Perry Syndrome

Disease characteristics. Perry syndrome is characterized by parkinsonism, hypoventilation, depression, and weight loss. The mean age at onset is 48 years; the mean disease duration is five years. Parkinsonism and psychiatric changes (depression, apathy, character changes, and withdrawal) tend to occur early; severe weight loss and hypoventilation manifest later. Diagnosis/testing. The diagnosis is based on clinical findings and molecular genetic testing of DCTN1, the only gene known to be associated with Perry syndrome. Management. Treatment of manifestations: Dopaminergic therapy (particularly levodopa/carbidopa) should be considered in all individuals with significant parkinsonism. Although response to levodopa is often poor, some individuals may have long-term benefit. Noninvasive or invasive ventilation support may improve quality of life and prolong life expectancy. Those patients with psychiatric manifestations may benefit from antidepressants and psychiatric care. Weight loss is managed with appropriate dietary changes. Surveillance: routine evaluation of weight and calorie intake, respiratory function (particularly at night or during sleep), strength; and mood. Agents/circumstances to avoid: Central respiratory depressants (e.g., benzodiazepines, alcohol). Genetic counseling. Perry syndrome is inherited in an autosomal dominant manner. The proportion of cases attributed to de novo mutations is unknown. Each child of an individual with Perry syndrome has a 50% chance of inheriting the mutation. No laboratories offering molecular genetic testing for prenatal diagnosis are listed in the GeneTests Laboratory Directory; however, prenatal testing may be available through laboratories offering custom prenatal testing for families in which the disease-causing mutation has been identified.

Perry Municipal Waterworks, June 30, 2002

City Audit Report - Municipal Waterworks

Perry Municipal Waterworks, June 30, 2003

City Audit Report

Perry Municipal Waterworks, Independent Auditor's Reports, Financial Statement and Supplementary Information Schedule of Findings, June 30, 2004

Other Audit Report - Utilities

Perry Community School District, July 1, 2004 through March 31, 2005

Community School District Audit Report

City of Perry, Auditor of State's Report on Reaudit for the Period July 1, 2002 through June 30, 2003

City of Perry, Auditor of State's Report on Reaudit for the Period July 1, 2002 through June 30, 2003

Perry Municipal Waterworks, Independent Auditor's Reports, Basic Financial Statement and Supplementary Information, Schedule of Findings, June 30, 2005

Other Audit Reports - Utilities

Perry Community School District, Independent Auditor's Reports, Basic Financial Statements and Supplementary Information, Schedule of Findings and Questioned Costs, June 30, 2005

Community School District Audit Report

Perry Municipal Waterworks, Independent Auditor's Report, Basic Financial Statements and Supplementary Information, Schedule of Findings, June 30, 2006

Other Audit Reports - Utilities

City of Perry, Independent Auditor's Reports, Basic Financial Statements and Supplementary Information, Schedule of Findings, June 30, 2006

City Audit Report

Perry Community School District, Independent Auditor's Reports, Basic Financial Statements and Supplementary Information, Schedule of Findings and Questioned Costs, June 30, 2006

Community School District Audit Report

Audit report on the Perry Municipal Waterworks, Perry, Iowa for the year ended June 30, 2007

Audit report on the Perry Municipal Waterworks, Perry, Iowa for the year ended June 30, 2007

Audit report on Perry Community School District in Perry, Iowa for the year ended June 30, 2007

Audit report on Perry Community School District in Perry, Iowa for the year ended June 30, 2007

Audit report on the City of Perry, Iowa for the year ended June 30, 2007

Audit report on the City of Perry, Iowa for the year ended June 30, 2007

Special investigation of selected transactions at Perry High School for the period July 1, 2005 through November 30, 2007

Special investigation of selected transactions at Perry High School for the period July 1, 2005 through November 30, 2007