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| financial help with parkinson's disease: Much Abides: A Survival Guide for Aging Lives Charles H. Edwards, 2020-09-28 This book is intended to be a survival guide for aging lives. It is intended to be the welcome marker that finally appears when you think you have lost the trail. -from the book's prologue |
| financial help with parkinson's disease: Families Caring for an Aging America National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Health Care Services, Committee on Family Caregiving for Older Adults, 2016-12-08 Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults. |
| financial help with parkinson's disease: The Complete Guide for People With Parkinson’s Disease and Their Loved Ones Lianna Marie, 2020-10-15 A diagnosis of Parkinson’s disease is as disorienting as it is devastating. The Complete Guide for People With Parkinson’s Disease and Their Loved Ones helps make sense of what comes next and what can be done, not just for those suffering from the disease but for their family and friends as well. A trained nurse and primary caregiver for her mother, who was diagnosed with Parkinson’s disease in 1991, Lianna Marie draws upon over twenty years of education, research, and direct experience. Written in straightforward and easily accessible language, this essential guide aims to help patients better understand their role in their treatment so that they may continue to lead happy and hopeful lives. Topics covered include nutrition and exercise, alternative and complementary therapies, medication and treatment, and what caregivers can do to help. Written by an international expert on Parkinson’s who has confronted the disease firsthand, The Complete Guide serves as the go-to book for comprehensive, easy-to-understand information for all Parkinson’s patients and their loved ones. |
| financial help with parkinson's disease: Everything You Need to Know About Caregiving for Parkinson’s Disease Lianna Marie, 2020-10-15 Caregiving for those who suffer from Parkinson’s disease comes with many challenges, from how to deal with guilt and loneliness to avoiding burnout and figuring out what to expect from an unpredictable disease. When giving care, too often caregivers neglect their own well-being. Everything You Need to Know About Caregiving for Parkinson’s Disease is not just about caring for your loved one, but also about taking care of yourself. Lianna Marie served as her mother's caregiver for more than twenty years after she was diagnosed with Parkinson’s disease. Drawing on firsthand experience, her training as a nurse, and the many stories of others she has helped and counseled over the years, Marie shares her wisdom and advice—practical and emotional. Written accessibly and without jargon, Everything You Need to Know provides an essential resource full of useful information for all caregivers of those with Parkinson’s disease. |
| financial help with parkinson's disease: Non-Motor Symptoms of Parkinson's Disease K. Ray Chaudhuri, Eduardo Tolosa, Anthony Henry Vernon Schapira, W. Poewe, 2014 Patients with Parkinson's disease (PD) are known to suffer from motor symptoms of the disease, but they also experience non-motor symptoms (NMS) that are often present before diagnosis or that inevitably emerge with disease progression. The motor symptoms of Parkinson's disease have been extensively researched, and effective clinical tools for their assessment and treatment have been developed and are readily available. In contrast, researchers have only recently begun to focus on the NMS of Parkinson's Disease, which are poorly recognized and inadequately treated by clinicians. The NMS of PD have a significant impact on patient quality of life and mortality and include neuropsychiatric, sleep-related, autonomic, gastrointestinal, and sensory symptoms. While some NMS can be improved with currently available treatments, others may be more refractory and will require research into novel (non-dopaminergic) drug therapies for the future. Edited by members of the UK Parkinson's Disease Non-Motor Group (PD-NMG) and with contributions from international experts, this new edition summarizes the current understanding of NMS symptoms in Parkinson's disease and points the way towards future research. |
| financial help with parkinson's disease: Veterans and Agent Orange Institute of Medicine, Board on Population Health and Public Health Practice, Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Seventh Biennial Update), 2009-11-20 From 1962 to 1971, the U.S. military sprayed herbicides over Vietnam to strip the thick jungle canopy that could conceal opposition forces, to destroy crops that those forces might depend on, and to clear tall grasses and bushes from the perimeters of U.S. base camps and outlying fire-support bases. In response to concerns and continuing uncertainty about the long-term health effects of the sprayed herbicides on Vietnam veterans, Veterans and Agent Orange provides a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange and other herbicides used in Vietnam. The 2008 report is the eighth volume in this series of biennial updates. It will be of interest to policy makers and physicians in the federal government, veterans and their families, veterans' organizations, researchers, and health professionals. |
| financial help with parkinson's disease: What Your Doctor May Not Tell You About(TM): Parkinson's Disease Mary J. Shomon, Jill Marjama-Lyons, 2003-02-01 From established, trusted doctors comes another groundbreaking What Your Doctor May Not Tell You book on Parkinson's Disease, a debilitating neurological disorder that affects over one million people in the U.S. Parkinson's patients can now choose from a variety of increasingly effective treatments, including new drugs, revolutionary surgical techniques, and cutting-edge alternative treatments such as intravenous glutathione therapy. The book covers not only the pros and cons of prescription drug and surgical treatments for Parkinson’s, but discusses the latest alternative therapies, including herbal treatments, traditional Chinese medicine, Ayurvedic medicine, diet, exercise, mind-body approaches like Tai Chi, and energy work. With special sections focusing on how patients can deal with persistent problems such as fatigue, depression, and balance problems, and unique chapters that specifically address the interests of the growing number of both caregivers and young-onset Parkinson’s patients, this book is a must for anyone looking to alleviate the disabilities caused by this devastating illness. |
| financial help with parkinson's disease: Parkinson's Disease Abraham N. Lieberman, 1993-02 A guide for Parkinson patients and their caregivers that addresses the body and the spirit. |
| financial help with parkinson's disease: Voices of Resilience: Conversations with Parkinson’s Disease Warriors, Caregivers, and Advocates - Book I Dr. George Ackerman, 2024-09-07 This book of interviews aims to raise awareness and hope for a cure for Parkinson’s Disease. I contacted individuals worldwide to obtain the interviews because PD does not discriminate and affects individuals, families, and communities worldwide. I believe we must be family in this fight for a cure. When I learned that approximately 1 million individuals are diagnosed in the United States and over 10 million worldwide, I felt that many other journeys needed to be shared. So many inspired me to keep advocating for a cure! |
| financial help with parkinson's disease: Etiology of Parkinson's Disease Jonas H. Ellenberg, William C. Koller, James William Langston, 1995-03-01 This comprehensive reference provides a detailed overview of current concepts regarding the cause of Parkinson's disease-emphasizing the issues involved in the design, implementation, and analysis of epidemiological studies of parkinsonism. |
| financial help with parkinson's disease: Occupational Therapy for People with Parkinson's Disease Ana Aragon, Jill Kings, 2010 These practice guidelines draw upon the widest relevant knowledge and evidence available to describe and inform contemporary best practice occupational therapy for people with Parkinson's disease. They include practical examples of interventions to allow occupational therapists to apply new treatments to their practice. |
| financial help with parkinson's disease: Atypical Parkinsonian Disorders Irene Litvan, 2007-10-27 A comprehensive review of what is known not only about the cause and treatment of atypical parksonian disorders, but also the issues that clinicians, researchers, patients, and caregivers face in dealing with them. The authors cover the basic science (history, epidemiology, genetics, pathology, nosology, computer modeling, and animal models), detailed clinical and laboratory assessments, and available diagnostic tools, including neuropsychiatric, neurologic, neuropsychologic, speech, electrophysiologic, and imaging evaluations. Current and future therapeutic approaches are also detailed, along with extensive discussions about future research directions. |
| financial help with parkinson's disease: Neuropalliative Care Claire J. Creutzfeldt, Benzi M. Kluger, Robert G. Holloway, 2018-10-01 This comprehensive guide thoroughly covers all aspects of neuropalliative care, from symptom-specific considerations, to improving communication between clinicians, patients and families. Neuropalliative Care: A Guide to Improving the Lives of Patients and Families Affected by Neurologic Disease addresses clinical considerations for diseases such as dementia, multiple sclerosis, and severe acute brain injury, as well discussing the other challenges facing palliative care patients that are not currently sufficiently met under current models of care. This includes methods of effective communication, supporting the caregiver, how to make difficult treatment decisions in the face of uncertainty, managing grief, guilt and anger, and treating the pain itself. Written by leaders in the field of neuropalliative care, this book is an exceptional, well-rounded resource of neuropalliative care, serving as a reference for all clinicians caring for patients with neurological disease and their families: neurologists and palliative care specialists, physicians, nurses, chaplains, social workers, as well as trainees in these areas. |
| financial help with parkinson's disease: The Parkinson's Handbook Dwight C. McGoon, 1994 An inspiring, practical guide for patients and their families by a Mayo Clinic surgeon with Parkinson's Disease. |
| financial help with parkinson's disease: Neurological Disorders World Health Organization, 2006 Although there are several gaps in understanding the many issues related to neurological disorders, we know enough to be able to shape effective policy responses to some of the most common. This book describes and discusses the increasing public health impact of common neurological disorders such as dementia, epilepsy, headache disorders, multiple sclerosis, neuroinfections, neurological disorders associated with malnutrition, pain associated with neurological disorders, Parkinson's disease, stroke and traumatic brain injuries. It provides information and advice on public health interventions that may reduce their occurrence and consequences, and offers health professionals and planners the opportunity to assess the burden caused by these disorders. The clear message that emerges is that unless immediate action is taken globally, the neurological burden is likely to become an increasingly serious and unmanageable. |
| financial help with parkinson's disease: The Case of the Frozen Addicts J.W. Langston, J. Palfreman, 2013-12-02 In the summer of 1982, hospital emergency rooms in the San Francisco Bay Area were suddenly confronted with mysteriously “frozen” patients – young men and women who, though conscious, could neither move nor speak. Doctors were baffled, until neurologist J. William Langston, recognizing the symptoms of advanced Parkinson’s disease, administered L-dopa – the only known effective treatment – and “unfroze” his patient. Dr. Langston determined that this patient and five others had all used the same tainted batch of synthetic heroin, inadvertently laced with a toxin that had destroyed an area of their brains essential to normal movement. This same area, the substantia nigra, slowly deteriorates in Parkinson’s disease. As scientists raced to capitalize on this breakthrough, Dr. Langston struggled to salvage the lives of his frozen patients, for whom L-dopa provided only short-term relief. The solution he found lay in the most daring area of research: fetal-tissue transplants. The astonishing recovery of two of his patients garnered worldwide press coverage, helped overturn federal restrictions on fetal-tissue research, and offered hope to millions suffering from Parkinson’s, Alzheimer’s, and other degenerative brain disorders. This is the story behind the headline – a spellbinding account that brings to life the intellectual excitement, ethical dilemmas, and fierce competitiveness of medical research. This new updated edition of the classic neurological mystery tale, “The Case of the Frozen Addicts,” illuminates how the solution to a baffling mystery of the brain’s chemistry opened a new frontier in medicine and restored life to people without hope. “It begins with a series of quixotic discoveries, escalates to providing possible solutions for one of humanity’s most intractable medical problems, and then catapults the reader into the center of America’s hottest political arena – abortion and fetal sanctity. Bravo! A brilliant read.” – Laurie Garrett, author of The Coming Plague “[Langston and Palfreman] weave a highly readable and spellbinding medical detective tale... It is as absorbing as a good mystery, as entertaining as an exciting novel, and as enlightening as a good biography.” – Stanley Fahn, New England Journal of Medicine “I could not put it down... it is the lives of the ‘frozen addicts’ themselves – and the fullness with which this is presented – which makes the whole thing overwhelming.” – Oliver Sacks |
| financial help with parkinson's disease: I Have Parkinson's: What Should I Do? Ann Andrews, 2011-10-30 A realistic, compassionate, supportive guide to living positively with a disease that is usually portrayed in depressing terms. Drawing on her own experience and that of others with early onset Parkinson's, the author combines clear information about the symptoms and treatments with practical strategies for adapting to the challenges of life with the disease. |
| financial help with parkinson's disease: Parkinson's Disease: An Interdisciplinary Guide to Management Fiona Lindop, Rob Skelly, 2021-11-17 Evidence shows that a multidisciplinary approach to Parkinson's care provides better patient outcomes and is more cost effective. This new title provides a practical guide to this approach, with the perspective of the person living with Parkinson's firmly at its core. Written by experts in their field and firmly grounded in up-to-date evidence, Parkinson's Disease: A Multidisciplinary Guide to Management addresses multidisciplinary intervention through the various stages of disease, rather than by discipline. It covers all aspects of care, from pharmacological management to non-drug interventions that are helpful for Parkinson's symptoms. This book is unique in its holistic approach to the patient and their family, and will help all members of the team to implement a biopsychosocial model of health that puts the person with Parkinson's at the centre of care. - Clinician-led content provides perspectives of different members of the interdisciplinary team, including medics, nurses, physiotherapists, occupational therapists and psychologists - Includes practical advice and top tips enhance management of common problems - Includes best practice for Parkinson's as well as Atypical Parkinsonian Syndromes - Progressive Supranuclear Palsy, Corticobasal Syndrome and Multiple System Atrophy - Includes management of falls and bone health, palliative care, management of inpatients - Provides practical advice on delivering services remotely by telephone or video |
| financial help with parkinson's disease: Deep Brain Stimulation for Parkinson's Disease Gordon H. Baltuch, Matthew B. Stern, 2007-03-19 Considered the largest breakthrough in the treatment of Parkinson's disease in the past 40 years, Deep Brain Stimulation (DBS) is a pioneering procedure of neurology and functional neurosurgery, forging enormous change and growth within the field. The first comprehensive text devoted to this surgical therapy, Deep Brain Stimulation for Parkinson's |
| financial help with parkinson's disease: Ferri's Clinical Advisor 2020 E-Book Fred F. Ferri, 2019-06-01 Significantly updated with the latest developments in diagnosis and treatment recommendations, Ferri's Clinical Advisor 2020 features the popular 5 books in 1 format to organize vast amounts of information in a clinically relevant, user-friendly manner. This efficient, intuitive format provides quick access to answers on 1,000 common medical conditions, including diseases and disorders, differential diagnoses, and laboratory tests – all reviewed by experts in key clinical fields. Updated algorithms, along with hundreds of new figures, tables, and boxes, ensure that you stay current with today's medical practice. - Contains significant updates throughout, covering all aspects of current diagnosis and treatment. - Features 27 all-new topics including chronic traumatic encephalopathy, medical marijuana, acute respiratory failure, gallbladder carcinoma, shift work disorder, radial tunnel syndrome, fertility preservation in women, fallopian tube cancer, primary chest wall cancer, large-bowel obstruction, inguinal hernia, and bundle branch block, among others. - Includes a new appendix covering Physician Quality Reporting System (PQRS) Measures. - Provides current ICD-10 insurance billing codes to help expedite insurance reimbursements. - Patient Teaching Guides for many of the diseases and disorders are included, most available in both English and Spanish versions, which can be downloaded and printed for patients. |
| financial help with parkinson's disease: Parkinson's Disease For Dummies Michele Tagliati, Gary Guten, Jo Horne, 2011-03-01 A user-friendly guide to coping with the daily issues of Parkinson’s If you or someone you love has been diagnosed with Parkinson’s Disease you’re probably wrestling with fear, despair, and countless questions about the future. It’s brighter than you think. In Parkinson’s Disease for Dummies, you’ll discover how to keep a positive attitude and lead an active, productive life as this user-friendly, guide pilots you through the important steps toward taking charge of your condition. It helps you: Make sure you have an accurate diagnosis Assemble and work with your health care team Inform others about your condition Choose the most effective medications Establish a diet and exercise regimen Consider surgical options, alternative therapies, and clinical trials Maintain healthy personal and professional relationships Adjust your routine as your PD progresses This one-stop resource provides proven coping skills, first-hand advice, and practical tools, such as worksheets to assess care options, questions to ask doctors, and current listings of care providers. |
| financial help with parkinson's disease: Understanding Parkinson's Disease David Lee Cram, Xiao Gao, Steven Schechter, 2009 Inspiring guide on both the basics of the illness and ways to stay more active from two unique perspectives--that of a physician and as a person with Parkinson's. |
| financial help with parkinson's disease: Dementia with Lewy Bodies John O'Brien, David Ames, Ian McKeith, Edmond Chiu, 2005-11-29 Filling a noticeable gap in the market for a new text solely focused on Dementia with Lewy Bodies, this book discusses cutting-edge topics covering the condition from diagnosis to management, as well as what is known about the neurobiological changes involved. With huge progress having been made over the last decade in terms of the disorder |
| financial help with parkinson's disease: Funding The Cure Martin M. Shenkman, CPA, MBA, JD, 2009-10-13 Funding the Cure: Charitable Giving to Help The Michael J. Fox Foundation for Parkinson's Research Find the Cure for Parkinson's Disease is an elegant, noteworthy book that instructs the reader on using charitable giving strategies for loved ones with Parkinson's Disease. While the concept is simple and the focus is narrow, the book will be of great interest to those with Parkinson's Disease, their friends, family and loved ones. Funding the Cure tells the reader how he/she can specifically tailor charitable giving to not only accomplish tax and charitable goals, but to also achieve vital personal and human goals like protecting a relative living with Parkinson's Disease, or leaving property to fund Parkinson's Disease research. The book is written in easy to understand language and offers practical examples of charitable giving geared to The Michael J. Fox Foundation - not generic tax jargon. |
| financial help with parkinson's disease: Parkinson's Disease and Quality of Life Lucien Cote, Lola L. Sprinzeles, Robin Elliott, Austin H. Kutscher, 2014-01-21 Learn to handle the problems that Parkinson's patients face Through Parkinson's Disease and Quality of Life, you will discover common problem areas seen in patients with Parkinson's disease. This book explores problems that interfere with functional independence of patients and gives examples of occupational therapy intervention and treatment techniques. Parkinson's Disease and Quality of Life boldly deals with many seldom talked about real-life issues facing people with Parkinson's disease, including continued sexual intimacy and urinary incontinence. Although these issues may not be curable, this book provides you with effective treatments through data and case studies. Parkinson's Disease and Quality of Life offers caregivers a step-by-step plan to get organized. It includes a plan to put together a workbook of all relevant information, as well as tips on how to safeguard every room for a Parkinson's disease patient. This book helps remind you that the families of the patient must not be forgotten and that they can get the help they need through support groups, community resources, and from professional staffing such as nurses and aides. Parkinson's Disease and Quality of Life will assist you in helping your patients by: using music therapy to help calm patients realizing the legal impact of Parkinson's disease by discussing living wills, health care proxies, durable power of attorney, and revocable and irrevocable trusts with your clients discovering that cognitive changes, dementia, and depression can complicate the treatment of the disease and be more disabling than the loss of motor function exploring the nursing home as a viable options for clients as well as their families Parkinson's Disease and Quality of Life also brings to light the important subject of knowing the patients insurance policies and working out contingency plans, like living wills, before they are needed. This book gives you much-needed information on accessing benefits for Parkinson's patients, including medicare, social security, Veteran's benefits, and much more. Parkinson's Disease and Quality of Life is full of methods and ideas to improve the lives of the Parkinson's patient as well as their families. |
| financial help with parkinson's disease: Patient Education for People with Parkinson's Disease and their Carers Marcia Smith Pasqualini, Gwenda Simons, 2006-10-02 This manual provides the information and materials needed to conduct an eight-session patient education programme for people with Parkinson’s disease and their carers, complementing medical treatment. This programme was developed within an interdisciplinary European consortium, comprising research and clinical centres in Germany, Spain, Finland, Italy, The Netherlands, Estonia and the United Kingdom. In addition to dealing with the motor symptoms of Parkinson’s disease, many people also struggle with the psychological and social effects. In fact, people at every stage of the disease can be faced with problems such as depression, anxiety, stressful social interactions, and difficulties communicating, all of which can disrupt their lives. This programme draws upon basic psychological principles and presents specific strategies that people can use to manage these difficulties. The ultimate goal of the programme is to empower people with Parkinson’s disease and their carers to improve their own quality of life. Although the programme is standardised, flexibility is built into the programme to facilitate its use in different cultures, and with different types of patient and carer groups. Patient Education for People with Parkinson’s Disease and Their Carers: A Manaual is essential reading for all health care professionals and trained volunteers working with people with Parkinson’s disease and their carers. |
| financial help with parkinson's disease: Parkinson's Disease and Other Movement Disorders Mark Edwards, Niall Quinn, Kailash Bhatia, 2008 A reference on the management of Parkinson's disease and other movement disorders, this book offers practical advice on the classification and diagnosis of patients, and available treatment options. |
| financial help with parkinson's disease: Deep Brain Stimulation Management William J. Marks, Jr, 2015-09-03 Essential reference guide for clinicians working with DBS patients, fully revised throughout with new chapters on epilepsy and psychiatric disorders. |
| financial help with parkinson's disease: Easing the Family Caregiver Burden, Programs Around the Nation United States. Congress. Senate. Special Committee on Aging, 1999 |
| financial help with parkinson's disease: The New Parkinson's Disease Handbook Professor Harvey Sagar, 2012-11-02 Some people with Parkinson's Disease find they can't speak very well while others lose the ability to write or control a knife and fork. Some get treated like children while others are ignored. Many manage their disease for years and continue to live extremely fruitful and fulfilling lives. But it's always there, in the back of one's mind. How long will I keep this up? Over 120,000 people in the UK have Parkinson's Disease, and this figure is rising. It can strike very early in life, as with the actor Michael J. Fox, or much later. It is a progressive, neurological disorder, treated mainly with drug therapy but also alleviated with physical therapy and diet. Although each person with Parkinson's is different, and the ability to perform movements may differ from one day to the next, Parkinson's has a dramatic effect on a person's quality of life and also affects those around the sufferers. This is a compassionate and helpful guide to the disease and its treatments. The good news is that Parkinson's can be controlled very effectively for many years with the right treatment and care. This definitive handbook allows you to ask all the right questions and to understand the disease so that the answer to the question above is, 'as long as possible'. |
| financial help with parkinson's disease: Affordable Excellence William A. Haseltine, 2013 Today Singapore ranks sixth in the world in healthcare outcomes well ahead of many developed countries, including the United States. The results are all the more significant as Singapore spends less on healthcare than any other high-income country, both as measured by fraction of the Gross Domestic Product spent on health and by costs per person. Singapore achieves these results at less than one-fourth the cost of healthcare in the United States and about half that of Western European countries. Government leaders, presidents and prime ministers, finance ministers and ministers of health, policymakers in congress and parliament, public health officials responsible for healthcare systems planning, finance and operations, as well as those working on healthcare issues in universities and think-tanks should know how this system works to achieve affordable excellence.--Publisher's website. |
| financial help with parkinson's disease: Early Diagnosis and Preventive Therapy in Parkinson’s Disease Horst Przuntek, Peter Riederer, 2012-12-06 At the time when Parkinson's Disease is diagnosed in a patient, roughly two thirds of dopaminergic neurons of substantia nigra are already degenerated. The onset of the disease must, therefore, be much earlier. This book deals with early diagnosis and early preventive treatment which may sustain the process underlying the disease. By use of psychometric, kinesiologic, physiologic, histologic, biochemical, endocrinologic, pharmacologic and imaging techniques, including positron-emission tomography and brain mapping, specialists tried to focus on new diagnostic criteria. New methods including psychometric evaluation, apparative measurement of movement, analysis of peripheral blood and urinary constituents have supplemented this approach. It has been agreed that early preventive therapy consists of low dosis of L-DOPA plus benserazide, L-deprenyl and dopaminergic agonists. |
| financial help with parkinson's disease: Parkinson's Disease National Institute of Neurological and Communicative Disorders and Stroke, 1976 |
| financial help with parkinson's disease: Parkinson's Disease National Collaborating Centre for Chronic Conditions (Great Britain), 2006 |
| financial help with parkinson's disease: Parkinson's Disease in the Older Patient Jeremy R. Playfer, John V. Hindle, 2008 This text represents a detailed guide to the holistic assessment and the management of older patients with Parkinson's disease, based on current concepts in the management of chronic diseases and the caring strategies required in the four stages. |
| financial help with parkinson's disease: Levodopa pharmacokinetics -from stomach to brain Maria Nord, 2019-01-07 Parkinson’s disease (PD) is one of the most common neurodegenerative disorders and it is caused by a loss of dopamine (DA) producing neurons in the basal ganglia in the brain. The PD patient suffers from motor symptoms such as tremor, bradykinesia and rigidity and treatment with levodopa (LD), the precursor of DA, has positive effects on these symptoms. Several factors affect the availability of orally given LD. Gastric emptying (GE) is one factor and it has been shown to be delayed in PD patients resulting in impaired levodopa uptake. Different enzymes metabolize LD on its way from the gut to the brain resulting in less LD available in the brain and more side effects from the metabolites. By adding dopa decarboxylase inhibitors (carbidopa or benserazide) or COMT-inhibitors (e.g. entacapone) the bioavailability of LD increases significantly and more LD can pass the blood-brain-barrier and be converted to DA in the brain. It has been considered of importance to avoid high levodopa peaks in the brain because this seems to induce changes in postsynaptic dopaminergic neurons causing disabling motor complications in PD patients. More continuously given LD, e.g. duodenal or intravenous (IV) infusions, has been shown to improve these motor complications. Deep brain stimulation of the subthalamic nucleus (STN DBS) has also been proven to improve motor complications and to make it possible to reduce the LD dosage in PD patients. In this doctoral thesis the main purpose is to study the pharmacokinetics of LD in patients with PD and motor complications; in blood and subcutaneous tissue and study the effect of GE and PD stage on LD uptake and the effect of continuously given LD (CDS) on LD uptake and GE; in blood and cerebrospinal fluid (CSF) when adding the peripheral enzyme inhibitors entacapone and carbidopa to LD infusion IV; in brain during STN DBSand during oral or IV LD treatment. To conclude, LD uptake is more favorable in PD patients with less severe disease and GE is delayed in PD patients. No obvious relation between LD uptake and GE or between GE and PD stage is seen and CDS decreases the LD levels. Entacapone increases the maximal concentration of LD in blood and CSF. This is more evident with additional carbidopa and important to consider in avoiding high LD peaks in brain during PD treatment. LD in brain increases during both oral and IV LD treatment and the DA levels follows LD well indicating that PD patients still have capacity to metabolize LD to DA despite probable pronounced nigral degeneration. STN DBS seems to increase putaminal DA levels and together with IV LD treatment also increases LD in brain possibly explaining why it is possible to decrease LD medication after STN DBS surgery. Parkinsons sjukdom (PS) är en av de vanligaste s.k. neurodegenerativasjukdomarna och orsakas av förlust av dopamin(DA)producerande nervceller i hjärnan. Detta orsakar motoriska symptom såsom skakningar, stelhet och förlångsammade rörelser. Levodopa (LD) är ett ämne, som kan omvandlas till DA i hjärnan och ge symptomlindring och det är oftast förstahandsval vid behandling av patienter med PS. Flera faktorer påverkar tillgängligheten av LD, bl.a. den hastighet som magsäcken tömmer sig med och denna verkar förlångsammad hos personer med PS vilket ger sämre tillgänglighet av LD i blodet och därmed i hjärnan. LD bryts även ner i hög grad av olika enzym ute i kroppen vilket leder till mindre mängd LD som hamnar i hjärnan och till fler nedbrytningsprodukter som orsakar biverkningar. Tillägg av enzymhämmare leder till ökad mängd LD som kan nå hjärnan och omvandlas till DA. Det anses viktigt att undvika höga toppar av LD i hjärnan då dessa verkar bidra till utvecklandet av besvärliga motoriska komplikationer hos patienter med PS. Om LD ges mer kontinuerligt, exempelvis som en kontinuerlig infusion in i tarmen eller i blodet, så minskar dessa motoriska komplikationer. Inopererande av stimulatorer i vissa delar av hjärnan (DBS) har också visat sig minska dessa motoriska komplikationer och även resultera i att man kan minska LD-dosen. Huvudsyftet med den här avhandlingen är att studera LD hos patienter med PS; i blod och fettvävnad då LD ges i tablettform och se om det finns något samband med LD-upptag och hastigheten på magsäckstömningen (MT) och om kontinuerligt given LD påverkar LD-upptaget eller MT; i blod och i ryggmärgsvätska då enzymhämmarna entakapon och karbidopa tillsätts LD; i hjärna vid behandling med DBS och då LD ges både som tablett och som infusion i blodet. Sammanfattningsvis kan vi se att LD-upptaget är mer gynnsamt hos patienter med PS i tidigare skede av sjukdomens komplikationsfas. MT är förlångsammad hos patienter med PS och det är inget tydligt samband mellan LD-upptag och MT eller mellan MT och sjukdomsgrad. Kontinuerligt given LD minskar LDnivåerna. Enzymhämmaren entakapon ökar den maximala koncentrationen av LD i blod och ryggmärgsvätska och effekten är mer tydlig vid tillägg av karbidopa vilket är viktigt att ta i beaktande vid behandling av PS för att undvika höga toppar av LD i hjärnan. LD ökar i hjärnan då man behandlar med LD i tablettform och som infusion i blodet och DA-nivåerna i hjärnan följer LD väl vilket visar på att patienter med PS fortfarande kan omvandla LD till DA trots trolig uttalad brist av de DA-producerande nervcellerna i hjärnan. DBS verkar öka DA i vissa områden i hjärnan och tillsammans med LD-infusion i blodet verkar det även öka LD i hjärnan och det kan förklara varför man kan sänka LDdosen efter DBS-operation. |
| financial help with parkinson's disease: Disease Control Priorities in Developing Countries Dean T. Jamison, Joel G. Breman, Anthony R. Measham, George Alleyne, Mariam Claeson, David B. Evans, Prabhat Jha, Anne Mills, Philip Musgrove, 2006-04-02 Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries. |
| financial help with parkinson's disease: Social Isolation and Loneliness in Older Adults National Academies of Sciences, Engineering, and Medicine, Division of Behavioral and Social Sciences and Education, Health and Medicine Division, Board on Behavioral, Cognitive, and Sensory Sciences, Board on Health Sciences Policy, Committee on the Health and Medical Dimensions of Social Isolation and Loneliness in Older Adults, 2020-05-14 Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish. |
| financial help with parkinson's disease: Brain Fables Alberto Espay, Benjamin Stecher, 2020-07-09 An estimated 80 million people live with a neurodegenerative disease. That number is expected to increase rapidly as populations age, lifespans increase, and exposure to toxins rises. Despite decades of research and billions in funding, there are no medications that can slow, much less stop, the progress of these diseases. This is because diseases such as Parkinson's and Alzheimer's do not exist in biology. Yet, hundreds of clinical trials around the world are examining the potential of single therapies in thousands of people sharing one of these labels. Compounding the problem, these therapies were developed on evidence from models that do not come close to capturing the complexity of these diseases in the affected humans. These practices must end. Brain Fables is a call to refocus on understanding living and aging to create the personalized treatments each affected individual desperately needs. |
| financial help with parkinson's disease: The New Parkinson's Disease Treatment Book J. Eric Ahlskog, PhD, MD, 2015-08-03 The fundamental guide to the most effective treatments for Parkinson's Disease, from a Mayo Clinic doctor with thirty years of clinical and research experience. In this second edition follow-up to the extremely successful first edition, Dr. Ahlskog draws on thirty years of clinical experience to present the definitive guide to dealing with all aspects of Parkinson's Disease, from treatment options and side effects to the impact of the disease on caregivers and family. Dr. Ahlskog's goal is to educate patients so that they can better team up with their doctors to do battle with the disease, streamlining the decision-making process and enhancing their treatment. To do this, Dr. Ahlskog offers a gold mine of information, distilled from his years of experience treating people with Parkinson's at the Mayo Clinic. In addition to providing a comprehensive account of Parkinson's medications, this book also examines additional aspects of treatment, such as the role of nutrition, exercise, and physical therapy. Although many commendable texts have been written on the subject of Parkinson's Disease, their discussions of treatment have not been in depth. Dr. Ahlskog sifts through aspects of the disease in order to give the reader a comprehensive sense of Parkinson's and the best available treatment options. With a broader understanding of the disease and the available options, patients are able to make more informed choices, and doctors are able to provide more tailored care. This book delivers hopeful, helpful, and extensive information to all parties concerned: patients, caregivers, and doctors. The ultimate guide to symptoms and treatment, this thoroughly updated second edition is the first place patients should turn for reliable, easy-to-grasp information on Parkinson's Disease. |
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