have directed local or nationwide lockdowns. During these times, the provision of regular outpatient rehabilitation service is drastically limited, making it actually impossible for community-dwelling patients with neurological disorders to receive prescribed rehabilitation interventions. Case presentation A 67-year-old White Swiss man with two chronic neurological diseases, Parkinson’s disease and multiple sclerosis, underwent a 4-week inpatient rehabilitation in our hospital. The main rehabilitation goals were related to improvements of mobility and a decrease in the risk of falls. The patient gained significant functional improvements that he maintained over the following months, supported by the continuation of physiotherapy in the domestic environment. Due to a coronavirus disease 2019 pandemic-related interruption of the regular ambulatory rehabilitation for several weeks during the first coronavirus disease 2019 wave in Switzerland, the patient’s functional abilities decreased significantly. Thus, the patient was again referred to our hospital for intensive inpatient rehabilitation to regain his physical functioning and mobility capacity. At hospital discharge, the patient improved most of his physical functioning to a prepandemic level. Conclusions The interruption of a rehabilitation service due to a pandemic-related lockdown can significantly impact the functional abilities of patients with chronic neurological diseases. This case report supports the claim for continuous access to rehabilitation services for all people with rehabilitation needs.

Polypharmacy in chronic neurological diseases: Multiple sclerosis, dementia and Parkinson’s disease

2021 ◽  
Vol 27 ◽  
Author(s):  
Niklas Frahm ◽  
Michael Hecker ◽  
Uwe Zettl
Keyword(s):  
Multiple Sclerosis ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neurological Diseases ◽  
Severe Disease ◽  
Inappropriate Medication ◽  
Medication Management ◽  
Chronically Ill ◽  
Symptom Profile ◽  
Quantitative Definition

: Polypharmacy is an important aspect of medication management and particularly affects elderly and chronically ill people. Patients with dementia, Parkinson’s disease (PD) or multiple sclerosis (MS) are at high risk for multimedication due to their complex symptomatology. Our aim was to provide an overview of different definitions of polypharmacy and to present the current state of research on polypharmacy in patients with dementia, PD or MS. The most common definition of polypharmacy in the literature is the concomitant use of ≥5 medications (quantitative definition approach). Polypharmacy rates of up to >50% have been reported for patients with dementia, PD or MS, although MS patients are on average significantly younger than those with dementia or PD. The main predictor of polypharmacy is the complex symptom profile of these neurological disorders. Potentially inappropriate medication (PIM), drug-drug interactions, poor treatment adherence, severe disease course, cognitive impairment, hospitalisation, poor quality of life, frailty and mortality have been associated with polypharmacy in patients with dementia, PD or MS. For patients with polypharmacy, either the avoidance of PIM (selective deprescribing) or the substitution of PIM with more suitable drugs (appropriate polypharmacy) is recommended to achieve a more effective therapeutic management.

scholarly journals Aptamer Applications in Neuroscience

2021 ◽  
Author(s):  
Meric Ozturk ◽  
Marit Nilsen-Hamilton ◽  
Muslum Ilgu
Keyword(s):  
Multiple Sclerosis ◽  
Amyotrophic Lateral Sclerosis ◽  
Nucleic Acid ◽  
Brain Tumors ◽  
Neurological Disorders ◽  
Neurological Diseases ◽  
Treatment Options ◽  
Health Community ◽  
Theranostic Applications ◽  
Lateral Sclerosis

Being the predominant cause of disability, neurological diseases have received much attention from the global health community. Over a billion people suffer from one of the following neurological disorders: dementia, epilepsy, stroke, migraine, meningitis, Alzheimer's disease, Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis, Huntington’s disease, prion dis-ease, or brain tumors. Diagnosis and treatment options are limited for many of these diseases. Aptamers, being small and non-immunogenic nucleic acid molecules that are easy to chemically modify, offer potential diagnostic and theranostic applications to meet these needs. This review covers pioneer studies to apply aptamers, which show promise for future diagnostics and treatments of neurological disorders that pose increasingly dire worldwide health challenges.

scholarly journals Aptamer Applications in Neuroscience

2021 ◽  
Vol 14 (12) ◽  
pp. 1260
Author(s):  
Meric Ozturk ◽  
Marit Nilsen-Hamilton ◽  
Muslum Ilgu
Keyword(s):  
Multiple Sclerosis ◽  
Amyotrophic Lateral Sclerosis ◽  
Nucleic Acid ◽  
Brain Tumors ◽  
Global Health ◽  
Neurological Disorders ◽  
Neurological Diseases ◽  
Treatment Options ◽  
Health Community ◽  
Lateral Sclerosis

Being the predominant cause of disability, neurological diseases have received much attention from the global health community. Over a billion people suffer from one of the following neurological disorders: dementia, epilepsy, stroke, migraine, meningitis, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis, Huntington’s disease, prion disease, or brain tumors. The diagnosis and treatment options are limited for many of these diseases. Aptamers, being small and non-immunogenic nucleic acid molecules that are easy to chemically modify, offer potential diagnostic and theragnostic applications to meet these needs. This review covers pioneering studies in applying aptamers, which shows promise for future diagnostics and treatments of neurological disorders that pose increasingly dire worldwide health challenges.

The contribute of cerebrospinal fluid free light-chain assay in the diagnosis of multiple sclerosis and other neurological diseases in an Italian multicenter study

2021 ◽  
pp. 135245852110641
Author(s):  
Gaetano Bernardi ◽  
Tiziana Biagioli ◽  
Paola Malpassi ◽  
Teresa De Michele ◽  
Domizia Vecchio ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Neurological Disorders ◽  
Operating Characteristic ◽  
Neurological Diseases ◽  
Characteristic Curve ◽  
Oligoclonal Bands ◽  
Free Light Chains ◽  
Complementary Information ◽  
Combined Use

Background: Cerebrospinal fluid (CSF) free light chains (FLCs) can be an alternative assay to oligoclonal bands (OCBs) in inflammatory neurological disorders, but threshold has no consensus. Objective: To assess the diagnostic accuracy of CSF FLCs in multiple sclerosis (MS) and other neurological diseases. Methods: A total of 406 patients from five Italian centers. FLCs were measured in CSF and serum using Freelite MX assays on Optilite. Results: A total of 171 patients were diagnosed as MS, 154 non-inflammatory neurological diseases, 48 inflammatory central nervous system (CNS) diseases, and 33 peripheral neurological diseases. Both kFLC and λFLC indices were significantly higher in patients with MS compared to other groups ( p < 0.0001). The kFLC index ⩾ 6.4 is comparable to OCB for MS diagnosis (area under the receiver operating characteristic curve (AUC) = 0.876; sensitivity 83.6% vs 84.2%; specificity 88.5% vs 90.6%). λFLC index ⩾ 5 showed an AUC of 0.616, sensitivity of 33.3% and specificity of 90.6%. In all, 12/27 (44.4%) MS patients with negative OCB had kFLC index ⩾ 6.4. Interestingly, 37.5% of 24 patients with a single CSF IgG band showed high kFLC index and 12.5% positive λFLC index. Conclusion: Our findings support the diagnostic utility of FLC indices in MS and other CNS inflammatory disorders, suggesting a combined use of FLC and OCB to help clinicians with complementary information.

Neurological disorders

2013 ◽  
pp. 102-131
Author(s):  
Richard J. Hardie ◽  
Jon Poole
Keyword(s):  
Multiple Sclerosis ◽  
Side Effects ◽  
Neurological Disorders ◽  
Work Capacity ◽  
Job Applicants ◽  
Functional Abilities ◽  
Comorbid Illness ◽  
Precise Diagnosis ◽  
Job Title ◽  
Manual Handling

This chapter deals mainly with common acute and chronic neurological problems, particularly as they affect employees and job applicants. The complications of occupational exposure to neurotoxins and putative neurotoxins will also be covered in so far as they relate to the fitness of an exposed employee to continue working. In addition to a few well-known and common conditions, many uncommon but distinct neurological disorders may present at work or affect work capacity. Fitness for work in these disorders will be determined by the person’s functional abilities, any comorbid illness, the efficacy or side effects of the treatment, and psychological and social factors, rather than by the precise diagnosis. This will also need to be put into the context of the job in question, as the basic requirements for a manual labouring job may be completely different from something more intellectually demanding. Indeed, even an apparently precise diagnostic label such as multiple sclerosis (MS) can encompass a complete spectrum of disability, from someone who is entirely asymptomatic to another who is totally incapacitated. Similarly, the job title ‘production operative’ may be applied to someone who is sedentary or who undertakes heavy manual handling. Furthermore, reports by general practitioners, neurologists, or neurosurgeons may describe the symptoms, signs, and investigations in detail, but without analysing functional abilities. These colleagues may also fail to appreciate the workplace hazards, the responsibilities of the employer, or what scope exists for adaptations to the job or workplace.

Sign in / Sign up

Export Citation Format

Share Document