Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

New medical knowledge is emerging at a tremendous rate. Diseases such as Alzheimer's disease. Parkinson's disease, cancer, and others (diseases once considered beyond the scope of medicine) are receiving a great deal of attention. Yet it is a paradox that, at a time when we are learning more about the biology of the human being, it is more difficult to creatively develop the new knowledge into diagnostic tests, surgical interventions, and preventive strategies. The pace of biomedical innovation is being slowed by an increase in the intervention of nonmedical "managers of care." The driving force behind managed care is concern over cost. The managers of medical care have sought to control costs by controlling the doctor's decision making. This is the focus of managed care. The physicians of today, therefore, face a remarkable challenge. They must respond to the needs of patients while being held accountable to an increasing number of overseers in the public and private sectors. These managers of care justify their activities on the notion that the patient will be better off and the cost less if the doctor-patient encounter is regulated by protocols, statistical comparison, utilization review, and fee schedules. While doctor's decisions are being managed by others, who is managing the managers? The answer should be the medical community, principally doctors. Unfortunately, the answer at the moment is the payors--governmental reimbursement agencies, intermediaries, employers, hospitals, or new corporations designed to manage medical costs. The challenge to the physician is to retain the responsibility for those things for which he or she is held accountable. The challenge should not be ignored.
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PMID:Who manages the managers? The 1989 Harvey Cushing oration. 276 82

The atoll community of Fenuafala was surveyed during July-August, 1987. A disproportionate demographic structure was found: There was a large, young population with an uneven sex distribution in the adolescent cohorts. Adoption of relatives was frequent. Employment varied according to sex, with women restricted from horticulture, fisheries, and hard labour. The use of alcohol and tobacco was common. Causes of mortality included cancer, heart failure, meningitis, alcoholism, and accidents. Bacterial and fungal skin infections were prevalent. There were several cases of congenital disorders. Malaria, leprosy, and most other tropical diseases were absent. However, there was a single case of filariasis. Musculoskeletal disorders were numerous and more common among women. Falls from trees have resulted in serious sequelae including epilepsy and death. Hypertension, diabetes, and gout appear to be on the increase, but angina and myocardial infarction were not reported. There were also cases of epilepsy and Parkinson's disease.
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PMID:Fenuafala health survey: the ecology of health and disease on a coral atoll village. 280 43

Degenerative central nervous system diseases such as Alzheimer's disease and lymphoreticular malignancies such as multiple myeloma occur with increased frequency with advancing age. Relatives of early-onset Alzheimer's disease patients may have an increased risk of lymphoreticular malignancies. This led us to evaluate the family history of central nervous system diseases in a case-control study of multiple myeloma. Thirteen of 439 multiple myeloma cases had one or more first-degree relatives with degenerative or demyelinating central nervous system disease. In comparison, there were nine "positive" family histories in 1,317 matched hospital controls (relative risk = 4.4, 95% confidence interval = 1.9-10.3). Relative risks for the component categories of Parkinson's disease, multiple sclerosis, and miscellaneous degenerative central nervous system diseases were 3.0, 4.0 and 11.9, respectively. Our findings suggest that the degenerative and demyelinating central nervous system diseases and the lymphoreticular malignancies may comprise an etiologically related group of "protean diseases." These diseases may have a shared genetic susceptibility, possibly an immunologic abnormality. The varied disease manifestation in family members suggests a second necessary etiologic step of a variable and possibly environmental nature.
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PMID:Familial aggregation of multiple myeloma and central nervous system diseases. 292 51

With several notable exceptions, interest in the area of multiple molecular forms of phosphodiesterase remained relatively dormant during the decade following Thompson's discovery of more than one phosphodiesterase in brain in 1971. Within the last several years, however, over 20 novel agents have been identified that exert selective inhibitory effects on the various molecular forms of phosphodiesterase present within different cells. In addition, several studies have documented that such agents can produce discrete changes in cyclic AMP and cyclic GMP, an action that is not shared by "first generation" phosphodiesterase inhibitors such as theophylline. The purpose of this Perspective is to provide some clarity to this rapidly evolving area of selective phosphodiesterase inhibitors. Thus, we have attempted to characterize the different forms of phosphodiesterase present in various tissues and cells according to their kinetic properties, substrate specificity, etc. and also to characterize those major classes of agents that have been shown to inhibit phosphodiesterase activity, whether selectively or nonselectively. In addition, we have described several therapeutic areas wherein selective phosphodiesterase inhibitors might prove efficacious, paying particular attention to those areas in which selective phosphodiesterase inhibitors have already been shown to exert beneficial effects, namely, stimulation of myocardial contractility, inhibition of mediator release, and inhibition of platelet aggregation. Although focusing on these three areas, it is obvious that the potential therapeutic utility of selective phosphodiesterase inhibitors could conceivably extend to several other areas in which modulation of cyclic nucleotides can have desirable effects, including cancer chemotherapy, analgesia, the treatment of depression, Parkinson's disease, and learning and memory disorders. For example, the selective type III phosphodiesterase inhibitor rolipram has been shown to antagonize reserpine-induced hypothermia and also to potentiate yohimbine lethality, two tests that are indicative of antidepressant activity. In addition, microinjection of the selective PDE III inhibitor Ro 20-1724 into the rat brain stem has been shown to produce analgesia.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:A new generation of phosphodiesterase inhibitors: multiple molecular forms of phosphodiesterase and the potential for drug selectivity. 298 81

The experience that the supplementation of depleted dopamine in the nigro-striatal system of parkinsonian patients with L-dopa improves the clinical triad, akinesia, rigidity and tremor, mainly applies to long-term treatment in the early phase of Parkinson's disease. Complications in motor performance, like on-off response, wearing-off phenomena, peak-dose dyskinesia, biphasic dyskinesia, off-period dystonia and others, after more than 3 to 5 years following the onset of treatment indicate fluctuations in the dopaminergic feedback control system. It is suggested that these complications are due to progressive presynaptic degeneration and late changes in postsynaptic receptor amplification. However, as fluctuations are not imperative in all patients, an important additional aspect seems to be the topography of denervation, which involves different portions of the striatum to varying degrees. Location and extent of denervation are criteria which appear to have predictive value for the malignancy of the disease, the therapeutic response of drugs and complications in long-term treatment.
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PMID:Factors contributing to fluctuations of the dopaminergic nigro-striatal feedback system in Parkinson's disease. 316 34

All suicides occurring among the inhabitants of the County of Uppsala in Sweden between 1977 and 1984 were analyzed on the basis of information from autopsy reports and from somatic and psychiatric medical records. Among the 416 persons who committed suicide, 70 (17%) had a somatic disease of probable importance for the suicidal act. No somatic diagnosis appeared to stand out as being especially associated with a very high risk of suicide. Some diagnoses (e.g. malignant neoplasm, Parkinson's disease, multiple sclerosis) were, however, associated with a suicidal rate above that in the general population. Further knowledge about the relation between suicide and specific somatic diagnoses would be of value, since a high suicide rate in association with a particular illness might indicate insufficient medical care and rehabilitation.
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PMID:Physical disease and disability among 416 suicide cases in Sweden. 319 26

A laryngeal carcinoma presenting as severe dyspnea and stridor due to bilateral vocal cord paralysis was found in a 66-year-old man who had been suffering from Parkinson's disease (PD) for twenty years. Although laryngeal carcinoma is a common cause of bilateral vocal cord paralysis, patients with PD have been suspected to have a low cancer incidence, and this may be the first case report. Therapeutics have extended the survival of patients with PD, and the possibility of developing vocal cord paralysis. Thus, it is important for the physician to be aware that this condition may be caused by carcinoma even in PD cases.
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PMID:Bilateral vocal cord paralysis due to laryngeal carcinoma in Parkinson's disease. 348 Sep 35

Mortality rates for deaths "due to" and "with" motor neuron disease are presented for the first time. Age-specific mortality rates increase with age until 70 to 74 years and then decline. There appear to be no major differences by race in the age-adjusted mortality rates, but these rates are higher for males both white and nonwhite. A case-control study of all deaths with amyotrophic lateral sclerosis (ALS) was conducted for deaths due to ALS in the year 1971. Conditions associated with ALS at the time of death include pneumonia and bronchopneumonia, symptoms referable to respiratory system, superficial injury to shoulder and upper arm, essential benign hypertension, chronic skin ulcer, and malnutrition. No association was found between ALS and malignancies, Parkinson's disease, or dementia.
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PMID:Motor neuron disease in the United States, 1971 and 1973-1978: patterns of mortality and associated conditions at the time of death. 361 53

Some epidemiologic studies have selected subjects from death registries. This method is, however, subject to substantial systematic bias that arises from the fact that different segments of society have different risks of death in any year. Different occupational groups will thus have unequal probabilities of entering the pool of potential controls, and biased estimates of the odds ratios that relate occupation to disease will result. Failure to recognize the bias may lead to invalid conclusions. This selection bias is discussed, with particular reference to studies of malignancies among farmers. The bias is demonstrated by using data from studies of Parkinson's disease and sinonasal cancer.
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PMID:Selection bias in occupational case-control studies that use death registries to select subjects: a discussion and demonstration. 361 98

Among 406 patients with Parkinson's disease, the cancer rate (all sites combined) was bout one-third that for the general population. The risk of cancer increased during the treatment period but remained significantly low. Malignant and benign thyroid neoplasms were significantly more frequent than expected among patients with Parkinson's disease. We suggest that high levels of total body potassium in patients with Parkinson's disease is the protective factor against cancer.
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PMID:Low cancer rates among patients with Parkinson's disease. 400 73


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