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)

Retroperitoneal fibrosis has been observed in two patients with Parkinson's disease treated with bromocriptine. The patients complained of abdominal or lower back pain and presented with various degrees of renal insufficiency, with anuria in one. Laboratory evaluation furthermore showed an increased sedimentation rate and inflammatory anemia. Computerized tomography disclosed marked retroperitoneal thickening, and biopsy was performed in one patient. The symptoms appeared eighteen months and five years after treatment was started, at doses of 20 and 22.5 mg of bromocriptine daily. The medication was discontinued in both patients and steroid therapy was initiated, with resolution of all clinical, biological and radiological evidence of disease. This potential but rare complication of a widely prescribed drug warrants monitoring of renal function and sedimentation rate in patients undergoing bromocriptine treatment.
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PMID:Retroperitoneal fibrosis in two patients with Parkinson's disease treated with bromocriptine. 217 99

Experiences and views of patients are presented concerning psychological, professional, family life, cognitive and financial aspects of the costs of several chronic diseases: arterial hypertension, autonomous dialysis, back pain, bronchial asthma, chronic obstructive pulmonary disease, colostomy, diabetes mellitus, epilepsy, laryngectomy, Parkinson's disease. The posters expressed what patients would really like to tell their doctors.
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PMID:Patients' experiences with their disease: learning from the differences and sharing the common problems. 749 42

Sleep disorders occur in 74-98% of patients with idiopathic Parkinson's disease (PD), adversely affecting their quality of life. Sleep disruption takes the form of sleep fragmentation with frequent and prolonged awakenings and daytime sleepiness. Nocturia, difficulty in turning over in bed, painful leg cramps, vivid dreams/nightmares, back pain, limb/facial dystonia and leg jerks are the main causes of nocturnal awakening in PD patients. Sleep disturbance gradually worsens with disease progression, suggesting that it is related to the severity of the disease. Sleep disturbances may be generally considered as part of the normal aging process, being more common in the elderly. However, no significant associations between sleep disturbances and either age or disease duration was found in a survey of 100 PD patients. Disturbed sleep maintenance in PD patients was more severe than in age-matched controls, and nocturnal awakening was frequently caused by nocturia, pain, stiffness and difficulty in turning over in bed. Sleep disturbance is also a complication of chronic levodopa therapy. Recent data suggest that controlled-release levodopa is less likely to cause nocturnal symptoms than standard levodopa, particularly in mild-to-moderate disease. Depression, which is common in PD patients, contributes to sleep disturbance but has a lesser influence than the disease process itself. Hypnotic and sedative agents, as well as anti-depressants if required, are useful in ameliorating sleep disturbances in PD patients; intranasal desmopressin appears to be effective in reducing nocturia.
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PMID:Sleep disorder related to Parkinson's disease. 911 82

Low back pain in the elderly has a much wider range of possible causes than in younger patients. In addition to nonspecific mechanical causes, malignancy presenting as back pain occurs more often in older patients. Other systemic and visceral causes of back pain such as polymyalgia rheumatica, aortic aneurysm, Paget disease, Parkinson disease, and osteoporosis with compression fracture occur almost exclusively in persons over age 50. Keys to diagnosis and management of low back pain in older patients are presented.
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PMID:Evaluating back pain in older patients. 998 54

We report here a unique case of a 55-year-old woman presenting with a clinical picture of Parkinson disease, severe back pain, splenomegaly, and pronounced dyspnea. Radiographic examination of the spine showed multiple vertebral fractures. Niemann-Pick disease type B was diagnosed by findings of lipid-loaded histiocytes and a strongly reduced sphingomyelinase enzyme activity. She was homozygous for the deletion of codon 608 (delR608), which encodes an arginine residue in the Acid Sphingomyelinase gene. To investigate the cause of the unusual vertebral fractures, we screened for polymorphisms previously described as possibly associated with increased risk for osteoporosis and fractures. Our patient was heterozygous for the polymorphisms of the vitamin D receptor gene, the estrogen receptor gene, and the collagen 1A1gene. Increased physical activity after Parkinson treatment, a genetic predisposition, together with worsening disease due to interfering medications could explain the dramatic presentation of this patient. She was treated with cholesterol lowering drugs such as statins to decrease sphingomyelin synthesis, avoidance of drugs that inhibit sphingomyelinase, and bisphosphonates. No new fractures have occurred, but the interstitial lung disease has progressed.
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PMID:Niemann-Pick disease type B: an unusual clinical presentation with multiple vertebral fractures. 1193 91

Postural abnormalities and increased muscle tone in Parkinson's disease (PD) may cause back pain. In this controlled study, we analyzed features of back pain in PD patients. The prevalence of back pain was 74% in PD patients (n = 101) when compared with 27% in control patients (n = 132; P < 0.0001, fisher's exact test), but did not correlate with disease severity or duration. The mean back pain intensity (visual analog scale of 0-10) was 4.3 for PD patients, and 1.3 for controls. Both radicular and nonradicular types of back pain were more frequent, and back pain caused more impairment in PD patients. However, it is noteworthy that the PD patients in our study did not receive more pain medication than control patients. This suggests that back pain in PD patients is often neglected and insufficiently treated. Our results argue for the routine evaluation of back pain in every patient suffering from PD.
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PMID:Radicular and nonradicular back pain in Parkinson's disease: a controlled study. 1735 31

The clinical features of a 67-year-old female suffering recurrent low back pain (LBP) who developed Parkinson's disease (PD) are presented. PD is a progressive, age-specific neuro-degenerative disorder characterized by a combination of bradykinesia (slowness of movement), rest tremor (initially unilaterally and usually of the hands), rigidity or stiffness of the arms, legs or neck, and/or postural instability. Other non-motor and cognitive symptoms may accompany these features. Tremor, at rest, is usually the earliest and most prominent cardinal symptom of PD, but is absent in approximately 30% of patients. Considering mechanical back pain commonly presents with slowed movement and gait disturbance due to pain avoidance behavior, and considering Canada's population is aging and living longer will inevitably cause the number of Parkinson's patients to increase, it is important for chiropractic doctors to maintain an awareness of the condition to facilitate its early referral, diagnosis and management.
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PMID:Parkinson's disease without tremor masquerading as mechanical back pain; a case report. 1876 2

An aim of a study was to establish the relationship between pain, motor complications and depression in Parkinson's disease and evaluate an effect of the 3 months therapy with the dopamine receptor agonist pramipexole (mirapex). Seventy-eight patients with idiopathic parkinsonism, aged 56-73 years, including 18 patients in stage 1-1,5 of the disease; 31 patients - in stage 2; 20 patients - in stage 3 and 9 patients - in stage 4, were studied. A stable response to the therapy was observed in 28 patients, motor complications in 50. A patient's state was assessed with widely-used scales. Thirty patients were assigned to pramipexole as an add-on therapy to L-DOPA and amantadin. Patients with dementia did not receive pramipexole. Thirty-five patients (44,8%) had pain complaints. This percentage was significantly higher (62%) in patients with motor complications. Multiple regression analysis revealed that pain scores were significantly correlated with motor complication and motor fluctuation scores. Back pain scores were correlated with an extent of posture disturbances. Mild depression and depressed mood were found in 37 patients (47,4%). VAS scores in these patients were significantly higher compared to patients without mood disturbances. The intensity of pain was correlated with depression severity. Patients treated with mirapex reported the reduction of pain by 48,2% (p<0,0001) during the "on-period". During the "off-period", the reduction of pain intensity was less (23,7%) but still significant. Depression scores were decreased to the end of the 12th week of treatment from 15,2+/-2,3 to 10,4+/-3,5 (p<0,0001).
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PMID:[Pain and depression in Parkinson's disease: new therapeutic possibilities of pramipexole]. 1900 98

Osteoporotic thoracolumbar compression fracture occasionally occurs in patients with Parkinson's disease and can lead to neural compromise due to delayed vertebral body collapse, requiring surgical treatment. Surgical treatment and postoperative care are difficult because of poor bone quality, involuntary exercise, and postural imbalance. Due to such difficulties in treatment, few reports exist about surgery for osteoporotic thoracolumbar compression fracture in patients with Parkinson's disease. Anterior decompression and posteroanterior reconstructive stabilization were performed for 3 patients with Parkinson's disease and osteoporotic vertebral body collapse. To prevent instrument-related complications, it is important to achieve initial rigid stability. Regarding the stabilization of the posterior elements, laminar hooks were used. Two pedicle screws and 1 hook were placed at 1 level above and 1 level below the injured vertebra. As for the stabilization of the anterior part, a titanium cage was used. All patients resumed their activities of daily living postoperatively. Two of 3 patients experienced sinking of the rib cage after commencement of ambulation with a hard brace postoperatively. After these patients wore a body cast for 2 months, they were able to resume activities of daily living under careful treatment. In all patients, junctional kyphosis improved postoperatively and progressed postoperatively. None experienced recurrent neural deterioration or backache related to the fracture through >3 years of postoperative follow-up. Combined posteroanterior reconstruction surgery was useful for osteoporotic thoracolumbar compression fracture with Parkinson's disease. However, maintenance of postoperative alignment was difficult to achieve. Careful postoperative management was important for good clinical results.
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PMID:Combined posteroanterior surgery for osteoporotic delayed vertebral fracture and neural deficit in patients with Parkinson's disease. 1982

Exercise plays a critical role in promoting healthy aging and in the management of chronic illness. In this paper, we provide an overview of the leading research regarding exercise and chronic illness, and the variables influencing exercise participation among persons with a chronic illness. We then examine the Empoli Adaptive Physical Activity (APA) program as a model program that has overcome many of the obstacles to exercise adherence. Piloted by Local Health Authority 11 in Tuscany, Italy, APA has over 2,000 participants, and it provides tailored exercise opportunities for persons with stroke, back pain, Parkinson's disease or multiple sclerosis, among others illnesses. The Empoli APA program serves as a model community exercise program and is now being replicated throughout Tuscany and in the United States.
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PMID:Community exercise: a vital component to healthy aging. 2005 13


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