Parkinson’s Disease: Its Over Diagnosis And Under Diagnosis

In this era of genuinely marvelous, high-tech, medical devices, it is sometimes surprising that certain diseases are still diagnosed “clinically,” meaning that the clinician makes the call based on just the story of symptoms and the physical exam. Parkinson’s disease is one such disease. There is no “Parkinson scan” or “Parkinson blood-test” to rely upon. MRI scans, CT scans and blood tests are usually normal in people with this disease.

Of course, once upon a timebefore scans and blood-tests even existedthis is how all diagnoses were made. So, in a sense, diagnosing Parkinson’s disease gets back to the very roots of what doctors are supposed to do. But when there are no corroborative tests available to prove or disprove a diagnosis, even the doctor sometimes gets it wrong.

Before delving into the challenges of diagnosing Parkinson’s disease, let’s first consider what is known about this condition.In 1817 James Parkinson, an English surgeon and apothecary, published a classic, short book entitled “An Essay on the Shaking Palsy.” In it, Parkinson identified a consistent pattern of physical abnormalities in six patients he had examined. Although people with identical abnormalities had doubtlessly been around for thousands of years, Parkinson was the first to recognize this pattern of abnormalities as a distinct condition. For this important achievement, the disease was eventually named for him.

In the book’s opening sentence Parkinson wasted no time in laying out prominent features of this disease: “Involuntary tremulous motion, with lessened muscular power, in parts [of the body] not in action and even when supported; with a propensity to bend the trunk forwards, and to pass from a walking to a running pace: the senses and intellects being uninjured.”

Subsequently, scientists discovered that degeneration of a limited group of brain cells containing the chemical transmitter dopamine was responsible for these clinical changes. (The group of brain cells involved is too slight to show up on brain scans in all but the most advanced of cases.) In 1967, levodopa (one of two ingredients in brand-name Sinemet) a drug the body can convert into dopamine, was found helpful in alleviating many of the symptoms. Later, other drugs (dopamine agonists) were created that improved symptoms by mimicking the action of the missing dopamine. These include bromocriptine (brand name Parlodel), pergolide (Permax), pramipexole (Mirapex) and ropinirole (Requip). To date, there are no treatments that reliably stop or reverse the underlying disease-process.

As a condition that affects about one percent of people over the age of 60, Parkinson’s disease is usually on the radar screen of patients and doctors alike when new symptoms are present that suggest the disease. That other conditions can resemble it was not news to James Parkinson who devoted a chapter of his 1817 book to “Shaking palsy distinguished from other diseases with which it may be confounded.”In my consultation practice of neurology, I see both over-diagnosis and under-diagnosis of Parkinson’s disease. The problem usually centers on one of the most visible of symptoms, the tremor. When tremor of the hands is present, doctors often diagnose Parkinson’s disease, even when another condition is to blame. When tremor is absent, doctors often fail to consider Parkinson’s disease, even when it is present. One key to accurate diagnosis is to focus on the characteristics of the tremor itself. The Parkinsonian tremor usually affects one hand first, and at all stages of the disease the initially affected hand remains more tremulous than the other hand. And, as Parkinson himself emphasized, the tremor is most evident when the hand is at rest or supported, and decreases when the hand is in the air or put to use. In other conditions that cause hand-tremors, the hands are more equally affected, and the tremor is more evident when the hands are in the air or put to use.

What about cases in which no tremor is present? Because symptoms of Parkinson’s disease worsen slowlyyear by year instead of month by monthpatients and their families often mistake these changes as due to normal, healthy aging. Non-tremor symptoms of Parkinson’s disease can include relative immobility of body-parts (hypokinesia), especially of the face which can show a mask-like lack of expression. Movements, once initiated, are slow (bradykinesia). Walking, as James Parkinson noted, involves a bent-forward posture with shuffling, short steps and reduced swinging of the arms. Sometimes the body’s center of gravity gets ahead of the feet’s ability to catch up, resulting in the passing “from a walking to a running pace” that Parkinson described and is known as festination.

The physical exam also shows clumsiness in hands and feet. Increased muscle tone, called “rigidity,” is encountered in the patient’s neck and arm muscles, even while they are supposed to be relaxed.

Patients who have Parkinson’s disease without tremor are often the most gratifying cases to treat. Having developed their problems slowly and having believed all along that their symptoms were due to aging, they are happily astonished by the rapid improvement in function produced by appropriate medication.

(C) 2005 by Gary Cordingley

CanadaVOTES: Liberal Sandra Gardiner running in Perth—Wellington

Friday, September 26, 2008

On October 14, 2008, Canadians will be heading to the polls for the federal election. Liberal Party candidate Sandra Gardiner is standing for election in the riding of Perth—Wellington. A Stratford resident for the last 17 years, she has worked as a Registered Nurse for the last 14, in hospital, long term, and community care settings. She is a member of Registered Nurses Association of Ontario, Canadian Association of Physicians concerned about the Environment, FarmGate5, Common Action for the Restoration of the Environment, Autism Ontario, the Planning Committee for Rotary Respite House, and board member of Optimism Place, the local women’s shelter.

Wikinews contacted Sandra, to talk about the issues facing Canadians, and what they and their party would do to address them. Wikinews is in the process of contacting every candidate, in every riding across the country, no matter their political stripe. All interviews are conducted over e-mail, and interviews are published unedited, allowing candidates to impart their full message to our readers, uninterrupted.

The riding is currently held by Conservative Gary Schellenberger, who was also MP for the previous riding, Perth—Middlesex. Perth—Wellington includes the County of Perth, and the Town of Minto and the townships of Mapleton and Wellington North in the County of Wellington. Also challenging Schellenberger are John Cowling (Green), Irma DeVries (Christian Heritage), Julian Ichim (Marxist-Leninist), and Kerry McManus (NDP).

For more information, visit the campaign’s official website, listed below.

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Air Canada back in the black in 2010

Saturday, February 12, 2011

In the final quarter of 2010, airline Air Canada (TSX:AC.B) earnings rose to 134 million CAD, 42 cents per share, capping a sharp return to profitability in 2010.

The year resulted in the company’s highest-ever earnings before interest, taxes, depreciation, amortisation, and rent (EBITDAR) of $1.39 billion, 707 million more than the previous year. Operating income for fourth quarter was reported as $85 million, which compared very favourably with an $83 million loss in 2009.

Only 21 months ago Air Canada was threatened with bankruptcy and using its financial weakness in negotiations with its employees, achieving status quo contracts. With labour contracts scheduled to end this month and next, the strong position of the airlines is expected to stiffen union resolve to share in the increased net revenues.

Those revenues were helped by increasing numbers of passengers and reducing costs, as well as foreign exchange gains. International travel, especially to the Pacific region, led the rises. US travellers through the main Toronto hub more than doubled, indicating the increase in foreign air traffic to and through Canadian airports.

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Cooking With Kids What You Should Know

By Mary-Lou Halvorson

At what age should kids be allowed to participate in the kitchen? If the thought of letting your kids loose in the kitchen conjures up visuals of sticky spaghetti mashed into the floor and accompanying sauce spray patterned on the wall, let me give you some advice. It’s not all ‘mess and clean-up’.

In the (sometimes) mad rush to get meals on the table on a regular basis, we can sometimes forget what a fun activity cooking can be. It’s pleasures are certainly not lost on children though, who embrace the process of creating something special with a simple list of healthy ingredients that they can enjoy eating as a finale.

From a very early age, children pretend to cook – they make mud pies in the sandpit, hold elaborate tea parties in the bath. They enjoy the process of choosing a recipe, planning the process, assembling the ingredients (creativity), measuring with cups and spoons (maths), and chopping and peeling tasks that require and develop their concentration skills. Guiding and assisting your children in the kitchen will help develop and reinforce these learning skills. Kids love projects that have a beginning (preparation), a middle (messy, creative fun), and an end (eating and enjoying what they’ve made).

Learning to cook is not only fun for children but a skill that will stay with them for the rest of their lives. Involving your children in cooking teaches them important life skills and if you guide them in choosing the ingredients wisely, can give them the appreciation of good nutritional food rather than fast unhealthy takeaway food.

Helping your child to feel confident with cooking has many benefits:

. Contributing to the household duties helps them to feel important.

. Learning to work together as a team to get the job done.

. Learning to plan and make responsible choices.

. Developing and practicing their creativity and imagination.

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A cooking party is a perfect way to celebrate the birthday of a young eager-to-learn child. Not only does a cooking party provide an invaluable hands-on activity to entertain them and their guests, but it concludes with a meal for them all to enjoy. Even fussy eaters will be thrilled to eat something they have made with their own hands. There’s something about creating a meal themselves which makes them more likely to eat whatever they had a hand in making.

It may take longer to prepare the meal but the moments with your children will be priceless.


. Always make sure children are supervised in the kitchen.

. Never leave children unattended in the kitchen.

. Keep it fun and age-appropriate.

. Let your child get involved in choosing a recipe everyone will enjoy.

. Have patience. Don’t worry about flour on the floor or spilled milk.

. Choose recipes that don’t involve sharp knives or the oven.

. Choose easy recipes – dips, pizzas, meatballs, icing cupcakes.

. Make sure the children tie their hair back and wash their hands.

Here’s an easy child’s recipe for starters:



1 tspoon Salad Dressing

1 pkt Cream Cheese





Combine (to taste required) salad dressing with cream cheese and place in a small bowl. Cut and wash celery, broccoli and carrots. Arrange cut pieces of vegetables around the bowl of dip. (The vegies are for dunking into the dip).


About the Author: Mary-Lou Halvorson is a mother of two children and creator of

Groovy Kids Parties

. Mary-Lou offers many ideas for Kids Birthday Parties including kids novelty birthday cakes with photos and instructions. Check out her

Cooking Party

for more ideas on cooking with kids together with easy recipes for kids to cook.


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Large increase in number of foreclosures across US

Sunday, April 27, 2008

Recently released figures have revealed that the number of foreclosures in California, United States has more than quadrupled. The figures for the first quarter of 2008 show a significant increase on previous figures.

There were 47,171 foreclosures on California properties in the first quarter of 2008. The figure for the same period last year was just over 10,000.

The Attorney General of Arizona released a report that showed an increase. It said that “the collective efforts of servicers and government officials to date have not translated into meaningful improvement in foreclosure prevention outcomes.” The Attorney General also commented on the report:

We continue to see a rising number of foreclosures in Arizona, which is a significant drag on Arizona’s economy. This report confirms that efforts made by servicers to prevent unnecessary foreclosures are not enough. We need to explore additional approaches to prevent tens of thousands of unnecessary foreclosures in Arizona.
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Sweden’s Crown Princess marries long-time boyfriend

Monday, June 21, 2010

Sweden’s first royal wedding since 1976 took place Saturday when Crown Princess Victoria, 32, married her long-time boyfriend and former personal trainer, Daniel Westling, 36. The ceremony took place at Stockholm Cathedral.

Over 1,200 guests, including many rulers, politicians, royals and other dignitaries from across the world, attended the wedding, which cost an estimated 20 million Swedish kronor. Victoria wore a wedding dress with five-metre long train designed by Pär Engsheden. She wore the same crown that her mother, Queen Silvia, wore on her wedding day 34 years previously, also on June 19. Victoria’s father, King Carl XVI Gustaf, walked Victoria down the aisle, which was deemed untraditional by many. In Sweden, the bride and groom usually walk down the aisle together, emphasising the country’s views on equality. Victoria met with Daniel half-way to the altar, where they exchanged brief kisses, and, to the sounds of the wedding march, made their way to the the silver altar. She was followed by ten bridesmaids. The couple both had tears in their eyes as they said their vows, and apart from fumbling when they exchanged rings, the ceremony went smoothly.

Following the ceremony, the couple headed a fast-paced procession through central Stockholm on a horse-drawn carriage, flanked by police and security. Up to 500,000 people are thought to have lined the streets. They then boarded the Vasaorden, the same royal barge Victoria’s parents used in their wedding, and traveled through Stockholm’s waters, accompanied by flyover of 18 fighter jets near the end of the procession. A wedding banquet followed in the in the Hall of State of the Royal Palace.

Controversy has surrounded the engagement and wedding between the Crown Princess and Westling, a “commoner”. Victoria met Westling as she was recovering from bulemia in 2002. He owned a chain of gymnasiums and was brought in to help bring Victoria back to full health. Westling was raised in a middle-class family in Ockelbo, in central Sweden. His father managed a social services centre, and his mother worked in a post office. When the relationship was made public, Westling was mocked as an outsider and the king was reportedly horrified at the thought of his daughter marrying a “commoner”, even though he did so when he married Silvia. Last year, Westling underwent transplant surgery for a congenital kidney disorder. The Swedish public have been assured that he will be able to have children and that his illness will not be passed on to his offspring.

Westling underwent years of training to prepare for his new role in the royal family, including lessons in etiquette, elocution, and multi-lingual small talk; and a makeover that saw his hair being cropped short, and his plain-looking glasses and clothes being replaced by designer-wear.

Upon marrying the Crown Princess, Westling took his wife’s ducal title and is granted the style “His Royal Highness”. He is now known as HRH Prince Daniel, Duke of Västergötland. He also has his own coat-of-arms and monogram. When Victoria assumes the throne and becomes Queen, Daniel will not become King, but assume a supportive role, similar to that of Prince Phillip, the husband of the United Kingdom’s Queen Elizabeth II.

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Billboard holds benefit Oscar party for Children Uniting Nations

Tuesday, February 27, 2007

Professional photographer John B. Mueller was at the Children Uniting Nations/Billboard Academy Awards afterparty red carpet, taking photos for Wikinews. It is one of the largest events, following only the Vanity Fair and Elton John AIDS Foundation Party in size.

Among the guests at the event were Lil’ Kim, Bow Wow, Ruben Studdard, Diane DeGarmo, DMX, Darryl ‘DMC’ McDaniels, DJ Spinderella, Dennis Hopper, Blu Cantrell, Tyler Hilton, Erik Palladino, Daniel Cage, Farnsworth Bentley, Aaron Carter, Nick Carter, Cindy Margolis, LaToya Jackson, AJ McLean, Joey Fatone, Shar Jackson, Tyrese, Tyson Beckford, Tara Reid, Rosie Perez, Radha Mitchell, MC Lyte, Jane Seymour, James Keach, Fran Drescher, Tommy Davidson, Bruce Davison, and Adam Kowalczyk.

Even Mickey Rooney stopped by to watch the ceremonies.

Larry Birkhead, boyfriend of the late-Anna Nicole Smith was still on the guest list, according to press materials. No media outlet reported him attending, so it is likely he stayed in Florida for the on-going legal proceedings.

All of the photos taken by Mueller at the event are released under the Creative Commons By Attribution license, which allows them to be used freely by anyone for any purpose, so long as they credit both Mueller and Wikimedia.

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Drug Treatment Centers Must Suit Your Needs

Drug Treatment Centers Must Suit Your Needs by Roberta GrocheThere are hordes of drug treatment centers in present days. If you are looking for drug treatment center to eliminate the grave addiction from your life, then selecting the best center to seek drug treatment can become very confusing. Thus, most of you people might be thinking as how to choose the ideal one from such centers. Moreover, individuals who need immediate attention may find it hard to select the drug treatment center that suits their needs.Therefore, here is brief information about drug treatment centers. Study it and select the one that suits you or your closed ones.Short-Term Drug Treatment Centers: If you wish to get rid of the drug addiction within a matter of weeks, then short-term drug treatment centers are for you. The duration of such drug treatment centers, vary from three to six weeks. The drug treatment program of such centers is designed in a way that requires you to complete a 12-step plan.Most short-term drug treatment centers scan the physical, mental, behavioral as well as emotional level of the addicted individuals. Using this basis, they design the customized drug treatment for them.When you enroll in such drug treatment center, you are required to undergo the 12-step treatment by making up your mind that you will come out successful. You will have to participate in various meetings, sessions and exercises conducted by the drug treatment center. The information as well as the sessions offered in such drug treatment center is very informative and educative. Later on after the successful completion of the course, a follow up drug treatment is given to you, which you can seek as an outpatient facility from any drug treatment center.Detoxification treatment: If you are recently started taking drugs or hooked to alcohol, then you need to opt for detoxification treatment. You may seek to choose the detoxification treatment offered by several medical centers or laboratories. This drug treatment programs assist you to combat the problem of addiction, which is impossible to leave it on your own. Detoxification drug treatment is carried out under the watchful eye of medical supervisor. The officials who carry out this treatment must posses a medical professional certificate. This drug treatment program may also consider the emotional side of you.Long-Term Drug Treatment Centers: This sort of drug treatment center carries out the drug treatments that last for one year or two years. You may seek the services of such centers all year round. The drug treatment program considers the behavioral side of you. The counselors then take into account the psychological reaction of the addicted individuals and decide the further sessions.To opt for long-term drug treatment centers you will have to stay in the facility center. The lengthy duration is a part of the drug treatment. It ensures that the individual is capable of reconstructing as well as remobilizing his or her life on a regular basis. Moreover, it helps the addicted individuals to steer away from relapse of drugs.If you cannot make it to the drug treatment centers only because of time constraints or other responsibilities, then you may avail drug treatment as outpatient. However, it is your responsibility to attend all the sessions organized by drug treatment centers.For more information about drug treatment and drug rehabilitation, please visit Cliffside malibu is a California’s premiere drug treatment center.Article Source:

Tornado touches down in New York City

Thursday, August 9, 2007

During heavy rainstorms that flooded rail lines and subways, a tornado touched down in New York City, the National Weather Service reports. It sustained winds around 111 mph to 135 mph, causing damage to buildings and vehicles. Starting from the Bay Ridge area, the tornado continued for two miles through Brooklyn. At least one person was killed.

The roof of a Nissan dealership had been ripped off, as was that of a Brooklyn church. At least 16 homes were damaged.

Torrential rain had drenched the region early Wednesday, causing delays at Newark, JFK, and LaGuardia airports. Wind and rain caused major slowdowns in the mass transit lines, virtually halting services. The brunt of the storm struck the city during morning rush hour, a time when hundreds of thousands of vehicles and people are in transit to work. Police Commissioner Raymond Kelly said that in some flooded subways, police resorted to crowd control tactics to stop rioting.

Trees were torn from the ground and some cars were crushed.

In a damage assessment tour of Brooklyn, Mayor Michael Bloomberg remarked, “I don’t know that God had rush hour in mind when the storms hit.”

The Metropolitan Transit Authority expects service to return to normal by Thursday. At a press conference MTA chairman Elliot “Lee” Sander said the pumps located citywide in the rail and subway lines are adequate to handle 1.5 inches of rain per hour. He said the rain, however, came “too fast and with little warning.”

“The storm took us by surprise because it was not predicted by the National Weather Service.”

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Sony refreshes VAIO brand for business and entertainment

Thursday, July 31, 2008

From the middle of July, Sony Corporation refreshed their senior laptop brand VAIO from “Video Audio Integrated Operation” to “Visual Audio Intelligent Organizer”. According to Sony Taiwan Limited, this refreshment is an attempt to relocate the laptop consuming market for business and entertainment factors.

In the “VAIO Experience 2008” press conference in Europe, Sony promoted their new product series for different populations including BZ for business, FW for home entertainment, Z for ultra-slim, and SR for complex applications.

Different with past series, Sony added “Clear Bright” screening technology for high-definition display, and “full-carbon production” features. BD-burning and Intel Centrino 2 processing technologies will be featured in all the new models. For security issue, Sony also embedded fingerprint system to prevent personal data to be stolen. Continued from TZ series, innovative designs including “Green Power Button”, “Situational Switch” are also added in newly-launched series.

“Due to consuming market differences, Sony only promoted BZ series in Europe and America but not included Asia. Although the TICA Show in Taipei will be different, functionality will be the greatest issue when a consumers choose a notebook [computer] before buying.” addressed by executives from Sony Taiwan Limited, during the “VAIO Experience 2008” press conference in Taiwan.

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