RESUMO
Dementia with Lewy bodies (DLB) is a synucleinopathy that is clinically distinct from Alzheimer's disease, associated with cognitive decline, fluctuations in alertness and cognition, visual hallucinations, and parkinsonism. Other clinical symptoms that can occur with DLB include dysautonomia and sleep disorders such as rapid-eye-movement sleep behavior disorder (RBD). The pathological criteria of DLB are associated with the location of Lewy body pathology and the extent of Alzheimer's pathology seen. Treatment is symptomatic. The genetic basis of DLB is being explored, and future studies will investigate ways to identify those most at risk for DLB prior to the onset of cognitive symptoms.
Assuntos
Doença por Corpos de Lewy , Humanos , Doença por Corpos de Lewy/diagnóstico , Doença por Corpos de Lewy/genética , Doença por Corpos de Lewy/patologia , Doença por Corpos de Lewy/fisiopatologiaRESUMO
OBJECTIVE: To study prevalence of and factors contributing to burnout, career satisfaction, and well-being in US neurology residents and fellows. METHODS: A total of 938 US American Academy of Neurology member neurology residents and fellows were surveyed using standardized measures of burnout, career satisfaction, and well-being from January 19 to March 21, 2016. RESULTS: Response rate was 37.7% (354/938); about 2/3 of responders were residents and 1/3 were fellows. Median age of participants was 32 years and 51.1% were female. Seventy-three percent of residents and 55% of fellows had at least one symptom of burnout, the difference largely related to higher scores for depersonalization among residents. For residents, greater satisfaction with work-life balance, meaning in work, and older age were associated with lower risk of burnout; for fellows, greater satisfaction with work-life balance and effective support staff were associated with lower risk of burnout. Trainees experiencing burnout were less likely to report career satisfaction. Career satisfaction was more likely among those reporting meaning in work and more likely for those working in the Midwest compared with the Northeast region. CONCLUSIONS: Burnout is common in neurology residents and fellows. Lack of work-life balance and lack of meaning in work were associated with reduced career satisfaction and increased risk of burnout. These results should inform approaches to reduce burnout and promote career satisfaction and well-being in US neurology trainees.
Assuntos
Esgotamento Profissional/epidemiologia , Internato e Residência , Satisfação no Emprego , Neurologistas/psicologia , Adulto , Fatores Etários , Despersonalização , Feminino , Humanos , Masculino , Análise Multivariada , Neurologia/educação , Prevalência , Fatores de Risco , Estados Unidos/epidemiologia , Equilíbrio Trabalho-VidaAssuntos
Benzimidazóis/uso terapêutico , Pirrolidinas/uso terapêutico , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Triazóis/uso terapêutico , Idoso , Benzimidazóis/efeitos adversos , Feminino , Humanos , Imidazóis , Masculino , Educação de Pacientes como Assunto , Pirrolidinas/efeitos adversos , Triazóis/efeitos adversosRESUMO
OPINION STATEMENT: Alzheimer's disease (AD) is a progressive neurological disorder typically associated with episodic memory loss as the initial symptom, but individuals <65 years old may present with executive dysfunction, word finding difficulties, or visual processing deficits. In those with AD, curative treatments are not available, but there are interventions which may modify disease course, symptom appearance and severity, enhance quality of life for patient and caregivers, and maintain safety. Both pharmacological and non-pharmacological interventions are important.