MyMedR

Four formal rounds of Trans-Pacific Partnership Agreement (TPPA) negotiations took place in 2010. They involved over 200 officials from Australia, the United States, New Zealand, Chile, Singapore, Brunei, Peru, Vietnam and Malaysia. Future negotiations officially are set to include three issues with public health and medicines policy implications for Australia and our region: ways to approach regulatory coherence and transparency; how to benefit multinational and small-medium enterprises; and multilateral investor-state dispute settlement. US-based multinational pharmaceutical companies are lobbying for TPPA provisions like those in the Australia-US Free Trade Agreement, which reduce government cost-effectiveness regulatory control of pharmaceuticals, threatening equitable access to medicines. They also advocate increased TPPA intellectual monopoly privilege protection, which will further limit the development of Australian generic medicine enterprises and restrict patient access to cheap, bioequivalent prescription drugs. Of particular concern is that proposed TPPA multilateral investor-state dispute settlement procedures would allow US corporations (as well as those of other TPPA nations) to obtain damages against Australian governments through international arbitral proceedings if their investments are impeded by Australian public health and environment protection legislation.

Myasthenia gravis and a rare complication of chemotherapy

Ng CV

Med J Aust, 2005 Feb 07;182(3):120.

PMID: 15698357

We describe a patient with myasthenia gravis and thymoma who developed recurrent severe myasthenic crises associated with the use of combination chemotherapy.

Epidemiology of HIV and AIDS in the Asia-Pacific region

Dore GJ, Kaldor JM, Ungchusak K, Mertens TE

Med J Aust, 1996 Nov 4;165(9):494-8.

PMID: 8937371

The incidence of new HIV infections in Asia and the Pacific will soon pass that in Africa and is projected to increase into the next century. The AIDS epidemic arising from these infections will have enormous consequences for the health and socioeconomic development of a region encompassing more than half the world's population.

Hepatitis B vaccine

Wilkinson IE

Med J Aust, 1992 May 18;156(10):741.

PMID: 1535682

Pig-bel but no pig: enteritis necroticans acquired in Australia

Watson DA, Andrew JH, Banting S, Mackay JR, Stillwell RG, Merrett M

Med J Aust, 1991 Jul 01;155(1):47-50.

PMID: 2067439

OBJECTIVE: To report a case of enteritis necroticans acquired in Australia, and to review the history, epidemiology, pathogenesis, clinical features, management and prevention of this disease.

CLINICAL FEATURES: A 44-year-old diabetic and alcoholic restaurateur of Chinese-Malay origin, who had been living in Australia for over 20 years, was admitted to hospital with bloody diarrhoea which progressed to fulminant toxaemia and circulatory collapse, and ultimately required laparotomy. Typical pathological features and the isolation of Clostridium perfringens type C from faeces confirmed the diagnosis of enteritis necroticans.

INTERVENTION AND OUTCOME: He was treated initially with ampicillin, gentamicin, metronidazole and chloramphenicol, and later with penicillin and metronidazole, and he required large volumes of intravenously administered fluid and blood for his toxaemic, hypotensive state. Laparotomy was performed as a life-saving procedure. Despite a lengthy convalescence, the patient recovered.

CONCLUSIONS: Enteritis necroticans is a rare disease in developed countries, however it is likely to be underdiagnosed. Clinicians are encouraged to be on the alert for signs of severity that may indicate the need for laparotomy in a predisposed individual with features of this condition.

Endometriosis and social class

Arumugam K, Templeton AA

Med J Aust, 1990 Nov 05;153(9):567.

PMID: 2233493

Haemorrhagic fever with renal syndrome involving the liver

Chan YC, Wong TW, Yap EH, Tan HC, Lee HW, Chu YK, et al.

Med J Aust, 1987 Sep 07;147(5):248-9.

PMID: 2890086

A case of haemorrhagic fever with renal syndrome that originated in Malaysia is reported. The patient presented with clinical symptoms which were not typical of the disease as seen in endemic regions. Renal involvement, which is characteristic of haemorrhagic fever with renal syndrome, was mild, and the predominant symptom was a persistently marked elevation of serum transaminase levels that was suggestive of hepatitis. Liver involvement has not been described in the Asian form of haemorrhagic fever with renal syndrome. The patient developed a petechial skin rash and had severe thrombocytopenia. Serological confirmation of the diagnosis of haemorrhagic fever with renal syndrome was obtained by the demonstration of significant antibody rises to hantaviruses in the patient's acute- and convalescent-phase sera.

Transportability of in-vitro fertilization technology

Yovich JL, Hamzah H, Massouras H

Med J Aust, 1987 Jun 15;146(12):657-8.

PMID: 3626918

Severe cutaneous adverse reactions and sulphadoxine-pyrimethamine in Sabah, Malaysia

Lyn PC, Fernandez E

Med J Aust, 1987 Mar 16;146(6):335-6.

PMID: 2950306

Intraperitoneal haemorrhage from a ruptured corpus luteum. A cause of "acute abdomen" in women

Sivanesaratnam V, Singh A, Rachagan SP, Raman S

Med J Aust, 1986 Apr 14;144(8):411, 413-4.

PMID: 3959969

During the 10-year period 1974-1983, 68 patients with intraperitoneal haemorrhage as a result of the rupture of a corpus luteum were managed at the University Hospital, Kuala Lumpur, Malaysia. Most of the patients were aged between 18 and 35 years. In 63% of the patients the rupture occurred between the 14th and the 35th day of the menstrual cycle, and 10 patients had intraperitoneal bleeding severe enough (450-1500 mL) to require blood transfusion. The condition is often confused with other surgical emergencies such as appendicitis and ectopic pregnancy. An increased awareness of the problem in women of reproductive age and the use of laparoscopy, when indicated, will allow a more conservative approach to be adopted for those patients with minimal bleeding. The performance of an appendicectomy in the presence of blood in the peritoneal cavity did not appear to increase morbidity in those patients with a preoperative diagnosis of "appendicitis".

Penetrating wounds caused by needle-fish in Oceania

Barss PG

Med J Aust, 1985 12 9;143(12-13):617-8, 621-2.

PMID: 3831754

Needle-fish are slender silvery fish with long pointed beaks. They are commonly seen swimming beneath the surface near fringing reefs in the Indo-Pacific area. Such areas are also frequented by Melanesian villagers. The speed of needle-fish, together with their tendency to leap out of the water when bright lights are used for fishing and at other times, occasionally result in deep, penetrating injuries to swimmers, waders, and, in particular, to fishermen who are working at night from small canoes. Injuries from needle-fish are a relatively common occupational hazard of subsistence village life in Oceania, and probably also for some fishermen in other coastal environments, such as those in Japan and Malaysia.

Phenylbutazone

Mansfield P

Med J Aust, 1985 Sep 2;143(5):219-20.

PMID: 4033497

Medicine in Malaysia. Shadows of transition

Nicks R

Med J Aust, 1983 Nov 26;2(11):578-9.

PMID: 6633393

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