scholarly journals Frequency and predictors of potential drug: Drug interactions in hospitalized patients with Parkinson's diseases

2021 ◽  
Vol 8 (3) ◽  
pp. 1099-1108
Author(s):  
Dejan Aleksić ◽  
Srđan Stefanović ◽  
Miloš Milosavljević ◽  
Jovana Milosavljević ◽  
Slobodan Janković
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Drug Interactions ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Hospitalized Patients ◽  
Elderly Persons ◽  
Potential Drug ◽  
Cross Sectional ◽  
Parkinson’S Diseases

Introduction: Patients with Parkinson's disease are exposed to higher number of drugs on average than other elderly persons. Levodopa, of the mainstay of Parkinson's disease therapy, is frequently interacting with numerous drugs. Aim: The aim of this study was to identify predictors of potential drug-drug interactions (pDDIs) in hospitalized patients suffering from Parkinson's disease (PD). Material and Methods: This was a academic retrospective cross-sectional study in PD patients hospitalized at the Clinic of Neurology, Clinical Center Kragujevac. Medical records of hospitalized patients during the period 1.1.2017 - 31.12.2019 were analysed. The pDDIs were identified by means of Micromedex andLexi-Interact online softwares, and multivariate regression methods were used to reveal potential predictors of number of pDDIs per patient. Results: Micromedex detected 160 different pDDIs in 77.8% of 72 patients with PD. The most frequent pDDIs were those that involved aspirin (with bisoprolol, sertraline and perindopril). Predictors of pDDIs in general was total number of drugs, while use of antidepressants presented a significant risk factor for major pDDIs. Lexi-Interact revealed 310 pDDIs in 98.6% of patients. The three most common pDDIs were with levodopa (bisoprolol, clonazepam, perindopril). Total number of drugs, number of co-morbidities, hospitalization at the neurodegenerative ward, and use of antipsychotics were identified as the relevant predictors of pDDIs. Lexi-interact software detected significantly more pDDIs than Micromedex (p<0.001). Conclusion: Neurologists should pay special attention when deciding whether to administer new drug to a PD patient with multiple comorbidities, hospitalized in a neurodegenerative ward and/or taking antidepressant or antipsychotic drugs.

Parkinson's disease and psychosis: Report of a case

2017 ◽  
Vol 41 (S1) ◽  
pp. s843-s844
Author(s):  
M. Valverde Barea ◽  
A. España Osuna ◽  
F. Cartas Moreno
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Family Background ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Behavioral Disorder ◽  
Psychotic Symptoms ◽  
Psychiatric Clinic ◽  
Good Tolerance ◽  
Competing Interest

IntroductionJealous delusional ideation appears in 7-14% of cases of Parkinson's disease. Treatment with dopaminomimetics drugs is a significant risk factor for psychosis. However, the most likely etiology of psychosis in these patients is a loss of central cholinergic function associated with age since described psychosis even before the introduction of the L-Dopamine. Cognitive impairment and sleep disorders are predictors of development of psychosis.ObjectivePresent a clinical case of psychosis in Parkinson's disease and its treatment.MethodReason for consultation. Patient diagnosed with Parkinson's disease with behavioral disorder and delusional.Current illnessThe patient after antiparkinsonian medication has increased suspicion, self-referentiality, delusional jealousy ideation to her husband, delusional interpretations regarding somatic symptoms, insomnia and behavioral disorders with aggression.Family backgroundMother with Alzheimer's.Personal historyNo contact with mental health.Psychopathological examinationConscious, repetitive language, dysphoric mood with delusions of prejudice and jealousy.Mixed insomnia.DiagnosisPsychosis in Parkinson's disease.TreatmentQuetiapine 300 mg/day. Carbidopa 25 mg/L-dopa 100 mg: 1-0-1. On subsequent visits quetiapine was suspended and replaced by clozapine 200 mg/day.ResultsThe treatment of psychosis was effective with the use of quetiapine and subsequently clozapine with good tolerance and effectiveness. He also said lower antiparkinsonian medication.ConclusionsPsychotic symptoms are the most common psychiatric clinic in Parkinson's disease. Often not enough antiparkinsonian dopaminomimetics reduced to control psychotic symptoms and use of antipsychotics is required. The use of antipsychotics in Parkinson's disease should be careful for the likely increase in motor clinical and increased mortality. The most useful, are especially quetiapine and clozapine atypical antipsychotics.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Golf as a Physical Activity to Potentially Reduce the Risk of Falls in Older Adults with Parkinson’s Disease

Sports ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 72
Author(s):  
Rebecca R. Bliss ◽  
Frank C. Church
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neurodegenerative Disorder ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Advanced Age ◽  
Golf Club ◽  
Increased Risk ◽  
Risk Of Falls

Advanced age is associated with an increased risk for falls in aging adults. Older adults are also more likely to be diagnosed with Parkinson’s disease (PD), with advanced age as the most significant risk factor. PD is a neurodegenerative disorder with four Cardinal motor symptoms: rigidity, bradykinesia, postural instability, and tremor. Thus, people (person)-with-Parkinson’s disease (PwP) have an even greater risk of falling than non-disorder age-matched peers. Exercise is an activity requiring physical effort, typically carried out to sustain or improve overall health and fitness, and it lowers the risk of falls in the general population. The sport of golf provides a low-impact all-around workout promoting a range of motion, activation of muscles in the upper and lower body, flexibility, and balance. Swinging a golf club offers a unique combination of high amplitude axial rotation, strengthening postural musculature, coordination, and stabilization, demonstrating the potential to impact PD symptoms positively. Golf may be a novel exercise treatment regimen for PD to use in conjunction with traditional medical therapy. We completed a literature review to determine the relationship between the game of golf, PD, and the risk of falls. We concluded that regularly playing golf can lower the risk for falls in community ambulating older adults with PD and demonstrates the potential to improve quality of life for PwP.

Frequency of Orthostatic Hypotension in Parkinson’s Disease

2021 ◽  
Vol 15 (11) ◽  
pp. 2886-2889
Author(s):  
Ali Qayyum ◽  
Ehsan Ul Haq ◽  
Shoaib Zafar ◽  
Javaria . ◽  
Muhammad Moss ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Orthostatic Hypotension ◽  
Diastolic Blood Pressure ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Parkinson’S Diseases ◽  
The Mean

Background: Parkinson’s Diseases (PD) cause some non-motor issues that could lead to disability. One of such determinal non-motor symptoms is orthostatic hypotension (OH) which is still understudied in our local setting despite of its high prevalence worldwide among patients of PD. Aim: To determine frequency of orthostatic hypotension in Parkinson’s disease Methods: This Cross-sectional study was conducted at Department of Neurology, Mayo Hospital, Lahore for 6 months after the approval of synopsis [April 9, 2018 till Oct 9, 2018]. A sample of 95 cases was selected using non probability consecutive sampling from 95 patients of Parkinson’s Disease aged 25 years and more. After taking consent from patient and recording sociodemographic information, a lying-to-standing orthostatic test was performed to evaluate the orthostatic hypotension and SBP and DBP was recorded. All data was collected using a self structured proforma and analyzed using SPSS v 21. Results: The mean age of cases was 47.46 ± 8.97 years with male to female ratio of 1.97:1. The mean systolic and diastolic blood pressure was 120.60 ± 11.80 and 86.20 ± 8.68 respectively. The frequency of orthostatic hypotension was seen in 51(53.7%) while other 44(46.3%) cases did not have orthostatic hypotension. Conclusion: Through the findings of this study we conclude that frequency of orthostatic hypotension in Parkinson’s disease is very much high i.e. 53.7% with highest frequency in cases with longer duration of disease. Keywords: Autonomic diseases, Parkinson’s disease, Systolic blood pressure, diastolic blood pressure, Orthostatic hypotension,

scholarly journals Functions of Intracellular Alpha-Synuclein in Microglia: Implications for Parkinson’s Disease Risk

2021 ◽  
Vol 15 ◽  
Author(s):  
Alix Booms ◽  
Gerhard A. Coetzee
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Risk ◽  
Significant Risk ◽  
Physiological Role ◽  
Significant Risk Factor ◽  
Cell Types ◽  
Alpha Synuclein ◽  
Vesicle Formation ◽  
Immune Functions

Alpha-synuclein accumulation in dopaminergic neurons is one of the primary features of Parkinson’s disease (PD). Despite its toxic properties during PD, alpha-synuclein has some important physiological functions. Although the activity of the protein has been extensively studied in neurons, the protein is also expressed in other cell types including immune cells and glia. Genetic studies show that mutations in synuclein alpha (SNCA), the gene that encodes alpha-synuclein, and alterations in its expression levels are a significant risk factor for PD, which likely impact the functions of a broad range of cell types. The consequences of altered SNCA expression in other cell types is beginning to be explored. Microglia, the primary macrophage population in the Central Nervous System (CNS), for example, are affected by variations in alpha-synuclein levels and functions. Studies suggest that deviations of alpha-synuclein’s normal activity influence hematopoiesis, the process that gives rise to microglia, and microglia’s immune functions. Alpha-synuclein levels also dictate the efficiency of SNARE-mediated vesicle formation, which could influence autophagy and cytokine release in microglia. Starting from the time of conception, these effects could impact one’s risk for developing PD. Further studies are needed to determine the physiological role of alpha-synuclein and how the protein is affected during PD in non-neuronal cells such as microglia. In this review we will discuss the known roles of alpha-synuclein in differentiation, immune responses, and vesicle formation, with insights into how abnormal alpha-synuclein expression and activity are linked to altered functions of microglia during PD.

scholarly journals A Comparison of Pain between Parkinson’s Disease and Multiple System Atrophy: A Clinical Cross-Sectional Survey

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
He-Yang You ◽  
Lei Wu ◽  
Hai-Ting Yang ◽  
Chen Yang ◽  
Xiao-Ling Ding
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Multiple System Atrophy ◽  
Rating Scale ◽  
Depression Scale ◽  
Healthy Controls ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Disease Rating ◽  
Vas Scores

Background. Pain is frequent in Parkinson’s disease (PD) and Parkinson-plus syndrome. This study aimed to assess the prevalence, characteristics, therapy (especially the effect of dopaminergic therapy), and associated symptoms of pain in Parkinson's disease and multiple system atrophy (MSA) patients. Methods. Seventy-one PD patients, sixty-five MSA patients, and forty age-matched healthy controls were enrolled and evaluated by using the German pain questionnaire and visual analogue scale (VAS). In addition, the influence of pain in PD patients on anxiety, depression, and the quality of life was assessed with the Hospital Anxiety and Depression Scale (HADS) and Parkinson’s Disease Questionnaire (PDQ-39). Results. Compared to that of the healthy controls, the PD and MSA patients had a significantly higher presence of pain (P<0.01, P<0.01). PD patients had a higher presence of pain than MSA patients (P=0.007). No difference in VAS scores was observed between the PD and MSA patients (P=0.148). A total of 21 PD patients (42.85%) with pain and 13 MSA patients (43.33%) with pain received treatment. A total of 13 PD patients with pain and 6 MSA patients with pain had an improved pain intensity after using dopaminergic medication. The differences in the disease duration, Hoehn and Yahr stages, and scores on the Unified Parkinson’s Disease Rating Scale motor score, HAD-D, HAD-A, and PDQ-39 were significant between the PD patients with and without pain. Conclusion. PD and MSA patients are prone to pain with insufficient treatment. Pain interventions should be provided as soon as possible to improve the patient’s life.

scholarly journals A Clinicopathologic and Epidemiologic Study of Chronic White Lesions in the Oral Mucosa

2017 ◽  
Vol 96 (8) ◽  
pp. E13-E17
Author(s):  
Sampurna Ghosh ◽  
Sudipta Pal ◽  
Soumya Ghatak ◽  
Somnath Saha ◽  
Surajit Biswas ◽  
...  
Keyword(s):  
Oral Mucosa ◽  
Epidemiologic Study ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Premalignant Lesions ◽  
Excision Biopsy ◽  
Severe Dysplasia ◽  
Cross Sectional ◽  
Malignant Lesions ◽  
Tobacco Chewing

Invasive oral squamous cell carcinoma is often preceded by the presence of clinically identifiable premalignant changes of the oral mucosa, including white lesions. We conducted a cross-sectional, observational study to assess the clinicopathologic and epidemiologic aspects of chronic oral mucosal white lesions to determine the necessity of early biopsy in these cases. Our study population was made up of 77 patients—50 males and 27 females, aged 15 to 70 years (mean: 42.9)—who presented with white lesions persisting for at least 4 weeks. All but 3 patients underwent a biopsy; the 3 exceptions were diagnosed with smear-proven candidiasis. Patients with moderate or severe dysplasia underwent an excision biopsy. The buccal mucosa was the single most common site of white lesions, occurring in 15 patients (19.5%), although 21 patients (27.3%) exhibited a diffuse involvement of the oral mucosa. Of the 77 patients, 59 (76.6%) had concerning findings: premalignant lesions in 45 patients (58.4%) and malignant lesions in 14 (18.2%). Also, dysplasia was seen in 8 patients (10.4%), all of whom had premalignant lesions. Tobacco chewing (p = 0.008) and betel quid chewing (p = 0.029) were significantly associated with the development of premalignant and malignant lesions; a longer duration of tobacco chewing (≥10 yr) was significantly associated with a higher risk of malignant but not premalignant lesions (p = 0.031). Finally, illiteracy was a significant risk factor for premalignant and malignant lesions (p = 0.03). Our findings support the necessity of biopsy in every case. Early detection of oral carcinoma by biopsy of all oral white lesions would not only prevent patients from undergoing disfiguring surgery and chemoradiation, but it also would increase the 5-year survival rate.

scholarly journals White matter integrity and cognition in Parkinson's disease: a cross-sectional study

BMJ Open ◽  
2014 ◽  
Vol 4 (1) ◽  
pp. e003976 ◽  
Author(s):  
Eirik Auning ◽  
Veslemøy Krohn Kjærvik ◽  
Per Selnes ◽  
Dag Aarsland ◽  
Astrid Haram ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
White Matter ◽  
Cross Sectional Study ◽  
White Matter Integrity ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Self-Reported Efficacy of Cannabis and Other Complementary Medicine Modalities by Parkinson’s Disease Patients in Colorado

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Taylor Andrew Finseth ◽  
Jessica Louise Hedeman ◽  
Robert Preston Brown ◽  
Kristina I. Johnson ◽  
Matthew Sean Binder ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Support Groups ◽  
Legal Status ◽  
Cross Sectional Study ◽  
Recent Change ◽  
High Rate ◽  
Cross Sectional ◽  
Metro Area ◽  
Cam Use

Introduction. Complementary and alternative medicine (CAM) is frequently used by Parkinson’s disease (PD) patients. We sought to provide information on CAM use and efficacy in PD patients in the Denver metro area with particular attention to cannabis use given its recent change in legal status.Methods. Self-administered surveys on CAM use and efficacy were completed by PD patients identified in clinics and support groups across the Denver metro area between 2012 and 2013.Results. 207 patients (age69±11; 60% male) completed the survey. Responses to individual CAM therapy items showed that 85% of respondents used at least one form of CAM. The most frequently reported CAMs were vitamins (66%), prayer (59%), massage (45%), and relaxation (32%). Self-reported improvement related to the use of CAM was highest for massage, art therapy, music therapy, and cannabis. While only 4.3% of our survey responders reported use of cannabis, it ranked among the most effective CAM therapies.Conclusions. Overall, our cross-sectional study was notable for a high rate of CAM utilization amongst PD patients and high rates of self-reported efficacy across most CAM modalities. Cannabis was rarely used in our population but users reported high efficacy, mainly for nonmotor symptoms.

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