nhs again

'Services fail' on Parkinson's

Parkinson's is a degenerative condition that affects the brain Some Parkinson's disease patients are going for years without seeing a specialist doctor or nurse, according to a parliamentary report. The All Party Parliamentary Group for Parkinson's Disease heard from hundreds of patients and care organisations. Its inquiry found inequalities in access to care and discrepancies across the country - with serious shortfalls in Wales and Northern Ireland. It urged a thorough review of services to ensure patients get what they need. Parkinson's disease is a chronic neurological condition which affects around 120,000 people in the UK. It disturbs the way the brain co-ordinates body movements, including walking, talking and writing. RECOMMENDATIONS: Parkinson's 'tsar' in government Monitoring of Parkinson’s services Ensuring enough qualified staff in place Access to specialist doctors has been a problem across the country, but the inquiry heard that in Northern Ireland there is not a single consultant with expertise in Parkinson's. Appointments with specialists were crucial, experts warned, particularly given the high rate of misdiagnosis and the subsequent implications for treatment. Many people with Parkinson's and their carers told the panel of MPs and peers how much they valued the services of specialist nurses. But despite research suggesting these nurses saved the NHS money by cutting down hospital visits and providing support in the home, there were "sizable shortfalls". Some people in Wales, for example, had no access at all to a nurse, while others had to travel to Liverpool for help. Capped therapy Meanwhile treatments were restricted in some areas. Deep Brain Stimulation (DBS) is seen as an effective way of improving physical ability and reducing tremors, but the inquiry reported examples of trusts with no, or very limited funding for the procedure. Provision of speech and language therapy was also found to be seriously wanting, particularly for those living away from major hospital centres. Again there were significant regional variations. In the north west of England, the proportion of people who had never had an assessment or course of therapy - be it diet, physio, or speech and language - was higher than in the rest of the country. Carers also reported a lack of support, with many describing a "feeling of abandonment and loneliness". Steve Ford, Chief Executive of the Parkinson's Disease Society said: "The report uncovers just how bad services are for so many people with Parkinson's. This needs to change. "We want to see effective monitoring of Parkinson's services to ensure they meet national guidelines and standards, an urgent review of the health and social care workforce, and stronger national and local leadership by government. "Why is it that some conditions have these - for example a 'tsar' within government - and other conditions like Parkinson's don't?" Baroness Gale, chair of the APPG for Parkinson's Disease said: "We hope that the APPG Inquiry report released today will provide the boost to the UK government and the devolved administrations in Wales and Northern Ireland to reprioritise Parkinson's and to deliver against the report's recommendations." Health Minister Ann Keen said medical staff in the field of neurology had increased by more than 50% since 1997 and that guidelines on how to establish multi-disciplinary neurological teams had been published by the Department of Health. "These measures, along with the continual work we are doing with local health and social care communities and the third and voluntary sector, will help people with Parkinson's disease to manage their condition and maintain their independence and quality of life.

dr.parkinson

The origins of the shaking palsy

Michael J Fox of Back to the Future fame has Parkinson's Diseasehttp://www.richimag.co.uk/parkinsons/

Dr James Parkinson was better known in his time for his work on fossils than for his essay on "the shaking palsy".

But it was this that would make his name famous around the globe two centuries after he was born.

The multi-talented GP is the name behind Parkinson's disease, the progressive neurological disorder whose sufferers include Muhammad Ali and film star Michael J Fox.

It can affect all aspects of a person's life and occurs when cells in the part of the brain which controls movement are lost.

Shaking palsy

Born in London in 1755, Dr Parkinson studied Latin, Greek, natural philosophy and shorthand - subjects which he considered as important basic tools for a physician.

His father was a GP and he took over his practice.

Dr Parkinson was by no means a typical GP. He had wide-ranging interests and, in his day, was probably better known for his three volume work on fossils than for his essay on the "shaking palsy".

Other medical works included a treatise on gout and he also published books on social, political and geological subjects.

He was extremely interested in bringing medicine to the masses and published a selection of self-help manuals aimed at encouraging people to adopt better sanitary standards.

His political beliefs were fairly revolutionary.

At a time when the French revolution was taking place, he advocated universal suffrage and an annual parliament.

However, it is for his "Essay on the shaking palsy", published in 1817 - 11 years before his death, that he has become universally known.

Symptoms

He was the first person to make an accurate description of the disorder which affects one in 500 people in the UK.

Its symptoms include shaking, slowness of movement and muscle stiffness.

Despite Dr Parkinson's success in describing the condition, his work was only recognised by French neuropathologist Dr Jean Martin Charcot 60 years after it was first published.

And it was not until the second half of the 20th century that scientists discovered what caused the disease.

They found that the lack of a chemical messenger called dopamine was responsible.

The symptoms of Parkinson's only appear after the death of 80% of the cells which produce dopamine which is linked to co-ordination.

Currently, the condition is treated with drugs which mimic the action of the chemical messengers.

Patients also often turn to alternative therapies. For example, massage has been found to be very helpful in the treatment of the disease.

Liz Cockerill, who has Parkinson's, told Radio Four's A Name to Remember programme: "It has been a life saver for me. Otherwise my muscles would just seize up."

In the last few years, there have been significant advances in the treatment of late stage Parkinson's.

For example, dopamine can now be injected and pacemakers have been fitted into some patients' brains with interesting results.

Some doctors predict there could be a cure or a preventive treatment for the disease in the next 20 years once scientists understand its genetic and environmental triggers.

They believe "a window of opportunity" exists between the time the cells start dying and the time symptoms begin to show.

This week has been named Parkinson's Awareness Week by the Parkinson's Disease Society

Parkinson's linked to insecticide

Parkinson's linked to insecticide use

Parkinson's causes muscle tremor

Exposure to insecticides in the home may double a person's risk of developing Parkinson's disease, say researchers.

Scientists suspect insecticide chemicals damage nerve cells in a vulnerable region of the brain, but cannot fully explain the link.

Certain chemicals that an individual is exposed to in the environment may cause selective death of brain cells

Dr Lorene Nelson, Stanford University

Dr Lorene Nelson and colleagues at the Stanford University School of Medicine, Palo Alto, California, questioned 496 people newly diagnosed with Parkinson's disease about their past use of pesticides, herbicides and fungicides in the home and garden.

Another group of 541 people without the disease were asked similar questions and the two sets of answers compared.

Use of insecticides at home was associated with the greatest risk of developing the disease. Parkinson's patients were more than twice as likely to have been exposed to the chemicals than the healthy participants.

There was also an association with herbicides. However, exposure to insecticides in the garden, and fungicides, were not found to be risk factors.

The findings were presented at the American Academy of Neurology's annual meeting in San Diego, California.

Association

Dr Nelson said: "It is the first study to show a significant association between home pesticide use and the risk of developing Parkinson's disease.

"Certain chemicals that an individual is exposed to in the environment may cause selective death of brain cells or neurons."

Damage to nerve cells in a part of the brain called the basal ganglia leads to the muscle tremor and stiffness characteristic of the disease.

Parkinson's is caused when brain cells that produce an important neurotransmitter, or message-carrying chemical, are destroyed.

Dr Nelson said. "If we could understand why these neurons are being killed in certain circumstances, we can then try and prevent it."

Professor Adrian Williams, chairman of the Parkinson Disease Society's medical advisory panel, said: "This is the latest in a line of research which shows a suspected but as yet unproven link between pesticide exposure and development of Parkinson's disease.

"We welcome any further research on this subject."

parkinsons who gets it

Jobs 'linked to Parkinson's'

Mechanics are one of the at risk groups http://www.richimag.co.uk/parkinsons/

People who work with solvents such as petrol or rubber have a high risk of developing Parkinson's disease, according to a study.

They are also more likely to show symptoms of the disease early in life and risk developing a more severe form of the disease than those who do not work with solvents.

The study, carried out by researchers in Italy, suggests that the risks are greatest among people who work with hydrocarbon solvents.

These solvents are found in common petroleum-based products such as paints, glues and rubber.

As a result, the researchers suggest that painters, mechanics and printers are some of the most "at risk" jobs.

"Risky" jobs

Mechanics Printers Painters People working with petroleum, rubber or plastic

Others at risk of developing the disease are people working with petroleum, rubber and plastic.

Doctors at the Parkinson Institute in Milan studied almost 1,000 patients with the disease.

It found that people who had worked with hydrocarbon solvents were likely to develop symptoms of Parkinson's three years before somebody who did not.

They also revealed that the severity of the disease was greatest among those who worked in "at risk" jobs.

The study found that most of those who had been exposed to hydrocarbon were mostly male and less educated than those who were not exposed.

The doctors said their findings showed a need for further research.

Dr Gianni Pezzoli, of the Parkinson Institute, said the study raised serious questions.

Further study call

"These findings raise serious questions about specific occupational risk.

"This study more than merits further investigation into job-related Parkinson's risk factors."

Parkinson's disease is generally regarded as a brain disorder.

It is a progressive disease which attacks the part of the brain which controls movement.

Drugs are currently used to treat the disease but their success is limited and the side-effects can be significant.

There is no cure and treatments only last a few years.

The symptoms are caused by the loss of cells in a certain part of the brain that produce dopamine - an important message-carrying chemical or neurotransmitter linked with movement.

But no one has been able to find out why those cells get destroyed in the first place.

Around 120,000 people in the UK have Parkinson's disease

parkinsons cure

Hope of Parkinson's 'cure'

Parkiinson's causes shaking and muscle stiffness http://www.richimag.co.uk/parkinsons/index.html

Scientists have successfully reversed the spread of Parkinson's disease in monkeys.

The results have raised hopes that scientists could be close to stopping the disease in humans.

Researchers from the US and Switzerland used gene therapy techniques to reverse damage in the brains of monkeys caused by Parkinson's.

They used a special virus to boost nutrients in the brain. These nutrients increase the production of dopamine.

This study suggests a new approach to forestall disease progression in newly diagnosed patients

Dr Jeffrey Kordower

Dopamine sends signals in the brain to help individuals move smoothly and normally. The loss of dopamine has been linked to the symptoms of associated with Parkinson's.

Parkinson's is a brain disease and causes severe difficulty in performing movements including walking, talking, swallowing and smiling. This causes sufferers to shake and experience muscle stiffness.

Each person with Parkinson's is affected differently and to different degrees. Their ability to perform movements may vary from one day to the next.

Sufferers eventually die from secondary complications such as pneumonia, urinary tract infection, pressure sores, septicaemia and stroke.

The condition is treated with drugs and there is no cure. It affects around 120,000 people in the UK.

It usually strikes people between the ages of 50 and 60 although it can also affect younger people.

Latest research

This latest research was carried out on two groups of monkeys. The first group involved eight older monkeys with early Parkinson's disease. The second included younger monkeys with no signs of the condition.

The first group received six injections of the special virus called lenti-GDNF to boost nutrients in their brain.

After three months the level of dopamine in their brains had dramatically increased and were similar to those found in younger monkeys.

The second group were injected with a chemical to cause Parkinson's disease. They developed the condition but this was reversed once they received lenti-GDNF.

Dr Jeffrey Kordower, from Rush Presbyterian St Luke's Medical Centre and one of those involved in the study, said: "By giving GDNF, we can stimulate dopamine production and prevent both the structural and functional consequences of cell degeneration that are characteristic of Parkinson's disease."

The scientist are hoping to use this special virus on humans in clinical trials within five years. The virus was developed by researchers at the Lausanne University in Switzerland.

Dr Kordower added: "This study suggests a new approach to forestall disease progression in newly diagnosed Parkinson's disease patients.

dardarin/parkinsons

Target found for Parkinson's test

A gene mutation which could be behind one in 25 cases of Parkinson's disease has been discovered by scientists. It is hoped the findings could lead to the earlier detection of the disease and the development of treatments. Three separate studies by US, UK and Dutch research teams are published in The Lancet medical journal. Parkinson's, for which there is no cure, is a degenerative disease in the part of the brain controlling movement and affects 3% of people over 75. 'Dardarin' protein Each of the three studies looked at genetic faults in the LRRK2 gene. It controls the action of a protein named dardarin by researchers, after the Basque word dardara, which means tremor. Scientists do not yet fully understand what the protein's intended function is. This could lead to new improved treatments and potentially a cure for some people with the condition Linda Kelly, Parkinson's Disease Society The mutation of the gene, found on a region of chromosome 12, is called PARK8. It was identified in a study of five families with a history of Parkinson's disease who lived in the Basque region of northern Spain, and in England The US study, by scientists from Indiana University and Cincinnati Children's Hospital, involved 767 Parkinson's disease patients from 358 families across America. It was found that 34, or just under 5%, of patients carried the same gene mutation. In an Institute of Neurology study, 482 people from families without a known history of Parkinson's were studied and eight were found to have the same mutation. In the third study, by researchers from Erasmus MC in the Netherlands, the mutation was present in four out of 61 families with a history of Parkinson's disease. From the results of all three studies the researchers concluded that the mutation appears to be responsible for up to 5% of Parkinson's in people with a family history of the disorder and up to 2% of cases in people who do not have a family history of the disease. 'New treatments' Andrew Singleton, of the National Institute of Aging's said: "Knowing that this mutation is not only important in familial forms of disease, but in typical sporadic disease, where there is no strong family history, could lead to earlier detection of Parkinson's disease. "Further study of how this gene works also might help scientists identify new treatments." Dr William Nichols, of the Cincinnati Children's Hospital suggested screening for the mutation would soon become a key part of genetic testing for Parkinson's. And Linda Kelly, the chief executive of the UK's Parkinson's Disease Society, said: "If further research could uncover why this leads to neurodegeneration and the symptoms of Parkinson's then this could lead to new improved treatments and potentially a cure for some people with the condition.

parkinsons

Depression risk with Parkinson'shttp://www.richimag.co.uk/parkinsons/

Parkinson's disease is a degenerative, neurological condition Over 80% of people with Parkinson's disease frequently experience depression, a European survey finds. But the poll of 500 patients with mild-to-moderate forms of the disease found 40% rarely - or never - talked to their doctors about depression. And two thirds of doctors polled said they considered other symptoms were more important than depression. But Parkinson's experts said depressive symptoms were as important as motor problems for people with the disease. In many cases, it's not the symptoms that one normally associates with Parkinson's disease that cause the most distress Mary Baker, European Parkinson's Disease Association Around one in 500 people in the UK have Parkinson's disease. Around 10,000 new cases are diagnosed annually, with one in 20 affected someone under 40. The most well-known symptom is tremors in the arms and legs. But depression can stem from people's feelings about their condition, or as another symptom caused by the neurological effects of the disease. This survey covered patients in France, Germany, Italy, Spain and the UK. Normal outlook 'difficult' Researchers also spoke to 500 specialist doctors in the same countries. Virtually all said the majority of their patients "often" or "sometimes" experienced symptoms of depression. But 49% said such symptoms were difficult to recognise. Doctors said the main reason they did not discuss depression was that they felt that patients did not rate these symptoms as being as important as other aspects of their condition. But patients said depression was almost as significant for them as movement problems. Mary Baker, president of the European Parkinson's Disease Association, said: "This survey has confirmed what we've been hearing from people with PD, and the people who care for them, for some time. "In many cases, it's not the symptoms that one normally associates with Parkinson's disease that cause the most distress. "When your mood is affected, it can be very difficult to maintain a normal outlook on life." She added: "Those who are caring for people with PD often report that seeing their loved one feeling depressed is one the hardest aspects of the condition to deal with."