The Medical journal of Australia
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Evidence is increasing that neurorehabilitation lessens patient disability and improves quality of life in both acute and chronic neurological conditions. A focused, multidisciplinary team approach is the key to a successful rehabilitation outcome. ⋯ GPs will supervise function over the long term and activate community rehabilitation resources when necessary to maintain patient function. Ideally, rehabilitation services should be available for most patients with neurological disorders, as it is difficult to predict which individual patients will not benefit.
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In the evidence-based medicine stakes, obstetrics has risen from being the holder of the "wooden spoon" to being a world leader in the pursuit of best evidence and the use of formal systematic reviews. A prime example of evidence-based obstetric practice is the use of corticosteroids to reduce respiratory distress syndrome in preterm infants. ⋯ Researchers in Australia are now examining strategies to maximise dissemination of available best evidence into obstetric practice. Without reflective practice and effective dissemination of evidence, the present litigation phobia surrounding obstetric care could lead to evidence-based medicine being replaced by "nervousness-based medicine".
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An acute polyneuropathy developing over days to several weeks is most likely to be Guillain-Barré syndrome or a toxic neuropathy, although vasculitis can also present acutely. This presentation should be referred immediately for further investigation. ⋯ Idiopathic chronic axonal neuropathy is an indolent, predominantly sensory neuropathy that typically occurs in older patients. Neuropathies occurring in young or middle age or with more subacute onset always warrant further investigation.