Biomedical subjects
L A Mackin
Publications and source records attributed to L A Mackin.
Understanding Parkinson's disease: detection and early disease management.
Parkinson's disease (PD) is a common, debilitating, neurodegenerative disorder characterized by neuronal loss within the basal ganglia and insufficient levels of the neurotransmitter dopamine. Symptoms include resting tremor, rigidity, bradykinesia (slowness of voluntary movement), and postural disturbances. Exact cause is unknown, but theories surrounding environmental or endogenous toxicities have been suggested. Differential diagnoses include genetic and other neurologic disorders that may share symptoms similar to those seen in PD. Clinical progression has been categorized into three phases of the disease: early, nonfluctuating, and fluctuating. Medications generally offer good symptom relief during the early and nonfluctuating phases of the disease. Classifications of anti-PD medications include anticholinergics, dopamine agonists, amantadine, MAO-B inhibitors, levodopa-carbidopa, and Catechol-o-methyl transferase inhibitors. Surgical intervention may be an option for select patients whose conditions are not well controlled though medical management strategies. Primary care providers often can manage patients in the early stage of PD, but later stages require expert neurologic management. Patient/family education and anticipatory guidance is imperative.
Screening for tuberculosis in the primary care setting.
Screening for tuberculous infection and active disease is an important part of primary care practice across the lifespan. It is estimated that between 10 and 15 million people living in the United States are infected with Mycobacterium tuberculosis. Specific ethnic groups and persons with medical comorbidities are at an increased risk for progressing to active disease. The Mantoux method using 5TU purified protein derivative (PPD) antigen solution is the recommended skin testing technique for all age groups and settings. Companion anergy testing is no longer widely recommended. Interpretation of the tuberculin skin test reaction is also specific to age, lifestyle, and medical or environmental risk factors. Evaluation of risk of tubeculosis in the refugee or immigrant population requires careful evaluation of risk factors and interpretation of screening tests.
Respiratory tract infection.
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