ABSTRACT
OBJECTIVE: To evaluate swimming disorders in patients with Parkinson's disease (PD). MATERIAL AND METHODS: During the pilot study, we examined 40 patients with PD, who were divided into two groups depending on the presence or absence of swimming disorders. The assessment on the Hoehn-Yahr scale in both groups ranged from 1 to 3. The severity of PD was assessed according to the unified Parkinson's disease scale of the International Society of Movement Disorders (MDS-UPDRS). The Montreal Cognitive Assessment Scale, the Hospital Scale of Anxiety and Depression, a new questionnaire of freezing when walking, a 6-minute walk test, the Eysenck Personality Questionnaire were administered. RESULTS: Of 40 patients with PD, 60% reported swimming disorders. No association was found between swimming disorders and the severity of motor symptoms of PD. At the same time, an increased level of anxiety was noted in the group of patients with swimming disorders. CONCLUSION: Further research is needed to study the mechanisms of the development of swimming disorders in PD.
Subject(s)
Parkinson Disease , Humans , Parkinson Disease/diagnosis , Swimming , Pilot Projects , Psychiatric Status Rating Scales , Surveys and QuestionnairesABSTRACT
For a long time it was believed that respiratory disorders (RD) in Parkinson's disease (PD) are rare. However, the situation has changed dramatically over the past 10 years. Thus, special studies have revealed RD in almost half of patients with PD. The paper presents: a literature review, classification of RD in PD, various mechanisms of their development and general approaches to their treatment. Classification of RD in PD is presented.
Subject(s)
Parkinson Disease , Respiratory Insufficiency , Humans , Parkinson Disease/complications , Respiratory Insufficiency/etiologyABSTRACT
The results of individual observations and several studies confirm the frequent complaints of patients with Parkinson's disease (PD) about difficulty or inability to swim. Difficulties moving the limbs, coordination and maintaining the horizontal position during swimming appear to be the main problems that prevent normal swimming. Further studies are needed to assess the frequency of swimming disorders in PD and the mechanisms of their development. Patients with PD must be educated about the potential risk of drowning and the need to evaluate and carefully monitor their swimming skills before going into deep water.
Subject(s)
Drowning , Parkinson Disease , Humans , Parkinson Disease/complications , SwimmingABSTRACT
Chronic kidney disease (CKD) is characterized by poor outcomes, an increasing frequency of new cases, the need for expensive method of renal replacement therapy at the terminal stage. The main task facing the doctor is slowing the progression of CKD and delay the start of dialysis by applying the nephroprotective strategy, of which diet therapy is an essential part. The key components of the diet for CKD patients are reducing sodium intake to 2.3 g per day in order to improve control of blood pressure (BP), dietary protein restriction adequate to renal function from 0.8 to 0.3 g/kg of body weight per day combined with the prescribing of ketoanalogues of essential amino acids, hyperglycemia control. With the progression of CKD, the main objectives of the diet therapy are the prevention/correction of complications: protein-energy waisting, metabolic acidosis, ensuring sufficient calories, corresponding to the bodys energy expenditures (3035 kcal/kg of body weight per day), limiting phosphate intake to 0.81 g a day, restriction of food potassium. Low-protein diet in combination with ketoanalogues of amino acids, regular monitoring and correction of the nutritional status of patients at the pre-dialysis stages of CKD is an effective and safe method of nephroprotection, which allows delaying the start of dialysis.
Subject(s)
Renal Insufficiency, Chronic , Dialysis , Diet, Protein-Restricted , Humans , Nutritional Status , Nutritional Support , Renal Dialysis , Renal Insufficiency, Chronic/therapyABSTRACT
Preservation of visual functions in patients with chiasmo-sellar region compression (CSRC) is possible with early diagnosis and surgical decompression. PURPOSE: To analyze the parameters of optical coherence tomography (OCT) and optical coherence tomography-angiography (OCTA) in patients with CSRC. MATERIAL AND METHODS: The study included 10 patients (20 eyes) with CSRC, 15 healthy volunteers (30 eyes). OCT, OCTA was performed on Cirrus HD-OCT 5000 AngioPlex™ (Carl Zeiss Meditec, U.S.A.) with AngioVue system. RESULTS: Patients with CSRC were revealed to have decreased thickness of ILM-RPE in the nasal sector of outer circle (p<0.001) and average mGCIPL - total and for all six sectors (p<0.001), decreased RNFL in the inferior sector (p=0.017); decreased superficial vessel density (SVD) and perfusion density in the inner and outer circle areas and in all sectors of the ETDRS grid (p<0.001) except temporal; in the peripapillary area, decreased vessel perfusion density (VPD) in the inferior sector (p=0.025), capillary flux index (CFI) in all sectors (p<0.001; p=0.025 in the inferior sector). Informative diagnostic criteria included ILM-RPE in nasal sector of the outer circle (AUC=0.896); mGCIPL in the inferonasal sector (AUC=0.914), average (AUC=0.846), superior (AUC=0.829) and superonasal (AUC=0.846) sectors; average SVD (AUC=0.805) and SVD in the inner circle area (AUC=0.810); CFI in the inferior sector (AUC=0.806) with p<0.001. CONCLUSION: In CSRC, changes can be seen in OCT and OCTA parameters recorded in the macular and peripapillary regions before the changes in the central visual field. Informative diagnostic OCT and OCTA criteria can help diagnose the pathology early, expand the indications for decompression, and preserve the visual funcitons.
