Facilitating Communication with Diverse Teams

Non- hierarchical communication structures are associated with greater clarity across all levels. These structures can be implemented in a variety of ways under different circumstances. A variety of communication processes should be implemented to improve communication with individualizing the technique to the type of information being communicated

Norepinephrine: the next therapeutics frontier for Parkinson\u27s disease

Abstract Tissue concentrations of norepinephrine (NE) are markedly decreased in various regions of the Parkinson\u27s disease (PD) brain. As in the substantia nigra pars compacta, neuronal dropout and Lewy bodies are prominent changes affecting the locus coeruleus, which is the source of ascending NErgic projections. Despite the major roles of NE throughout the brain, there has been only minimal exploration of pharmacological intervention with NErgic neurotransmission. Cognitive operations, freezing of gait, tremor, dyskinesia, REM sleep regulation, and other aspects of brain function are tied into signaling by NE, and there is also evidence that it may have a role in the neurodegenerative process itself. This article reviews the reported pharmacological experience in PD therapeutics

Sources of Cardiovascular Health Information and Channels of Health Communication Among Urban Population in Nigeria

This study employed mixed methods to investigate the preferred sources of health information and later explored the views of community healthcare workers on the enablers, barriers and ways of overcoming barriers to health communication. The study found that majority of the participants preferred their source of CV (cardiovascular) health information from the healthcare workers including the medical doctors, nurses, and pharmacists. On the other hand, the least preferred source of health information was from friends, family members, and community leaders. Some of the identified enablers to community health communication include awareness programme via Non-Governmental Organisations (NGOs), community-based organisations such as faith-based organisations and healthcare facilities. Others are traditional media and social media. The identified barriers to community-based health communication include lack of knowledge and poverty, language barriers, and other miscellaneous issues including misuse of internet, lack of basic amenities and religious beliefs. The community-based healthcare providers articulated ways to overcome the identified barriers, including enlightenment programmes, using the language of the target audience, funding health awareness programmes, and monitoring of health education interventions. This study concludes that dissemination of health information using numerous channels is essential in ensuring population-wide primary prevention of diseases

The role of Insulin-like Growth Factors (IGFs) and IGF-binding proteins in the nervous system

The insulin-like growth factors (IGF-I and IGF-II) and their receptors are widely expressed in nervous tissue from early embryonic life. They also cross the blood brain barriers by active transport, and their regulation as endocrine factors therefore differs from other tissues. In brain, IGFs have paracrine and autocrine actions that are modulated by IGF-binding proteins and interact with other growth factor signalling pathways. The IGF system has roles in nervous system development and maintenance. There is substantial evidence for a specific role for this system in some neurodegenerative diseases, and neuroprotective actions make this system an attractive target for new therapeutic approaches. In developing new therapies, interaction with IGF-binding proteins and other growth factor signalling pathways should be considered. This evidence is reviewed, gaps in knowledge are highlighted, and recommendations are made for future research

Levodopa therapy for Parkinson disease: A look backward and forward

Although levodopa is widely recognized as the most effective therapy for Parkinson disease (PD), its introduction 5 decades ago was preceded by several years of uncertainty and equivocal clinical results. The translation of basic neuroscience research by Arvid Carlsson and Oleh Hornykiewicz provided a logical pathway for treating PD with levodopa. Yet the pioneering clinicians who transformed PD therapeutics with this drug--among them Walther Birkmayer, Isamu Sano, Patrick McGeer, George Cotzias, Melvin Yahr, and others--faced many challenges in determining whether the concept and the method for replenishing deficient striatal dopamine was correct. This article reviews highlights in the early development of levodopa therapy. In addition, it provides an overview of emerging drug delivery strategies that show promise for improving levodopa\u27s pharmacologic limitations

A case of Rhizopus infection in an immunocompetent IVDA host

Introduction: Mucormycosis is a rare fungal infection most commonly seen in patients with neutropenia, diabetic ketoacidosis, or prolonged use of corticosteroids. Here we present an unusual case of isolated cerebral mucormycosis in a young, immunocompetent patient. Case: A 36 year-old female with chronic Hepatitis C and intravenous drug abuse (IVDA) presented with sudden hemiparesis of the left upper and lower extremities. Her Glasgow Coma Scale was 15. MRI brain revealed a gadolinium-enhancing lesion adjacent to the right basal ganglia and thalamus consistent with an abscess, with surrounding vasogenic edema, mass effect causing right-to-left midline shift involving her right lateral ventricle (Figures 1 and 2). The abscess was surgically debrided and biopsy of the lesion revealed multinucleated giant cells and scattered groupings of branching fungal forms consistent with Rhizopus oryzae infection. Her remaining infectious and immunologic workup was unremarkable, including undetectable Hepatitis C RNA and absent HIV antibodies. During her hospital course, she exhibited new neurological findings including right lateral gaze palsy, left facial weakness, left hemi-neglect, and left ankle clonus. This was attributed to worsening vasogenic edema despite a medical regimen including IV amphotericin B and anidulafungin. Subsequently, isavuconazole was added. She continued on this regimen for four weeks after her initial debridement and was discharged to an in-patient rehabilitation center. On follow up examinations, she has exhibited gradual improvement in her strength, however she continues to have visual field deficits and requires assistance with activities of daily living. Discussion: Mucormycosis is a rare, life-threatening fungal infection predominantly affecting immunocompromised hosts. The most significant risk factors for this infection include diabetic ketoacidosis, neutropenia, prolonged high-dose glucocorticoid therapy, bone marrow or solid organ transplantation, iron overload, and IVDA. Clinical presentation often reflects underlying risk factors for disease. For example, diabetic patients are likely to present with sinus involvement whereas patients with transplanted organs and malignancy more commonly present with pulmonary infection. Disseminated disease is most commonly seen in patients in an iron-overloaded state or those treated with deferoxamine. Isolated cerebral infection constitutes just 5% of all mucormyosis infections, but has a fatality rate exceeding 60%. Despite its rarity, however, isolated cerebral mucormycosis is the most common presentation among IVDA, constituting 62% of mucormycosis infections in this subgroup. Brain lesions are most commonly located within the basal ganglia, likely secondary to hematogenous seeding of the perforating branches of the Middle Cerebral Artery. It has been hypothesized that illicit injection drugs contaminated with mucormyosis spores enter the systemic arterial circulation before seeding the brain. Improved survival rates are seen among those patients treated with early stereotactic biopsy and aggressive amphotericin B therapy. Conclusion: For patients with a history of IVDA who present with brain abscess (especially in the basal ganglia), mucormycosis should be on the clinicians’ differential diagnosis. Early intervention with stereotactic brain biopsy and amphotericin B, as well as abscess debridement, can dramatically increase the likelihood of survival and can minimize permanent neurologic sequelae.https://scholarlycommons.henryford.com/merf2020caserpt/1076/thumbnail.jp

Sources of Cardiovascular Health Information and Channels of Health Communication among Urban Population in Nigeria

This study employed mixed methods to investigate the preferred sources of health information and later explored the views of community healthcare workers on the enablers, barriers and ways of overcoming barriers to health communication. The study found that majority of the participants preferred their source of CV (cardiovascular) health information from the healthcare workers including the medical doctors, nurses, and pharmacists. On the other hand, the least preferred source of health information was from friends, family members, and community leaders. Some of the identified enablers to community health communication include awareness programme via Non-Governmental Organisations (NGOs), community-based organisations such as faith-based organisations and healthcare facilities. Others are traditional media and social media. The identified barriers to community-based health communication include lack of knowledge and poverty, language barriers, and other miscellaneous issues including misuse of internet, lack of basic amenities and religious beliefs. The community-based healthcare providers articulated ways to overcome the identified barriers, including enlightenment programmes, using the language of the target audience, funding health awareness programmes, and monitoring of health education interventions. This study concludes that dissemination of health information using numerous channels is essential in ensuring population-wide primary prevention of diseases