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)

We report an autopsied case of Parkinson's disease manifesting Shy-Drager syndrome. At the age of 63 years, the patient noticed an onset of progressive orthostatic dizziness, which was followed by constipation, dysuria, and sexual impotence. When he was 66 years old, syncopal attack for a few minutes, tremor in the bilateral hands, and memory disturbance developed. On admission, his blood pressure was 142/72 mmHg in supine position, which fell to 58/42 mmHg on standing with appropriate increase of heart rate. Neurological examination revealed hallucination, memory disturbance, masked face, muscular rigidity, bradykinesia, mild postural tremor, and autonomic dysfunction including severe orthostatic hypotension, hypohydrosis, constipation, dysuria, and sexual impotence. Electroencephalogram showed diffuse slowing. Brain CT demonstrated absence of severe atrophy of the cerebellum, and brain stem. Pharmacological study revealed denervation hypersensitivity to the intravenously administrated noradrenaline. A diagnosis of Shy-Drager syndrome was made, and he was treated with anti parkinsonian drugs. However, no improvement was observed in his clinical symptoms. Seven months later, he died of pneumonia. Neuropathological examination revealed marked neuronal cell loss and gliosis in the substantia nigra and locus ceruleus. Lewy bodies were seen in those pigmented nuclei, dorsal vagal nucleus, hypothalamus and nucleus basalis of Meynert. No abnormality was found in the intermediolateral nucleus of the spinal cord. This is the first report on a Japanese patient who presented clinically Shy-Drager syndrome and pathologically typical Parkinson's disease. In this patient, from the pharmacological and pathological findings, sympathetic ganglia were supposed to be the responsible lesion for orthostatic hypotension.
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PMID:[An autopsied case of Parkinson's disease manifesting Shy-Drager syndrome]. 130 25

Causes of death, with special reference to cerebral haemorrhage, among 240 patients with pathologically verified Parkinson's disease were investigated using the Annuals of the Pathological Autopsy Cases in Japan from 1981 to 1985. The leading causes of death were pneumonia and bronchitis (44.1%), malignant neoplasms (11.6%), heart diseases (4.1%), cerebral infarction (3.7%) and septicaemia (3.3%). Cerebral haemorrhage was the 11th most frequent cause of death, accounting for only 0.8% of deaths among the patients, whereas it was the 5th most common cause of death among the Japanese general population in 1985. The low incidence of cerebral haemorrhage as a cause of death in patients with Parkinson's disease may reflect the hypotensive effect of levodopa and a hypotensive mechanism due to reduced noradrenaline levels in the parkinsonian brain.
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PMID:Cause of death among patients with Parkinson's disease: a rare mortality due to cerebral haemorrhage. 235 41

We have studied 97 patients with dementia who have been discharged from our hospital and 106 inpatients with dementia who have been admitted during last two years in our hospital. The diagnosis of dementia was done according to the criteria of DSM-III. Based on their clinical course, neurological signs, Hachinski's ischemic score and neuroradiological findings, we divided patients into 4 groups, [senile dementia of the Alzheimer type (SDAT), vascular dementia (VD), unclassified dementia and other dementias which includes dementia with Parkinson's disease or motor neuron disease, etc.]. Concerning 70 demented patients who died during hospitalization, the average age of onset and the duration of illness of SDAT were 80.5 years old and 4.6 years respectively and those of VD were 77.6 years old and 2.7 years respectively. The common causes of death were pneumonia (50%) and cardiac failure (24%). Recurrence of cerebral vascular accident (CVA) was also another frequent cause of death in VD. The most common behavioral problems causing admission in patients of SDAT were aimless wandering, nocturnal delirium, illusion and hallucination. In VD, nocturnal delirium, aimless wandering, violence and abnormal monologue were most common causes of admission. The important causes degrading ADL of inpatients were fracture, especially fracture of the hip joint, pneumonia, intestinal bleeding and CVA. Concerning the increase of the population of over 75 years old, it will be suggested that the care and treatment of demented patients in this age group will become a major social problem.
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PMID:[Clinical and epidemiological studies on inpatients with dementia]. 238 92

A retrospective study was performed of forty-nine patients (fifty fractures of the femoral neck) who had Parkinson disease and who had had an endoprosthetic replacement of the femoral head. The average age of the patients was seventy-four years (range, forty-seven to ninety-two years). All of the fractures were Garden Stage III or IV. An anterolateral surgical approach was used in twenty-five hips; a posterior approach, in twenty hips; and a transtrochanteric approach, in five hips. An adductor tenotomy was required in five patients to release an adduction contracture. Ten patients died by the sixth postoperative month. The remaining thirty-nine patients were followed for a minimum of two years (average, 7.3 years). Common postoperative complications were infection of the urinary tract (20 per cent) and pneumonia (10 per cent). There was only one dislocation. At the time of writing, nineteen (80 per cent) of the surviving patients could walk.
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PMID:Prosthetic replacement of the femoral head for fracture of the femoral neck in patients who have Parkinson disease. 335 23

A prospective prognostic study of all admissions to a geriatric assessment and rehabilitation unit was carried out which analysed the medical profiles of 205 patients admitted for the first time during a four month period. All patients were followed up for at least six months after discharge. Particularly poor prognosis was noted among patients with renal failure, ischaemic heart disease, depression, pneumonia, congestive cardiac failure, trauma, mental disorder and dementia. Good prognosis was reported in patients with Parkinson's disease, faecal impaction, stroke and adverse drug reactions. Multiple diagnoses were common, and only nine patients had no active medical problems during their admission. The implications for adequate training of geriatricians in medicine are discussed.
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PMID:Medical profiles of patients admitted to a geriatric assessment and rehabilitation unit. 345 Nov 40

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

The authors report a case of pleuro-pulmonary fibrosis after 9 months of high dose bromocriptine therapy for the treatment of Parkinson's disease. When the drug was stopped there was a significant improvement of the clinical state with complete regression of chest pain and dyspnea of effort. The major inflammatory biological syndrome disappeared completely. Chest X-rays showed partial improvement with signs of pleural pneumonitis. The results of ventilatory and respiratory function tests stabilised. After one year follow-up, the causal relationship of this iatrogenic pathology has therefore been established. The initial diagnostic problems are stressed, particularly with respect to malignant disease (mesothelioma) when there has been exposure to asbestos, as in our case. The early stages must be carefully looked for so as to prevent fibrosing complications. The presence of immune complexes in our case could indicate immuno-allergic mechanism.
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PMID:[Bromocriptine in Parkinson's disease: pleuropulmonary toxicity]. 406 41

In a 16-year mortality followup of some 293,000 insured U.S. veterans, specific causes of death were studied in relation to smoking status. The main results confirmed earlier findings.Mortality ratios for cigarette smokers as compared with nonsmokers were 1.73 for all causes of death, 1.58 for all cardiovascular diseases, 2.12 for all cancers, and 4.31 for all respiratory diseases. The highest ratios (those greater than 5.0) were observed for cor pulmonale, aortic aneurysm, emphysema and bronchitis, cancer of the pharynx, cancer of the esophagus, cancer of the larynx, and cancer of the lung and bronchus. The greatest excess in deaths in terms of observed numbers minus expected was found for the cardiovascular diseases, in particular for coronary heart disease.Mortality ratios for ex-cigarette smokers who had stopped smoking for reasons other than physicians' orders were much lower compared with nonsmokers than the mortality ratios for current cigarette smokers: 1.21 for all causes, 1.15 for all cardiovascular diseases, 1.39 for all cancers, and 2.08 for all respiratory diseases. For most causes of death, the mortality ratios for ex-cigarette smokers who had stopped smoking for reasons other than physicians' orders varied inversely with the number of years of cessation. For some diseases, the mortality risk for the ex-cigarette smoker returned to normal almost immediately after the cessation of smoking, whereas for others, the return to normal was more gradual. The first group included stroke and the combined category of influenza and pneumonia; the second group included cardiovascular diseases as a whole and coronary heart disease. For still other diseases, although the mortality ratio declined with the length of time smoking was discontinued, substantial excess risks remained even after 20 years of cessation. In this third group were aortic aneurysm, bronchitis and emphysema, and lung cancer-diseases with very high mortality ratios for current cigarette smokers. Parkinson's disease remained the one disease that clearly exhibited a negative association with cigarette smoking.
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PMID:Smoking and causes of death among U.S. veterans: 16 years of observation. 738 6

We report of 51-year-old man with early onset parkinsonism. The patient was well until 38 years of age, when he noted a difficulty in the use of his right leg; this difficulty improved after he received a medicine from his physician. He did not take medicine regularly, and he noted difficulty in standing up from a chair and in rolling over at age 40. Tremor was not a feature, but he noted slowness in his movements at age 42; at age 49, he noted diurnal fluctuation in his symptoms and at times he experienced hallucination. He was admitted to our hospital in September of 1992 for the first time when he was 50-year-old. At that time, neurologic examination revealed an alert and somewhat bradyphrenic man; Hasegawa dementia rating scale was 20/30. Cranial nerves were intact except for masked face and small voice. He showed stooped posture and small step gait cogwheel rigidity was noted in the four limbs more on the left; tremor was absent. Deep reflexes were within normal range and the sensation was intact. As he showed diurnal fluctuation in his symptoms, his medication was switched to levodopa 3,000 mg/day without a peripheral decarboxylase inhibitor. He was discharged for out patient follow up. But he did not take drugs regularly, and his neurologic condition deteriorated; he was admitted to another hospital. Neurologic examination at that time was essentially similar to that of his first admission to our hospital, except that he showed more severe rigidity and akinesia; again tremor was not detected. His cranial CT scan showed a mild ventricular dilatation without cortical or brain stem atrophy. During his hospital stay, he developed episodes of oculogyric crisis during peak dose of levodopa, and orthostatic hypotension. He developed pneumonia and expired on October 28, 1993. He was discussed in a neurological CPC, and the chief discussion arrived at the conclusion that the patient had early onset Parkinson's disease of Lewy body type. As differential diagnoses, early onset parkinsonism without Lewy body, pure form of diffuse Lewy body disease, pallidoluysian atrophy, and other conditions were considered; however, all of those possibilities were excluded. Early onset parkinsonism without Lewy body would have much earlier onset than this patient, and diffuse Lewy body disease would show more profound dementia 13 years after the onset. Pallidoluysian atrophy would be complicated with some dystonic features. Post-mortem examination showed marked discoloration and degeneration of the substantia nigra. The degeneration was most prominent in the ventrolateral tier of the substantia nigra.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[A 51-year-old man with early onset parkinsonism]. 760 92

Using data from death certificates, we compared underlying causes of death for two populations of Michigan decedents: (1) persons 40 years of age and older for whom Parkinson's disease (PD) was listed as a contributing cause of death and who died in the years 1970 through 1989, and (2) all persons in Michigan over 40 years of age who died in 1970, 1980, or 1990. PD decedents were approximately 1.5 times more likely to die from cerebrovascular disease and three to four times more likely to die from pneumonia/influenza, but they had just 29% of the expected number of deaths due to cancer. These associations were maintained irrespective of gender or race. PD decedents had diabetes mellitus and heart diseases as frequently as decedents in the general population, but liver diseases were less frequent among PD decedents. These trends held throughout the 21-year study period. When we stratified cancers by whether they are known to be (1) highly related, (2) moderately related, or (3) weakly related or unrelated to smoking, there were still 2.5 times fewer cancers unrelated or weakly related to smoking among PD decedents than among decedents in the general population. We believe that the greater frequency of cerebrovascular disease in PD decedents may be due to a detection bias, since PD patients are more likely to be seen by neurologists, who are more apt to diagnose and document diseases of the nervous system. Pneumonia/influenza is more common among PD patients because of their relative immobility near the end of life.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Parkinson's disease and its comorbid disorders: an analysis of Michigan mortality data, 1970 to 1990. 793 38


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