Cochrane library, Год журнала: 2024, Номер 2024(1)
Опубликована: Янв. 26, 2024
Язык: Английский
npj Parkinson s Disease, Год журнала: 2022, Номер 8(1)
Опубликована: Март 24, 2022
Abstract Growing evidence suggests an increasing significance for the extent of gastrointestinal tract (GIT) dysfunction in Parkinson’s disease (PD). Most patients suffer from GIT symptoms, including dysphagia, sialorrhea, bloating, nausea, vomiting, gastroparesis, and constipation during course. The underlying pathomechanisms this α-synucleinopathy play important role development progression, i.e., early accumulation Lewy pathology enteric central nervous systems is implicated pharyngeal discoordination, esophageal gastric motility/peristalsis impairment, chronic pain, altered intestinal permeability autonomic colon, with subsequent constipation. Severe complications, malnutrition, dehydration, insufficient drug effects, aspiration pneumonia, obstruction, megacolon, frequently result hospitalization. Sophisticated diagnostic tools are now available that permit more detailed examination specific impairment patterns. Furthermore, novel treatment approaches have been evaluated, although high-level trials often missing. Finally, burgeoning literature devoted to microbiome reveals its importance neurologists. We review current knowledge about pathoanatomy, pathophysiology, diagnosis, PD provide recommendations management daily practice.
Язык: Английский
Процитировано
113
Neurological Research and Practice, Год журнала: 2021, Номер 3(1)
Опубликована: Май 3, 2021
Abstract Introduction Neurogenic dysphagia defines swallowing disorders caused by diseases of the central and peripheral nervous system, neuromuscular transmission, or muscles. is one most common at same time dangerous symptoms many neurological diseases. Its important sequelae include aspiration pneumonia, malnutrition dehydration, affected patients more often require long-term care are exposed to an increased mortality. Based on a systematic pubmed research related original papers, review articles, international guidelines surveys about diagnostics treatment neurogenic dysphagia, consensus process was initiated, which included experts from 27 medical societies. Recommendations This guideline consists 53 recommendations covering in its first part whole diagnostic spectrum specific history, initial screening clinical assessment, refined instrumental procedures, such as flexible endoscopic evaluation swallowing, videofluoroscopic study high-resolution manometry. In addition, scenarios captured, among others management with nasogastric tracheotomy tubes. The second this dedicated dysphagia. Apart dietary interventions behavioral treatment, improve oral hygiene, pharmacological options, different modalities neurostimulation well minimally invasive surgical therapies dealt with. Conclusions diagnosis challenging requires joined effort professions. While evidence supporting implementation rather convincing, further trials needed quality for methods and, particular, options present article abridged translated version recently published online ( https://www.awmf.org/uploads/tx_szleitlinien/030-111l_Neurogene-Dysphagie_2020-05.pdf ).
Язык: Английский
Процитировано
67
Neurotherapeutics, Год журнала: 2020, Номер 17(4), С. 1464 - 1479
Опубликована: Авг. 13, 2020
Язык: Английский
Процитировано
51
Journal of the Neurological Sciences, Год журнала: 2021, Номер 430, С. 120008 - 120008
Опубликована: Сен. 27, 2021
Dysphagia is common in Parkinson's disease (PD). The effects of antiparkinsonian drugs on dysphagia are controversial. Several treatments for available but there no consensus their efficacy PD.To conduct a systematic review the literature and to define statements treatment PD related nutritional management.A multinational group experts field neurogenic and/or conducted evaluation reported results according PRISMA guidelines. evidence from retrieved studies was analyzed discussed conference organized Pavia, Italy, were drafted. final version subsequently achieved by e-mail consensus.The 64 papers nutrition patients with dysphagia, mainly Class IV quality. Based expert opinion cases where limited or lacking, 26 developed.The developed Consensus panel provide guidance multi-disciplinary PD, involving neurologists, otorhinolaryngologists, gastroenterologists, phoniatricians, speech-language pathologists, dieticians, clinical nutritionists.
Язык: Английский
Процитировано
50
Journal of Neurology, Год журнала: 2021, Номер 269(3), С. 1335 - 1352
Опубликована: Авг. 21, 2021
Abstract Background Parkinson’s disease (PD) is a neurodegenerative disorder characterized by combination of motor and non-motor dysfunction. Dysphagia common symptom in PD, though it still too frequently underdiagnosed. Consensus lacking on screening, diagnosis, prognosis dysphagia PD. Objective To systematically review the literature to define consensus statements screening diagnosis as well impact quality life (QoL) PD patients. Methods A multinational group experts field neurogenic and/or conducted systematic revision published since January 1990 February 2021 reported results according PRISMA guidelines. The output research was then analyzed discussed conference convened Pavia, Italy, where were drafted. final version subsequently achieved e-mail consensus. Results Eighty-five papers used inform Panel’s even most them Class IV quality. tackled four main areas: (1) dysphagia: timing tools; (2) clinical instrumental detection, severity assessment; (3) QoL: (4) prognostic value dysphagia; outcome role associated conditions. Conclusions elaborated Panel provide framework guide neurologist timely detection accurate
Язык: Английский
Процитировано
46
Expert Review of Gastroenterology & Hepatology, Год журнала: 2020, Номер 14(6), С. 411 - 424
Опубликована: Июнь 2, 2020
Introduction Bulbar dysfunction is common in Parkinson's disease (PD) with more than 80% of affected individuals developing dysphagia during the course disease. Symptoms can begin preclinical stage and may remain clinically asymptomatic for years. Furthermore, patients be unaware swallowing changes, which contributes to difference between prevalence self-reported deficits identified instrumental evaluations. Dysphagia underrecognized development aspiration pneumonia leading cause death PD. PD complex not completely understood. Both dopaminergic nondopaminergic pathways likely underpin dysphagia.Areas covered This comprehensive review will cover epidemiology, pathophysiology, clinical evaluation, expert management PD.Expert Opinion A multidisciplinary team approach important properly identify manage dysphagia. Regular screenings objective assessments are necessary early detection Studies needed better understand mechanism(s) involved dysphagia, establish markers progression, develop evidence-based treatment options.
Язык: Английский
Процитировано
37
Oral Surgery Oral Medicine Oral Pathology and Oral Radiology, Год журнала: 2025, Номер unknown
Опубликована: Фев. 1, 2025
Язык: Английский
Процитировано
0
European manual of medicine, Год журнала: 2025, Номер unknown, С. 405 - 458
Опубликована: Янв. 1, 2025
Язык: Английский
Процитировано
0
npj Parkinson s Disease, Год журнала: 2022, Номер 8(1)
Опубликована: Ноя. 12, 2022
Abstract Dysphagia is common in Parkinson’s disease (PD) and assumed to complicate medication intake. This study comprehensively investigates dysphagia for its association with motor complications PD. Based on a retrospective analysis, two-dimensional graduated classification of was introduced differentiating swallowing efficiency safety. In subsequent prospective study, sixty-six PD patients underwent flexible endoscopic evaluation swallowing, which included the 2 tablets capsules different sizes. present nearly 70% predicted according MDS-UPDRS-part-IV linear regression model. Capsules tended be swallowed more efficiently compared tablets, irrespective size. A score ≥1 swallow-related-MDS-UPDRS-items can considered an optimal cut-off predict medication. Swallowing impairment oral may predispose complications.
Язык: Английский
Процитировано
14
International Journal of Pharmaceutics, Год журнала: 2023, Номер 643, С. 123218 - 123218
Опубликована: Июль 18, 2023
3D printing offers the possibility to prepare personalized tablets on demand, making it an intriguing technology for hospital pharmacies. For implementation of 3D-printed into digital Closed Loop Medication Management system, required tablet formulation and development manufacturing process as well pharmaceutical validation were conducted. The goal was enable optimal rapid dissolution printed selected model drugs Levodopa ⁄ Carbidopa. prepared by direct powder extrusion. Printability, thermal properties, disintegration, dissolution, physical properties storage stability investigated employing analytical methods such HPLC-UV, DSC TGA. developed shows a high dose accuracy immediate drug release Levodopa. In addition, exhibit crushing strength very low friability. Unfortunately, Carbidopa did not tolerate process. This is first study develop excipient composition via extrusion in pharmacy setting. suitable Closed-Loop systems pharmacies could therefore contribute medication safety.
Язык: Английский
Процитировано
8