Neurological disorders in a rural Western Australian population

Panegyres, Peter K.; Gray, V. M.; Barrett, Leah J.; Perceval, S.

doi:10.1111/j.1445-5994.2008.01845.x

“…Within the study period prevalence rates were derived from PD cases and total population samples reported within the included studies. The estimated within study period prevalence was calculated using the method described in the article by Panegyres, Gray, 24 [( n = cases of PD × total study population) × 1000] = n per 1000). In the context of this review, the presentation of period prevalence estimates was approached with consideration of the heterogeneous nature of the studies and the potential variations in disease frequency across different populations and settings 20 .…”

Section: Methodsmentioning

confidence: 99%

Exploring Parkinson's disease prevalence in regional, rural and remote Australia: A systematic scoping review

Fealy,

Logan,

Micalos

et al. 2023

Australian J Rural Health

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IntroductionIdiopathic Parkinson's disease (PD) is the second most prevalent neurodegenerative disorder worldwide. Due to ageing populations, prevalence estimates for PD are set to increase in western countries including Australia.ObjectiveThis study aims to investigate the prevalence of PD in regional, rural and remote areas of Australia, to inform the provision of equitable PD‐specific care.DesignA scoping review, following the Joanna Briggs Institute methodology for scoping reviews and the Preferred Reporting Items for Systematic reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR), was conducted. An electronic search of four databases and the search engine google scholar was completed in May 2022 and updated in September 2023. Article screening and quality appraisal were undertaken independently by at least two reviewers.FindingsOf 514 records screened, six articles (between 1966 and 2019) were identified and included for review. Wide variations in PD prevalence were evident, ranging from 0.58 to 8.5 per 1000 people. Two studies suggested prevalence may be higher in regional, rural and remote areas of Australia than in urban localities.DiscussionThe limited number of studies identified, and wide variation in prevalence rates makes it difficult to draw firm conclusions to inform heath care planning and resource allocation.ConclusionA paucity of reliable prevalence data indicates the need for well‐designed, country‐specific epidemiological studies to be conducted to estimate the actual impacts of the disease to inform public health planning, particularly in regional, rural and remote areas where access to PD‐specific care is already inequitable.

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“…Panegyres et al . report, in your Journal, 1 an apparent epidemic of Parkinson's disease in a rural Western Australian population, citing a population period prevalence of 187.5/1000, or near 1 in 5, an intrinsically unlikely result, which would mean that (nearly) every person over 50 had the disease. The error arose from their use in the calculation of the clinic population, rather than the community population as the denominator.…”

mentioning

confidence: 97%

No evidence of an epidemic of Parkinson's disease in rural Western Australia

Adam

¹

2010

Internal Medicine Journal

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patient was diagnosed with cutaneous SCC of the right hand dorsum and underwent surgical excision with split thickness skin graft in September 2006. In December 2007, he had a recurrence of SCC in a right axillary lymph node and underwent lymph node dissection. At that time, postoperative radiotherapy was considered, but was not performed because the patient was lost to follow up. In July 2008, the patient was referred to us because of a rapidly growing axillary mass with skin ulceration. Chest computed tomography (CT) showed a 7.6-cm cystic mass with inhomogeneous enhancement in the right axillary area (Fig. 1a). No visceral metastasis was detected. At a multidisciplinary review, we planned chemoradiotherapy followed by surgery to obtain complete resection and to preserve adjacent structures. The patient underwent external beam radiation (2 Gy/day, 5 days a week for a total dose of 50 Gy) and two 3-week courses of chemotherapy with cisplatin (15 mg/m 2 on days 1-5) and 5-fluorouracil (850 mg/m 2 on days 1-5). The treatment was delivered without serious side effects. Chest CT after the chemoradiation showed a partial tumour response with reduction of tumour size to 3.2 cm (Fig. 1b). Subsequently, the patient underwent complete surgical excision with pathologically clear resection margin.Recently, Fujisawa et al. reported two patients with locally advanced cutaneous SCC who were treated successfully with chemoradiation using cisplatin and 5-fluorouracil. 2 In addition, a case of distant lymph node metastasis managed successfully with the same chemoradiation protocol has been reported. 3 In our case, chemoradiation with cisplatin and 5-fluorouracil, which was based on Fujisawa's report, induced a partial tumour response, which enabled complete tumour resection, suggesting the possible role of chemoradiotherapy followed by surgical excision in the treatment of unresectable metastatic SCC of the skin. It is difficult to perform a prospective clinical trial of chemoradiotherapy followed by surgery in the treatment of metastatic cutaneous SCC because of its rarity, but this treatment constitutes a treatment option.

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“…We thank W. Adam 1 for his interest in our paper 2 on Neurological Disorders in a Rural Western Australian Community.…”

mentioning

confidence: 99%

“…The purpose of our paper 2 was to bring to readers' attention the spectrum of neurological disorders observed in a rural Western Australian community and highlight the significant number of individuals with Parkinson's disease attending this clinic.…”

mentioning

confidence: 99%

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Panegyres¹

2010

Internal Medicine Journal

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patient was diagnosed with cutaneous SCC of the right hand dorsum and underwent surgical excision with split thickness skin graft in September 2006. In December 2007, he had a recurrence of SCC in a right axillary lymph node and underwent lymph node dissection. At that time, postoperative radiotherapy was considered, but was not performed because the patient was lost to follow up. In July 2008, the patient was referred to us because of a rapidly growing axillary mass with skin ulceration. Chest computed tomography (CT) showed a 7.6-cm cystic mass with inhomogeneous enhancement in the right axillary area (Fig. 1a). No visceral metastasis was detected. At a multidisciplinary review, we planned chemoradiotherapy followed by surgery to obtain complete resection and to preserve adjacent structures. The patient underwent external beam radiation (2 Gy/day, 5 days a week for a total dose of 50 Gy) and two 3-week courses of chemotherapy with cisplatin (15 mg/m 2 on days 1-5) and 5-fluorouracil (850 mg/m 2 on days 1-5). The treatment was delivered without serious side effects. Chest CT after the chemoradiation showed a partial tumour response with reduction of tumour size to 3.2 cm (Fig. 1b). Subsequently, the patient underwent complete surgical excision with pathologically clear resection margin.Recently, Fujisawa et al. reported two patients with locally advanced cutaneous SCC who were treated successfully with chemoradiation using cisplatin and 5-fluorouracil. 2 In addition, a case of distant lymph node metastasis managed successfully with the same chemoradiation protocol has been reported. 3 In our case, chemoradiation with cisplatin and 5-fluorouracil, which was based on Fujisawa's report, induced a partial tumour response, which enabled complete tumour resection, suggesting the possible role of chemoradiotherapy followed by surgical excision in the treatment of unresectable metastatic SCC of the skin. It is difficult to perform a prospective clinical trial of chemoradiotherapy followed by surgery in the treatment of metastatic cutaneous SCC because of its rarity, but this treatment constitutes a treatment option.

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Neurological disorders in a rural Western Australian population

Abstract: Possible risk factors for Parkinson's disease for individuals living in Geraldton and Midwest region need to be investigated. This study raises issues pertaining to the provision of services and allocation of resources in rural areas, especially for patients with Parkinson's disease.

Cited by 6 publications

References 22 publications

Exploring Parkinson's disease prevalence in regional, rural and remote Australia: A systematic scoping review

Exploring Parkinson's disease prevalence in regional, rural and remote Australia: A systematic scoping review

No evidence of an epidemic of Parkinson's disease in rural Western Australia

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