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Many studies have linked cigarette smoke (CS) exposure and tuberculosis (TB) infection and disease although much fewer have studied second-hand smoke (SHS) exposure. Our goal is to review the epidemiologic link between SHS and TB as well as to summarize the effects SHS and direct CS on various immune cells relevant for TB. PubMed searches were performed using the key words "tuberculosis" with "cigarette," "tobacco," or "second-hand smoke." The bibliography of relevant papers were examined for additional relevant publications. Relatively few studies associate SHS exposure with TB infection and active disease. Both SHS and direct CS can alter various components of host immunity resulting in increased vulnerability to TB. While the epidemiologic link of these 2 health maladies is robust, more definitive, mechanistic studies are required to prove that SHS and direct CS actually cause increased susceptibility to TB., Competing Interests: Conflict of Interest: The authors declare no potential conflicts of interest.

Background: Patients with neurological disorders are the second most common patient population to receive inpatient palliative care services after cancer; however, there have been few reports describing the characteristics and needs of this population., Objective: To understand which patients with neurological diagnoses utilized these services, reasons for consultation, and whether patterns of use changed over time., Design: Retrospective case series., Setting/subjects: Neurological patients seen by our academic hospital-based palliative care consult service from January 2010 through December 2014., Measurement: Demographics, diagnoses, reasons for consultation, patient characterization, and outcomes were extracted from medical record., Methods: Data extracted from the chart was analyzed using primarily descriptive statistics with Chi-square used to compare group proportions and regression to examine temporal trends., Results: A total of 3170 patients received inpatient palliative care consultations, of whom 291 (9.2%) had a neurological diagnosis. Among these patients, 85 were excluded because of insufficient data, leaving 206 patients (mean age 70.0 ± 16.0 years; 111 (54%) female). Of the patients, 49% had a chronic diagnosis and 51% received a new diagnosis during their hospitalization, most commonly ischemic stroke. The proportion of patients with chronic diagnoses increased over time, with dementia representing the most common diagnosis in 2014. The most common reason for consultation was eliciting goals of care (82%). Advance directives were present at admission in 61 (30%), 130 (63%) at the time of consultation, and 190 (92%) patients after consultation. The proportion of people with advance directives after consultation significantly increased over the study period (p = 0.01)., Discussion: Hospital-based palliative care is primarily utilized to clarify goals of care in neurological patients and that advance directives were commonly not completed prior to consultation., Conclusions: Outpatient and hospital neurologists should routinely address advance directives, particularly as the proportion of patients with chronic neurological diagnoses increases.

Background: Parkinson disease (PD) may lead to functional limitations through both motor and nonmotor symptoms. Although patients with advanced disease have well-documented and profound functional limitations, less is known about the determinants of function in early to mid-stage disease where interventions may be more likely to benefit and preserve function., Objective: The objective of the current study was to identify motor, cognitive, and gait determinants of physical functional performance in patients with early to mid-stage PD., Design: This was a secondary analysis of cross-sectional baseline data from a randomized clinical trial of exercise., Setting: The study was performed at a tertiary academic medical center., Participants: The study included 121 patients with early to mid-stage PD., Methods: Our functional performance outcomes included the following: the Continuous Scale Physical Functional Performance Test (CS-PFP; primary outcome); the Timed Up and Go test (TUG); and Section 2 (Activities of Daily Living) of the Unified Parkinson's Disease Rating Scale (UPDRS). Explanatory variables included measures of disease severity, motor function, cognitive function, balance, and gait. Stepwise linear regression models were used to determine correlations between explanatory variables and outcome measures., Results: In our regression models, the CS-PFP significantly correlated with walking endurance (Six-Minute Walk Test; r(2) = 0.12, P < .0001), turning ability (360° Turn Test; r(2) = 0.03, P = .002), attention (Brief Test of Attention; r(2) = 0.01, P = .03), overall cognitive status (Mini-Mental State Examination; r(2) = 0.01, P = .04), and bradykinesia (timed tapping; r(2) = 0.02, P = .02). The TUG significantly correlated with walking speed (5-Meter Walk Test; r(2) = 0.33, P < .0001), stride length (r(2) = 0.25, P < .0001), turning ability (360° turn, r(2) = 0.05, P = .0003), and attention (r(2) = 0.016, P = .03). Section 2 of the UPDRS was significantly correlated with endurance (r(2) = 0.09, P < .0001), turning ability (r(2) = 0.03, P = .001), and attention (r(2) = 0.01, P = .03)., Conclusions: Gait, motor, and cognitive function all contribute to objectively measured global functional ability in mild to moderate PD. Subjectively measured functional activity outcomes may underestimate the impact of both motor and nonmotor symptoms., (Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.)

Nonmotor symptoms are increasingly recognized as important determinants of quality of life and disability in a wide range of movement disorders. There is a limited body of research suggesting that many of these symptoms are also commonly associated with primary and other genetic forms of dystonia. However, the significance, etiology, pathophysiology, and treatment of these symptoms remain poorly described. The following is a review of the literature that focuses primarily on the association of these types of dystonia with psychiatric disorders, cognition, sleep, pain, and autonomic symptoms. We will also discuss potential mechanisms and approaches to treatment for nonmotor features of dystonia., (Copyright © 2011 Movement Disorder Society.)