| Authors gratefully acknowledge the Deans of Stanley Medical College and Madras Medical College for their support and encouragement. The Madras Medical College Animal Ethics Committee approved the study. Special thanks to the animal house of the Madras Medical College for the supply of animals and support.
Traumatic Brain Injury 145. Yudofsky SC, Silver JM, Jackson W, et al. The Overt Aggression Scale for the objective rating of verbal and physical aggression. J Psychiatry. 1986; 143: 3539. Silver JM, Hales RE, Yudofsky SC. Neuropsychiatric aspects of traumatic brain injury. In: Yudofsky SC, Hales RE, eds. The American Psychiatric Press Textbook of Neuropsychiatry. Washington, DC: American Psychiatric Press; 1992: 363395. 147. Wood RLI. Neurobehavioral Sequelae of Traumatic Brain Injury. New York: Taylor & Francis; 1990. 148. Hall KM, Hamilton BB, Gordon WA, Zasler ND. Characteristics and comparisons of functional assessment indices: Disability Rating Scale, Functional Independence Measure, and Functional Assessment Measure. J Head Trauma Rehabil. 1993; 8 2 ; : 6074. 149. Hall KM. Overview of functional assessment scales in brain injury rehabilitation. NeuroRehabilitation. 1992; 2 4 ; : 98113. 150. Uomoto J, McLean A. Care continuum in traumatic brain injury. Rehabil Psych. 1989; 34: 7180. Mackay LE, Bernstein BA, Chapman PE, et al. Early intervention in severe head injury: Long-term benefits of a formalized program. Arch Phys Med Rehabil. 1992; 73: 635641. Ragnaarson KT, Thomas JP, Zasler ND. Model systems of care for individuals with traumatic brain injury. J Head Trauma Rehabil. 1993; 8 2 ; : 111. 153. Zasler ND. A medical perspective on physician training and brain injury rehabilitation. In: Durgin CJ, Schmidt ND, Fryer LJ, eds. Staff Development and Clinical Intervention in Brain Injury Rehabilitation. Baltimore, Md: Aspen Publishers; 1993: 257269. 154. Bontke CF, Baize CM, Boake C. Coma Management and Sensory Stimulation. In: Berrol S, ed. Phys Med Rehabil Clin North Am. 1992; 3 2 ; : 259272. 155. Sandel ME. Rehabilitation management in the acute care setting. In: Horn LJ, Cope DN, eds. State of the Art Reviews: Physical Medicine and Rehabilitation. Philadelphia, Pa: Hanley & Belfus; 1989: 2742. 156. Deaton AV, Holland A, Stonnington H, Veach S, Wilkins SL. Postacute rehabilitation: The day rehabilitation model. NeuroRehabilitation. 1991; 1 3 ; : 6269. 157. Blackerby WF, Gualtieri T. Recent advances in neurobehavioral rehabilitation. NeuroRehabilitation. 1991; 1 3 ; : 5361. 158. Cope DN, Cole JR, Hall KM, Barkan H. Brain injury: Analysis of outcomes in a post-acute rehabilitation system: General analysis. Brain Injury. 1991; 5 2 part 1 ; : 111125. 159. Fraser RT, Clemmons DC, McMahon BT. Vocational rehabilitation counseling. In: Kreutzer JS, Wehman P, eds. Community Integration Following Traumatic Brain Injury. Baltimore, Md: Paul H Brooks; 1990: 169184. 160. McMahon BT, Shaw LR, eds. Work Worth Doing: Advances in Brain Injury Rehabilitation. Orlando, Fla: Paul M Deutsch; 1991. 161. Cervelli L. Re-entry into the community and systems of post-hospital care. In: Rosenthal M, Griffith ER, Bond MR, Miller JD, eds. Rehabilitation of the Adult and Child with Traumatic Brain Injury. Philadelphia, Pa; FA Davis; 1990: 463475. 162. Cervelli L, Berrol S. Description of a model care system. In: Head Injury Rehabilitation Project Final Report. Grant #13-P-59156 9. San Jose, Calif: Santa Clara Valley Medical Center; 1982: 4. 163. Van Der Schaaf S. Personal communication. 1992, for instance, progesterone.
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Received for publication February 20, 2001, and accepted for publication July 9, 2001. Abbreviation: SIA, small intestinal atresia. From the Slone Epidemiology Unit, Boston University School of Public Health, Boston, MA. Reprint requests to Dr. Martha M. Werler, Slone Epidemiology Unit, 1371 Beacon Street, Brookline, MA 02446 e-mail: mwerler slone.bu, for example, rxlist.
The pharmacists have been undertaking medication reviews in 22 out of the 57 practices in Bolton. To date 1276 patients have been reviewed and 3217 interventions made resulting in a monthly saving of 5, 500 for this number of patients. The chart below shows a breakdown of interventions made by category and tolterodine.
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Antibody was persistently negative. CSF oligoclonal bands may be present in up to 90% of patients with MS 13 ; , but 42% of SLE 14 ; patients also have oligoclonal bands. So this test is of little help.There is a genetic and familial predisposition to development of MS, SLE and other autoimmune disease. There have been instances where one identical twin developed MS and the other SLE 15 ; , familial cases of SLE 16 ; , and MS occurring in one generation and SLE in another 17 ; . The mother of our patient has longstanding scleroderma. Both show remarkably similar HLA typing. However, neither showed profiles commonly seen in MS 18 ; SLE 19 ; . CONCLUSION This patient illustrated some of the diagnostic dilemma in differentiating MS from SLE. ACKNOWLEDGEMENTS Professor D. J. Pudifin's immunology laboratory performed the serological tests. Secretarial assistance was provided by Mrs V. Pillay. REFERENCES and phenoxybenzamine.
Figure 17 Hypothetical illustration of cardioversion failure. Three types of recurrences after electrical cardioversion of persistent atrial fibrillation AF ; are shown. The efficacy of drugs varies in enhancement of shock conversion and suppression of recurrences. Modified with permission from van Gelder IC, Tuinenburg AE, Schoonderwoerd BS, et al. Pharmacologic versus direct-current electrical cardioversion of atrial flutter and fibrillation. J Cardiol 1999; 84: 147R51R, with permission from Excerpta Medica Inc.704 ECV indicates external cardioversion; IRAF, immediate recurrence of AF defined as the first recurrence of AF after cardioversion; SR, sinus rhythm.
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And antibiotic therapy in the community? How can barriers to care seeking for newborn illness be overcome most effectively so that home-based care and care seeking can be effectively linked with referrallevel care at facilities? What is the impact and costeffectiveness of postnatal visitation for promotion of healthful behaviors and recognition of neonatal illness? Can the same worker address the postnatal needs of both mothers and newborns? What is the optimal timing and number of routine visits with a health care provider? Skilled care during delivery is universally recognized as a major long-term priority for improving the care of mothers and newborns, and plans for advancing health system capabilities for providing this care are paramount. Based on a consideration of the fact that most births and neonatal deaths occur at home during the early neonatal period, due to birth asphyxia and or infections, and among LBW infants, the following emerge as major research gaps: 1. Understanding and improving household and community practices and their determinants: Local formative research is needed to better understand local beliefs and practices and the reasons behind them so that effective behavior-change strategies can be developed and evaluated.23 This must be followed by appropriate research to develop intervention strategies to improve careseeking behaviors at the household and community levels. 2. Improving health systems' capacity for providing essential preventive and special curative neonatal health care: As noted above, some of the most challenging questions in neonatal health care relate to how to most effectively deliver services to newborns in an integrated way within existing programs for maternal and child health.2022 Although difficult, determining the answers to these questions requires that many packages and combinations of interventions be tested through effectiveness trials in health system settings. 3. Preventing and improving recognition and management of birth asphyxia: Identification of sustainable interventions for management of intrapartum hypoxia birth asphyxia is urgently needed at the community level.24 Solutions must allow for immediate response at the time of delivery in a cost-effective manner and necessarily will require integration with skilled health care for mothers at delivery16 and links with referral facilities. 4. Preventing and improving recognition and management of infections: There is an urgent need to identify how the burden and severity of maternal infections relate to perinatal outcomes. These infections may range from subclinical intrauterine infection and bacterial vaginosis to overt genital tract infections that may lead to preterm labor. The true burden of bacterial neonatal infections in community settings is also unclear, because many clinical bacterial infections may represent viral infections. Narrowing this information gap is vital; to devise optimal antibiotic treatment strateSUPPLEMENT 525.
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McGeer, Edith McGeer PL, Yasojima K, McGeer EG. 2002 ; . Association of interleukin-1b polymorphisms with idiopathic Parkinson's disease. Neurosci Lett, 326: 67-69. McGeer PL, McGeer EG, Yasojima K. 2002 ; . Expression of COX-1 and COX-2 mRNAs in atherosclerotic plaques. Exp Geront, 37: 925-929. McGeer PL, McGeer EG. 2002 ; . Inflammatory processes in amyotrophic lateral sclerosis. Muscle & Nerve, 26: 459-470. McGeer PL, McGeer EG. 2002 ; . The possible role of complement activation in Alzheimer disease. Trends Mol Med, 8: 519-523. McGeer PL, McGeer EG. 2002 ; . Local neuroinflammation and the progression of Alzheimer's disease. J Neurovirol, 8: 529-538. McGeer PL, McGeer EG. 2003 ; . Is there a future for vaccination as a treatment for Alzheimer's disease? Neurobiol Aging, 24: 391-395. McGeer EG, McGeer PL. 2003 ; . Clinically tested drugs for Alzheimer's disease. Expert Opin Investig Drugs, 12: 1143-1151. McGeer EG, McGeer PL. 2003 ; . Inflammatory processes in Alzheimer; s disease. Progr Neuro-Psychopharmacol & Biol Psychiatry, 27: 741-749. McGeer, Patrick Schwab C, McGeer PL. 2002 ; . Complement activated C4d immunoreactive oligodendrocytes delineate small cortical plaques in multiple sclerosis. Exp Neurol, 174: 81-88. Wakita H, Tomimoto H, Akiguchi I, Matsuo A, Lin J-X, Ohara M, McGeer PL. 2002 ; . Axonal damage and demyelination in the white matter after chronic cerebral hypoperfusion in the rat. Brain Res, 924: 63-70. Klegeris A, Liutkevicius E, Mikalauskiene G, Duburs G, McGeer PL, Klusa V. 2002 ; . Anti-inflammatory effects of cerebrocrast in a model of rat paw edema and on mononuclear THP-1 cells. Eur J Pharmacol, 441: 203-208. Klegeris A, Singh EA, McGeer PL. 2002 ; . Effects of C-reactive protein and pentosan polysulphate on human complement activation. Immunology, 106: 381388. McGeer PL, Yasojima K, McGeer EG. 2002 ; . Association of interleukin-1b polymorphisms with idiopathic Parkinson's disease. Neurosci Lett, 326: 67-69. McGeer PL, McGeer EG, Yasojima K. 2002 ; . Expression of COX-1 and COX-2 mRNAs in atherosclerotic plaques. Exp Geront, 37: 925-929. McGeer PL, McGeer EG. 2002 ; . Inflammatory processes in amyotrophic lateral sclerosis. Muscle & Nerve, 26: 459-470. Klegeris A, McGeer PL. 2002 ; . Cyclooxygenase and 5-lipoxygenase inhibitors protect against microglial neurotoxicity. Neurobiol Aging, 23: 789-796. McGeer PL, McGeer EG. 2002 ; . The possible role of complement activation in Alzheimer disease. Trends Mol Med, 8: 519-523. McGeer PL, McGeer EG. 2002 ; . Local neuroinflammation and the progression of Alzheimer's disease. J Neurovirol, 8: 529-538. McGeer PL, McGeer EG. 2003 ; . Is there a future for vaccination as a treatment for Alzheimer's disease? Neurobiol Aging, 24: 391-395.
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