Advance care planning in Parkinson's disease: ethical challenges and future directions.

Recent discoveries support the principle that palliative care may improve the quality of life of patients with Parkinson's disease and those who care for them. Advance care planning, a component of palliative care, provides a vehicle through which patients, families, and clinicians can collaborate to identify values, goals, and preferences early, as well as throughout the disease trajectory, to facilitate care concordant with patient wishes. While research on this topic is abundant in other life-limiting disorders, particularly in oncology, there is a paucity of data in Parkinson's disease and related neurological disorders.

Changes in Prescribing Practices of Dopaminergic Medications in Individuals with Parkinson's Disease by Expert Care Centers from 2010 to 2017: The Parkinson's Foundation Quality Improvement Initiative.

Background: During the past decade, there has been increasing awareness of the side effects of dopamine agonists (DAs), including impulse control disorders. We hypothesized that there may be a shift toward more conservative use of DAs.

Objective: To explore the change in prescribing practices for dopaminergic medications in Parkinson's disease between 2010 and 2017.

The impact of direct vertebral body derotation on the lumbar prominence in Lenke Type 5C curves.

Object: The thoracic rib hump, caused by axial rotation of the spine, is one of the most dissatisfying cosmetic features associated with adolescent idiopathic scoliosis (AIS). However, advances in instrumentation and surgical techniques, such as direct vertebral body derotation (DVBD), have allowed improved correction in the axial plane and the rib hump. In cases of thoracolumbar/lumbar curves (Lenke Type 5), the lumbar prominence can be equally disfiguring and is often associated with waist asymmetry, another cosmetic concern.

The -258A/G (SNP rs12885300) polymorphism of the human type 2 deiodinase gene is associated with a shift in the pattern of secretion of thyroid hormones following a TRH-induced acute rise in TSH.

Objective: Type 2 deiodinase gene (DIO2) polymorphisms have been associated with changes in pituitary-thyroid axis homeostasis. The -258A/G (SNP rs12885300) polymorphism has been associated with increased enzymatic activity, but data are conflicting. To characterize the effects of -258A/G polymorphism on intrathyroidal thyroxine (T(4)) to triiodothyronine (T(3)) conversion and thyroid hormone (TH) secretion pattern, we studied the effects of acute, TRH-mediated, TSH stimulation of the thyroid gland.

The Thr92Ala 5' type 2 deiodinase gene polymorphism is associated with a delayed triiodothyronine secretion in response to the thyrotropin-releasing hormone-stimulation test: a pharmacogenomic study.

Background: The common Thr92Ala D2 polymorphism has been associated with changes in pituitary-thyroid axis homeostasis, but published results are conflicting. To investigate the effects of the Thr92Ala polymorphism on intrathyroidal thyroxine (T4) to triiodothyronine (T3) conversion, we designed prospective pharmacogenomic intervention aimed to detect differences in T3 levels after thyrotropin (TSH)-releasing hormone (TRH)-mediated TSH stimulation of the thyroid gland.

Methods: Eighty-three healthy volunteers were screened and genotyped for the Thr92Ala polymorphism.