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NEWS 11
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X OCTO- MONTH library at www . ausdoc . com . au / therapy-update
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2022
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NEWS 11
Local Buruli ulcer detected in NSW
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Antony Scholefield BURULI ulcer has officially spread to NSW after health authorities uncovered the first locally acquired case of the necrotising skin disease in the seaside town of Batemans Bay .
The surprise diagnosis sparked an investigation that turned up two historical cases in the same area going back to 2021 , according to the local health district .
“ All three people are understood to have been infected locally and are the only local transmissions observed
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in NSW to date ,” said April Roberts-Witteveen , Southern NSW Local Health District ’ s acting director of public health .
“ Previous cases of Buruli ulcer in NSW have been diagnosed in people who have travelled to affected areas of Victoria or Queensland , so finding the infection in NSW in people who have not travelled is unusual .”
Until now , reports of Buruli ulcer — also known as the Bairnsdale or Daintree ulcer — have been limited to 200-300 cases a year in Victoria , plus
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occasional outbreaks in Queensland and the NT .
NSW Health is investigating whether possums or mosquitoes brought the disease to Batemans Bay , which is a four-hour drive from Sydney and two hours from Canberra .
Ms Roberts-Witteveen has urged NSW patients with non-healing skin ulcers to see a GP .
The spread of the disease-causing Mycobacterium ulcerans has continued to perplex doctors and scientists . Last year , Victorian authorities
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warned it was spreading from well-defined endemic zones in coastal regions , such as the Mornington Peninsula , to metropolitan Melbourne and Geelong .
Last year , infectious diseases physician Professor Paul Johnson said migrating birds or fruit bats could also be responsible for the spread at the “ macro level ”.
“ Mosquitoes don ’ t tend to travel those sorts of distances ,” said Professor Johnson , from Austin Health and the University of Melbourne .
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Three cases have been identified in Batemans Bay . |
GPs sign up to supervise pharmacists
FROM PAGE 1 practice .
According to Queensland Health , around 300 pharmacists are now going through the prescribing training . With the expansion of the pilot , the number is expected to increase dramatically .
Ms Fentiman claimed the “ nation-first ” pilot was an “ innovative way to ensure Queenslanders have access to high-quality and cost-effective primary healthcare ”. Doctor groups have already branded it a “ reckless experiment ”.
There is still no information on the specific S4 medications available for pharmacist prescribing , but none will be covered by the PBS , with pharmacists therefore writing private scripts .
RACGP vice-president Dr Bruce Willett urged GPs to “ think carefully ” about signing up as supervisors because of the lack of remuneration and public information about their medicolegal responsibilities .
“ My main concerns are that GPs are putting themselves at risk legally for no or very little compensation and the message we are sending the future generation of GPs that their job could potentially be done by a pharmacist .”
Earlier this year , Dr Evan Ackermann wrote about the original pilot , saying no community pharmacist activity had yet been proven to reduce GP , ED or hospital use .
“ And certainly no document has been published which provides the evidence base for appropriateness , effectiveness and safety for the North Queensland pharmacy pilot ,” the Brisbane GP said .
“ Queensland Health is still to publish a scoping review to confirm actual scope of practice proposals .
“ It is a foundational problem for the pilot …
“ Where are the safety parameters around pharmacist therapeutic substitution , given that pharmacists will also be empowered to unilaterally change a patient ’ s medication ?”
OLOPATADINE HYDROCHLORIDE + MOMETASONE FUROATE MONOHYDRATE
Combination NASAL SPRAY for allergic rhinitis
In patients 6 years of age and older . 1
MOMETASONE FUROATE Corticosteroid for long-lasting relief 1 , 2
OLOPATADINE Antihistamine for fast symptom relief 1 , 2
≥6 yrs
Fast onset of action † 3 , 4 For patients ≥6 yrs 1
MY COMBINATION FOR A GOOD DAY *
* Improvement in allergic rhinitis symptoms and quality of life measures vs placebo ( p < 0.05 ). 1 , 3 – 5
TWICE as effective as mometasone furoate alone ( for nasal and ocular symptoms ) ‡ 1 , 3 , 4 , 6 , 7
†
iTNSS ; p < 0.05 vs placebo in patients ≥12 yrs . ‡ 104 % relative improvement with Ryaltris vs MF ( placebo-subtracted rT7SS results , post-hoc , pooled analysis of 3 double-blind , randomised , placebo-controlled 14-day studies in patients ≥12 yrs .); p < 0.001 ( N = 2,971 ). 7
Ryaltris is generally well tolerated , with similar incidences of adverse events to placebo and individual monotherapies . 1 , 3-5
In 6-11 year old children , periodic review of corticosteroid use is recommended .
PBS Information : This product is not listed on the PBS .
Please refer to the full Ryaltris Product Information before prescribing , which can be accessed by scanning the QR code . iTNSS : instantaneous total nasal symptom score . MF : Mometasone furoate . rT7SS : Reflective total of 7 ( 4 rhinitis + 3 ocular ) symptom scores .
References : 1 . Ryaltris Approved Product Information . 2 . Bousquet J et al . Allergy 2008 ; 63:8 – 160 . 3 . Gross GN et al . Ann Allergy Asthma Immunol 2019 ; 122:630 – 638 . 4 . Hampel FC et al . Allergy Asthma Proc 2019 ; 40 ( 4 ): 261 – 272 . 5 . Segall N et al . Allergy Asthma Proc 2019 ; 40 ( 5 ): 301 – 310 . 6 . Andrews CP et al . Ann Allergy Asthma Immunol 2020 ; 124 ( 2 ): 171 – 178 . 7 . Meltzer E et al . Poster presented at the European Respiratory Society ( ERS ) International Congress , 4 – 8 September 2021 , Barcelona . Data on file .
Ryaltris ® is a registered trademark of Glenmark Specialty SA . Seqirus ( Australia ) Pty Ltd . Melbourne , Victoria , Australia . ABN 66 120 398 067 . Medical Information : 1800 642 865 . AU-RYAL-23-0027 . Date of Preparation : April 2023 . 2004119 .