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Oncology Research and Development Myocet is a proprietary liposomal formulation of doxorubicin. Doxorubicin is commonly used with other cancer drugs to treat patients with metastatic breast cancer. One of the most debilitating side effects associated with the use of doxorubicin is irreversible damage to the heart. Myocet is designed to enhance the delivery of the drug to tumour cells and to reduce the cardiotoxic side effects associated with conventional formulations of the drug. Myocet has received community marketing authorisation from the EU for use in combination with cyclophosphamide for the first line treatment of metastatic breast cancer. Dermatology The three US dermatology markets in which Elan competes are topical corticosteroids "TCSs" ; , topical antifungals and topical anti-infectives. TCSs have the highest growth rate amongst the three market segments and also comprise the largest segment with US revenue of approximately $600 million in 2000. Topical anti-fungals are a relatively stable market segment with US revenue of approximately $520 million annually. Products Elan entered into a distribution agreement for five dermatology products with Glaxo Wellcome Inc. in September 2000. Elan currently promotes these five products in three separate dermatology categories in the US market. Cutivate, Etmovate and AclovateTM are all TCSs, each competing in the subcategories of high potency, medium potency and low potency, respectively. OxistatTM is a topical anti-fungal and EmgelTM is a topical anti-infective. Cutivate. Cutivate is used to provide relief for corticosteroid-responsive skin disease. Cutivate is the only topical steroid indicated for children under one year of age and older than three months. It has a fast onset of action and quickly relieves inflammation and itching. Temovate. Temovxte is for the treatment of severe inflammatory skin diseases. It relieves the redness, swelling, pain and itching associated with corticosteroid-responsive skin disease. Temovahe is effective and safe for the short term treatment of patients with skin diseases that are resistant to lower potency TCSs. Athena Diagnostics and Elan Diagnostics Elan operates two distinct diagnostics units--Athena Diagnostics and Elan Diagnostics. These businesses are part of the EP division. Revenue from the diagnostics businesses amounted to approximately $70 million in 2000, an increase of 35% over 1999. Athena Diagnostics is a laboratory business that receives and analyses samples sent from physicians. It provides testing services in the areas of peripheral nerve disorders, neurogenetic disorders, Alzheimer's disease, paraneoplastic syndromes, movement disorders, neuromuscular disorders and ataxia. This company also offers ApoTM genotyping services to contract research organisations and pharmaceutical companies for use in clinical trials, as well as antibody testing services for clinicians treating patients with MS and cervical dystonia. This business is based in Massachusetts, US. Elan Diagnostics manufactures and distributes equipment, chemistry reagents and test kits used in physicians' offices and clinical laboratories to assay blood specimens. This business is based in Rhode Island, US. US Integration An integration team was established in October 2000 to integrate Dura, Liposome and EP's existing operations. The objective of this integration process was to create a business capable of competing effectively in its chosen -22.
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Class B1 or B2 - noninfectious TB: Individuals are instructed to receive a medical examination within 30 days of arrival in the U.S. Class B3 - old, healed TB: Individuals are instructed to have a medical examination within 90 days of arrival in the U.S. CDC notifies the MDH TB Program of anticipated primary arrivals with TB Class Conditions. MDH and local public health departments collaborate to ensure appropriate followup evaluation for these individuals. Domestic Refugee Health Assessment Due to the potentially incomplete and inaccurate results of overseas medical examinations, a domestic health assessment is recommended for all newly arrived foreignborn persons. This is a comprehensive examination intended to identify and eliminate health-related barriers to the patient's resettlement and to protect the health of the community. Any health care provider can perform this examination. The MDH Refugee Health Assessment Form outlines components of this examination. The TB portion includes: - Mantoux TST regardless of BCG history - chest x-ray for persons with a reactive TST result and for persons with a TB Class Condition identified overseas regardless of their TST result and, if indicated: - further evaluation to diagnose or rule out TB disease; - evaluation as a candidate for treatment of latent TB infection LTBI ; . Federal, state, and local public health agencies track the outcomes of health assessments only for primary refugees who arrive in the U.S. This system does not address other.
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The following diagram summarises the different developments, which were clearly recognized in past years in raised bog grassland areas and will continue to take place even more rapidly in the future. In the diagram Figure 3 ; , the raised bog grassland is represented as status quo. Since no stable landscape type is concerned, the usage will adapt to the changing basic conditions. The decision, whether the use is intensified, reconverted and or forsaken, depends, apart from economic basic conditions, on the thickness of the peat layer, groundwater conditions and the type of mineral subsoil. However, independently of the directions, the development of the previous model runs contrary to nature conservation. From this, the current challenge for nature conservation of this model must be considered and topiramate.
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Antiageing creams: Where's the evidence? Dr Tamara Griffiths, Department of Dermatology, Macclesfield General Hospital, Macclesfield, Cheshire, UK By definition, cosmetics are designed to improve or beautify appearance, but should have no significant effect on the structure or function of the skin. This is in contrast to a drug, the purpose of which is to mitigate, prevent or treat disease. The FDA requires no premarketing approval for cosmetic formulations, although it will investigate if there are questions about safety. In contrast, drugs require extensive safety and efficacy requirements for approval, which are costly and time-consuming. Prof. Albert Kligman coined the term `cosmeceutical' in the 1980s to describe preparations which are sold as cosmetics but display some properties of a drug by having an effect on skin function. A precarious balance exists between the claims and effects of these products. Overzealous claims may attract negative attention from regulatory bodies. Intrinsic ageing is due to the passage of time and manifests as atrophic, pale skin with fine wrinkles. There is a reduction in sebum production and decreased skin-barrier function. Photoageing is caused by cumulative sun damage and is characterized by coarse wrinkles, solar elastosis Figure 5.
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Reasons to purchase assess leading antidepressants and identify key success factors within this sector understand key market drivers and predict the future performance of key compounds benchmark pipeline antidepressants against currently marketed products and assess their future market potential table of contents chapter 1 executive summary 3 scope of the analysis 3 datamonitor insight into the antidepressant market 4 the antidepressant market is set to undergo a period of rapid change as seven out of the eight leading brands suffer us patent expiries by 200 with only a handful of new products anticipated to replace these blockbuster products, the market is expected to decrease by -2 5% to $1 5 billion by 2011, as physicians are encouraged to utilize cheaper generics and valaciclovir.
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Fig. 8. Diagram illustrating the central division of the extended amygdala, its neuropharmacological components, afferent and efferent connections, and functional attributes. Based on anatomical integration of Refs. [6, 17] taken with permission from Ref.  and ceclor.
58. Are the skills of the community based health providers formally assessed after initial training? On a regular basis thereafter? o Yes How often? o No Why not? o If Yes, please describe the assessment evaluation procedure.
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Table 3.3: Views on Tied-selling by Income Groups.
According to the authors of an August 3, 2002 article in the British Medical Journal, "It is time to stop using high blood pressure readings documented by general practitioners to make treatment decisions."1 Overzealous diagnosis and treatment of hypertension result when readings obtained at the doctor's office are used to make decisions, because of the "white coat effect, for instance, hcl.
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4. Among all the methods studied, death was predominantly caused by a firearm throughout the 10 year period 59.4% ; followed by Hanging 18.3%, Drugs and Poisons10.2%. The remaining 22.9% included other causes such as asphyxia, fire, CO, drowning, blunt force and sharp force trauma, and vehicular related. Tarrant County, Suicide, Suicidal Rate.
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Stroke in young adults related to hypolastic vertebral artery S. Markoula, S. Giannopoulos, I. Sarmas, M. Argyropoulou, M. Kosmidou, S. Maragoudaki, A.P. Kyritsis, Department of Neurology, Department of Radiology, University of Ioannina Medical School, Greece.
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Taking forward pharmacy what have we done to help? The DH published A Vision for Pharmacy in the New NHS in July 2003 and a summary of this was presented to the PEC. The Vision stated that `pharmacists are probably the biggested untapped resource for health improvement'. A new national community pharmacy contract is currently being negotiated and new regulations governing where new NHS dispensing pharmacies can open are also forthcoming. An October 2003 presentation to the PEC covered these developments.
Forty consecutive adult Chinese patients 20 women, 20 men; mean age, 42.9 years 14.01 [SD]; median age, 41 years; age range, 25 82 years ; who were treated for SARS at Queen Mary Hospital, Hong Kong, China, were included in this study during a 6-week period. Diagnosis of SARS was determined according to established diagnostic criteria for probable cases, as proposed by the Centers for Disease Control and Prevention on March 27, 2003, and these criteria have been updated recently by the World Health Organization on May 2, 2003 20, ; . In all 40 patients, results from serologic tests subsequently confirmed that they had SARS-CoV infection 14 ; . Mean age for women was 37.5 years 9.5 median age, 35.5 years; age range, 2553 years ; and that for men was 48.3 years 15.8 median age, 46.5 years; age range, 25 82 years ; . All patients received combination therapy with intravenous 8 mg per kilogram of body weight thrice daily ; or oral.
Background: Providing information to their patients on the effects of medication exposure during pregnancy is a common challenge for family physicians. Women must receive accurate information as unrealistic perception of teratogenic risk may lead to inadequate treatment of maternal disease or termination of otherwise wanted pregnancies. Objectives: To collect data on the current practices of family physicians in Ontario in providing information regarding pregnancy-related drug exposures. Methods: A mailed survey was sent to a random sample of family physicians in Ontario in 2003. Results: Of the 756 surveys, 400 53% ; were returned, 265 66% ; of which were completed by practicing family physicians caring for women of childbearing age. Most 80.3% ; felt confident in providing counseling, though a majority 56% ; stated that the available sources of information are not adequate. The most commonly cited source consulted for obtaining information on drug use during pregnancy was Motherisk 62% ; , followed by the Compendium of Pharmaceuticals and Specialties CPS ; 25% ; , textbooks 13% ; , electronic sources 7% ; , obstetricians 4% ; , pharmacists 4% ; and peer-reviewed journals 1% ; . Lack of evidence-based information was cited as the major barrier to providing effective counselling in this area. Most respondents indicated that they had received "a little" teaching on the effects of drugs in pregnancy during their undergraduate 69% ; and postgraduate 65% ; medical education. With regards to future development of educational programs in this field many indicated a preference for electronic means. Conclusions: Although family physicians were confident in providing counseling to pregnant patients with regards to drug use, more than one-half thought that the available sources of information are not adequate. The dissemination of more evidence-based information in this field is needed, as is the development of electronic educational resources. Key Words: Family physicians, information, drugs, medications, pregnancy, counseling.
By one body, the Health Insurance Commission. This body can then also readily collate statistics about the prescription drugs dispensed in Australia. These in turn can be used to improve prescribing and to develop initiatives to improve the use of medicines in Australia interlinking with the Quality Use of Medicines arm of Australia's National Medicines Policy ; . Monitoring policy changes and effects of external influences eg. pivotal clinical trials ; can also then be evaluated at a population level.9, 12 For effective cost controls, it has been argued that the payer should also be the price negotiator.13 This is the case for pharmaceuticals in Australia. Australia also uses the expertise available in the country well. For example, there are only 19 million people, and therefore not too many pharmacoeconomists or experienced evaluators. The national system focuses these individuals and draws them together to enable the expertise to be used optimally for the small country. It is a physically disseminated system and is not just `controlled' from the capital city, Canberra. As the PBS is a national scheme, potential savings due to, for example, improved prescribing of very expensive drugs may be very large. These savings can be used to fund the intervention, for example academic detailing, which leads to such large savings. The National Prescribing Service in Australia, which has been fully evaluated for such cost savings, is run in just such a manner. Savings can also be put towards reimbursement for professional services, for example for pharmacists paying for professional activities designed to optimise medication use, rather than paying just for a drug product ; or for general practitioners to move away from the fee for service model.
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The absence of an optic cup in a mild-to-moderately `swollen' disc; the presence of anomalous vasculature at the disc, e.g. trifurcations. If there is still diagnostic doubt, the next move is to obtain a fluorescein angiogram of the discs usually with help from an ophthalmologist ; . It is important to also ask for `autofluorescence', as optic nerve head drusen often fluoresce before dye is injected. Another useful trick is to ask the medical photographer to photograph the discs while the patient is having their angiogram: this can prove invaluable in future management for the purposes of comparison. Some patients with IIH have unilateral papilloedema Sher et al. 1983; Wall & White 1998 ; , and a small number have no papilloedema at all Lipton & Michelson 1972; Mathew et al. 1996 ; . Why this should be is not clear, but it may reflect anatomical variations at the ocular end of the optic nerve sheath: in particular there may be more effective lymphatic drainage channels in some nerves than others Killer et al. 1999.
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