Website of the week
I have recently found some good things on the NICE site.
Their quick reference guide to Parkinson’s disease is top notch. It was published in June 2006.
There are 16 pages, but you only need to look at pages six to 14.
There is an excellent chart that summarises all the key interventions.
The section headed ‘Other key interventions’ is helpful. I was interested in the tests and neuroprotective treatments that should not be used.
It makes me realise how poorly served our patients were when I first came into practice, where all we could do was prescribe a couple of drugs laden with side-effects.
Why go there: all you need to know about management.
Information from: NICE.
I complained recently about a dull charity website, so I suppose I must not complain about this rather garish bright purple homepage that looks a little too busy. All the information you would expect is here.
Charities such as this do a great job and need much financial support. However, I am always impressed when ‘give us your money’ is not the first thing you see. This site is great in this respect and concentrates on informing patients first and asking for donations second.
I am also encouraged when there is a section dedicated to professionals, as there is here. I was taken with the quarterly publication, Parkinson’s News, aimed at healthcare professionals. The issue I read at contained articles on surgical advances.
Why go there: no hesitation in recommending to patients.
Downside: site design is not the best.
Information from: Parkinson’s Disease Society.
It is always handy to have a brief summary of a clinical condition without having to wade through all the extraneous matter, and you get this here.
This extract from a handbook of geriatric medicine summarises the key facts about this disease, its epidemiology, aetiology, subtypes, clinical manifestations and natural history.
The treatment section is brief, but you can go elsewhere for that. A GP registrar in need of a quick brush-up on Parkinson’s should find this website useful.
Why go there: brief summary.
Downside: plain presentation.
Information from: Liverpool University.
Patients tend to be given the impression by the media that there is a place for genetic testing in almost any condition, and with something like Parkinson’s disease, who can blame relatives for wondering if it can be passed on.
To inform yourself about what to say in response to such questions, take a look at this abstract in preparation.
Parkinson’s has been seen as an idiopathic condition, although Mendelian patterns of inheritance are occasionally described.
To date, nine genetic loci have been reported and four pathogenic genes have been identified, so there may be a place for testing, but will it yield a meaningful result? Beware the social and emotional consequences of the results.
Why go there: it only takes a minute.
Information from: Journal of the Movement Disorders Society.
An alternative treatment?
I could not resist taking a look to see what was on offer from the alternative world, and while some approaches may have merit, I am not sure this one does.
This stuff is called Mentat, with a list about half a million ingredients.
Well, I exaggerate, but you know what I mean: it contains such things as cow-itch (no, I am not making this up), trumpet creeper, giant potato and many other famous medicinal products that spring instantly into the minds of neurologists everywhere.
Apparently, Mentat ‘liberates the individual from social isolation, corrects speech defects and improves articulation.’
It also acts as a nervine sedative (pardon me?), treats insomnia and improves memory.
If you happen to suffer from bedwetting or Alzheimer’s disease you are in luck because it can also be used to treat these conditions.
Why go there: beats me.
Downside: I don’t think NICE will be recommending it.
Information from: Daya Distributors Ltd.
Dr Barnard is a former GP in Fareham, Hampshire