ABSTRACT
Palliative care is traditionally associated with cancer and pain relief: however, the range of diseases requiring palliative care is much wider and includes many neurodegenerative diseases (Alzheimer's disease and Parkinson's disease (PD)). Provision of palliative care to patients with PD and other neurodegenerative diseases, such as multisystem atrophy, progressive supranuclear palsy, dementia with Lewy bodies, etc. is «terra incognita¼ for many neurologists who are not acknowledged with palliative medicine as well as for specialists in palliative medicine, who are mainly trained in providing care to patients with oncological profile and do not know the intricacies of managing patients in the late stages of PD and other neurodegenerative diseases. The aim of the article is to systematize modern knowledge in the field of palliative medicine and neurodegenerative diseases.
Subject(s)
Alzheimer Disease , Multiple System Atrophy , Parkinson Disease , Supranuclear Palsy, Progressive , Humans , Palliative Care , Parkinson Disease/therapyABSTRACT
The article presents an experience of diagnostics and treatment in 21 patients with esophageal perforation at the period from 1995 to 2015. The perforation was often (13 patients) the complication of interventional surgery which was directed to reconstruction of esophagus passing (scarry stricture of the esophagus, esophageal cancer, achalasia of esophagus). There was noted an esophageal rupture of lower third part of esophagus in 14 cases. These complications were diagnosed in all cases and the patients underwent an operation. There was performed the opening and drainage of the mediastinum in order to prevent mediastinitis. Complications had one patient in postoperative period. There wasn't observed lethal outcome.
Subject(s)
Esophageal Perforation , Esophagoscopy/adverse effects , Esophagus , Intraoperative Complications , Mediastinitis , Wound Closure Techniques , Drainage/methods , Esophageal Perforation/complications , Esophageal Perforation/diagnosis , Esophageal Perforation/etiology , Esophageal Perforation/surgery , Esophagoscopy/methods , Esophagus/diagnostic imaging , Esophagus/injuries , Female , Humans , Intraoperative Complications/diagnosis , Intraoperative Complications/surgery , Male , Mediastinitis/etiology , Mediastinitis/prevention & control , Mediastinum/diagnostic imaging , Mediastinum/surgery , Middle Aged , Outcome and Process Assessment, Health Care , Postoperative Complications/diagnosisABSTRACT
The Capgras syndrome is one of delusional-like misidentification syndrome in which a person holds a delusion that one or several his/her friends or relatives have been replaced by an identical-looking impostor. As any other delusional disorder, the Capgras syndrome is characterized by stability despite the indisputable arguments against fault views. Initially, this syndrome was considered as a presentation of schizophrenia but later it has been described in brain organic disorders, primarily in elderly patients with dementia.
Subject(s)
Capgras Syndrome , Dementia/etiology , Schizophrenia, Paranoid/etiology , Capgras Syndrome/complications , Capgras Syndrome/diagnosis , Capgras Syndrome/psychology , Dementia/diagnosis , Dementia/psychology , Diagnosis, Differential , Humans , Schizophrenia, Paranoid/diagnosis , Schizophrenia, Paranoid/psychologyABSTRACT
Current concepts on the clinical presentations, diagnosis and treatment of dementia with Lewy bodies (DLB), that makes up 10% percent of dementia cases, are considered. The nosological status of DLB and the correlation between DLB and Parkinson's disease are reviewed in the historical context. The authors suggest approaches to the formulation of diagnosis and coding of DLB in according to ICD-10. A role of cholinesterase inhibitors, antipsychotic drugs, levodopa, razagiline and other drugs in the treatment of DLB is analyzed.
Subject(s)
Lewy Body Disease , Humans , Lewy Bodies/pathology , Lewy Body Disease/classification , Lewy Body Disease/diagnosis , Lewy Body Disease/drug therapy , Lewy Body Disease/pathology , Parkinson Disease/classification , Parkinson Disease/pathologyABSTRACT
Hashimoto's encephalopathy is an autoimmune inflammatory disease of the brain associated with the production of antithyoid antibodies. The case described in this article illustrates the diversity of clinical presentations of the disease that mimic symptoms of some neurological and mental disorders, difficulties of diagnosis and, at the same time, the importance of the timely diagnosis of this severe but curable disease. Diagnostic criteria of encephalopathy allowing the avoidance of both hypo- and hyper diagnosis of this disease are considered. The authors present the current tactics of its treatment based on the use of corticosteroids and other immunotropic drugs.
Subject(s)
Brain Diseases/diagnosis , Hashimoto Disease/diagnosis , Brain Diseases/complications , Brain Diseases/drug therapy , Encephalitis , Female , Hashimoto Disease/complications , Hashimoto Disease/drug therapy , Humans , Magnetic Resonance Imaging , Mental Disorders/diagnosis , Mental Disorders/etiology , Middle AgedSubject(s)
Antipsychotic Agents/adverse effects , Parkinson Disease, Secondary/chemically induced , Parkinson Disease, Secondary/diagnosis , Anticonvulsants/administration & dosage , Anticonvulsants/adverse effects , Antipsychotic Agents/administration & dosage , Calcium Channel Blockers/administration & dosage , Calcium Channel Blockers/adverse effects , Cinnarizine/administration & dosage , Cinnarizine/adverse effects , Diagnosis, Differential , Dopamine Antagonists/administration & dosage , Dopamine Antagonists/adverse effects , Humans , Metoclopramide/administration & dosage , Metoclopramide/adverse effects , Valproic Acid/administration & dosage , Valproic Acid/adverse effectsSubject(s)
Lewy Body Disease/complications , Parkinson Disease/complications , Psychotic Disorders/diagnosis , Psychotic Disorders/etiology , Antiparkinson Agents/therapeutic use , Humans , Lewy Body Disease/drug therapy , Lewy Body Disease/psychology , Parkinson Disease/drug therapy , Parkinson Disease/psychology , Psychotic Disorders/drug therapyABSTRACT
An open 10-day study of treatment effect of cereton in comparison to piracetam has been conducted. Cereton was used in 40 patients (main group) in dosage 1000 mg, piracetam - in 20 patients (control group) in dosage 2000 mg. Both drugs were used intravenous in drops in 200 ml of physiologic saline along with antiparkinsonian medications. Patient's state was assessed with a battery of psychometric scales and neuropsychological tests as well as with instruments for measuring intensity of parkinsonian symptoms, side-effects and quality of life. Marked and moderate improvement of cognitive functions was found in patients of the main group compared to the control one (40% and 25%, respectively, p<0,05). Deterioration of cognitive functions was seen less often in the main group than in the control group (5% and 15%, respectively, p<0,05). Cereton was well-tolerated by patients. Side effects (brief and short-term) were found only in 6 (15%) patients.
