The Medical journal of Australia
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Parkinson disease (PD) is a multisystem neurodegenerative disorder that affects about 1% of the population over the age of 55 years and has mean age of onset of about 60 years. The Braak hypothesis proposes that the earliest pathological evidence of PD is found in the enteric nervous system, medulla and olfactory bulb, and only subsequently progresses (over years) to the substantia nigra and cortex. Non-motor symptoms, such as constipation, hyposmia and sleep disorders, may precede typical motor features of PD by several years. ⋯ Treatment with apomorphine, Duodopa or deep-brain stimulation surgery may be beneficial for selected patients with advanced PD. Non-motor symptoms, such as mood disorders, cognitive impairment, autonomic dysfunction and sleep disorders, are responsible for significant morbidity. Management often requires a multidisciplinary approach.
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To determine population lipid profiles, awareness of hyperlipidaemia and adherence to Australian lipid management guidelines. ⋯ A comprehensive national strategy for lowering mean population cholesterol is required, as is better implementation of absolute risk management guidelines - particularly in rural populations.
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Case Reports
Oseltamivir-resistant pandemic (H1N1) 2009 influenza in a severely ill patient: the first Australian case.
After a 10-day course of oral oseltamivir for pandemic (H1N1) 2009 influenza infection, a renal transplant recipient developed rapid-onset severe primary viral pneumonia due to oseltamivir-resistant virus. Respiratory failure progressed despite high-dose oral oseltamivir, nebulised zanamivir and cessation of immunosuppressive medications, but his condition improved with intravenous zanamivir. He subsequently died of non-respiratory complications. This is the first case of oseltamivir-resistant pandemic (H1N1) 2009 in Australia and the first report of resistance in a solid organ transplant recipient.