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A. V. Pereira, O. Fatibello-Filho, Anal. Chim. Acta 1988, 366, 5562. D. G. Themelis, P. D. Tzanavaras, F. S. Kika, Talanta 2001, 55, 127134. A. Paula, S. Paim, B. F. Reis, Anal. Sci. 2000, 16, 487491. A. Paula, S. Paim, C. M. N. V. Almeida, B. F. Reis, R. A. S. Lapa, E. A. G. Zagatto, J. L. F. Costa Lima, J. Pharm. Biomed. Anal. 2002, 28, 12211225. M. A. Raggi, V. Cavrini, A. M. Dipietra, J. Pharm. Sci. 1982, 71, 13841386. M. N. Reddy, D. G. Sankar, V. V. Sekhar, N. Ravindra, G. D. Rao, Indian Drugs 1991, 28, 331333. L. Fu, Y. Ren, Fenxi Huaxue 1992, 20, 193195. P. B. Issopoulos, P. T. Economou, Anal. Chim. Acta 1992, 257, 203207. F. Buhl, U. Hachula, Chem. Anal. Warsaw ; 1984, 29, 483489. J. Bassett, R. C. Denney, G. H. Jeffery, J. Mendham, Vogel's Textbook of Quantitative Inorganic Analysis; 4th ed., Longman Scientific & Technical, London and New York, 1978, pp.741. N. K. Pandey, Anal. Chem. 1982, 54, 793798. W. Horwitz, Official Methods of Analysis of the Association of Official Analytical Chemists; Published by the Association of Official Analytical Chemists, Washington DC, 3rd ed., 1980, pp.746. D. A. Skoog, D. M. West, F. J. Holler, Fundamental of Analytical Chemistry; Saunders College Publishing, New York, 5th ed., 1988, chapter 7. K. Ozutsumi, M. Kurihara, T. Miyazawa, T. Kawashima, Anal. Sci. 1992, 8, 521526.
Apnoea-hypopnoea, patients treated with CPAP, and healthy men recruited from the general population. Participants were followed-up at least once per year for a mean of 101 years SD 16 ; . Endpoints were fatal cardiovascular events death from myocardial infarction or stroke ; and non-fatal cardiovascular events non-fatal myocardial infarction, non-fatal stroke, coronary artery bypass surgery, and percutaneous transluminal coronary angiography ; . A total of 264 healthy men, 377 simple snorers, 403 with untreated mild-moderate obstructive sleep apnoea-hypopnoea, 235 with untreated severe disease, and 372 with the disease and treated with CPAP were included in the analysis. Patients with untreated severe disease had a higher incidence of fatal cardiovascular events 106 per 100 personyears ; and non-fatal cardiovascular events 213 per 100 person-years ; than did untreated patients with mild-moderate disease 055, p 002 and 089, p 00001 ; , simple snorers 034, p 00006 and 058, p 00001 ; , patients treated with CPAP 035, p 00008 and 064, p 00001 ; , and healthy participants 03, p 00012 and 045, p 00001 ; . Multivariate analysis, adjusted for potential confounders, showed that untreated severe obstructive sleep apnoea-hypopnoea significantly increased the risk of fatal odds ratio 287, 95%CI 117-751 ; and non-fatal 317, 112-751 ; cardiovascular events compared with healthy participants. CPAP treatment reduces this risk, for example, ventolin nebs.
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Correspondence: Dr. P Meredith. Division of Cardiovascular and Medical Sciences, Department of Medicine and Therapeutics, University of Glasgow, Western Infirmary, Glasgow G11 6NT, Scotland, UK Tel: + 44141-211-2748; fax: + 44-141-211-2748. E-mail address: p.a.meredith clinmed.gla.ac P. Meredith.
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Ventolin to Salamol--a crossover study in New Zealand S Reti In July 1 2005, PHARMAC the New Zealand body responsible for governmentfunded pharmaceutical subsidies ; removed the subsidy on the Vwntolin metered dose inhaler MDI ; salbutamol GlaxoSmithKline ; in favour of a chlorofluorocarbon CFC ; -free equivalent, Salamol MDI salbutamol Baker Norton ; . This study utilised a validated Asthma Control Questionnaire to examine the effect on asthma stability of converting 36 asthma patients from Vengolin to Salamol for a period of 4 weeks. Six of the 36 had to withdraw prematurely, 15 36 returned to Vfntolin at some point, and of the remaining patients, 15 36 93% had worse asthma stability. Asthmatics: too drunk to drive? The time curve of exhaled ethanol levels after use of Salamol in normal subjects O O'Connell, L Beckert This study measures the effects of the alcohol-containing metered dose salbutamol inhaler, Salamol, on roadside breath testing available in New Zealand. The authors confirm that this inhaler affects the alcohol readings on the breath tests, sometimes giving a failed result over the current legal limit of 400 micrograms mcg ; L ; . However this effect is very transient in a normal population; all readings return to normal after 3 minutes. To reduce the likelihood of a failed roadside alcohol breath test due to the Salamol inhaler, the authors recommend that the asthma patient waits at least 5 minutes after 2 puffs of Salamol, although this time may need to be increased if a incorrect inhaler technique is used or more than 2 puffs are taken. Complete reference ranges for pulmonary function tests from a single New Zealand population S Marsh, S Aldington, M Williams, M Weatherall, P Shirtcliffe, A McNaughton, A Pritchard, R Beasley This study provides a complete set of lung function reference equations for a New Zealand population. These equations are long overdue as those in current use are not valid, having been produced over 25 years ago. Implementation of the new reference equations will allow for more accurate interpretation of lung function tests which are important in the diagnosis, assessment and management of a range of respiratory conditions.
2.4.2 Top Products Ventolin, GSK's anti-asthma drug, has consistently been the top selling product of all in the total market since 1993, only occasionally eclipsed by other products, such as Therapharma's Alaxan, which was briefly number 1 in 1997. In 2002, Ventolun registered sales of up to PhP1.2 billion. Alaxan, on the other hand, has consistently been in second place since 1998, and registered sales of up to PhP777 million in 2002. Other top brands as of 2002 are Norvasc by Pfizer 3rd ; , Enervon by Unilab 4th ; , and Augmentin by GSK 5th ; . Top brands have relatively stabilized since 2001, after some fast climbers entered the top 10 since 1996 and caused major shuffles in brand positions with the exception of course of Ventlin ; . Norvasc was one of these fast climbers, being out of the top 50 a decade ago, and now securely in the top 10. Lipitor by Pfizer has also dramatically shot up in sales, ranking only 68th in 1998, but now in 9th place. Ceelin by Pediatrica is also notable for its climb from number 20 in 1998 to 7 in 2002. In contrast, brands such as Ponstan by Pfizer dropped out of the top 10 list by 2000. Biogesic by Biomedis has also been steadily falling down the list since 1998, and fell to 10th place by 2002, from 3rd place in 1997. Table 35 ; 2.5 Pricing Pollard price indices are used to provide indications of price movements. The index is based on virtually the whole population rather than a small sample, with measurements taking place every six months. At the beginning of the six-month period, measurements are obtained by multiplying the quantity of each item sold by its price to obtain a beginning total. At the end of the six-month period, similar measurements are taken on the same products in order to obtain an ending total. The comparison of the ending total to the beginning total gives the weighted average price increase during that period. Products launched during a semester are not included, as well as those discontinued within the semester. The index uses a base date of December 1989 and differin.
Of Clinical Pharmacology, 3Department of Medicine, 2Division of Gastroenterology and 4Department of Pharmacology, Sunnybrook & Women's College Health Science Centre, University of Toronto Medical School, Toronto, Ontario Correspondence: Dr Neil Shear, Division of Clinical Pharmacology, Room E-240, Sunnybrook & Women's College Health Sciences Centre Sunnybrook Campus ; , 2075 Bayview Avenue, Toronto, Ontario M4N 3M5. Telephone 416-480-6100 ext 4767, fax 416-480-6897, e-mail neil.shear swchsc.on Accepted for publication April 3, 2001 59.
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Top 15 Accredited Organizations in CAHPS, 2.0H Member Satisfaction Measures Listed Alphabetically ; CAHPS, 2.0H Member Satisfaction Measures Capital District Physicians Health Plan Companion HealthCare Dean Health Plan, Inc. Excellus Health Plan, Inc. - Rochester Area Division Harvard Pilgrim Health Care of New England NH VT ; Health Alliance Medical Plans.
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In re Lernout & Hauspie Securities Litigation 218 F.R.D. 348 D. Mass. 2003 ; Plaintiffs moved to compel production of documents by defendant Klynveld Peat Marwick Goerderler Bedrijrsrevisoren "KPMG-B" ; , a Belgian entity, in the District of Massachusetts. The court found that KPMG-B would not be subject to sanction under Belgian law if it turned over its audit work papers and audit manuals to Plaintiffs and ordered the production thereof. Plaintiffs had previously sought these documents directly from KPMG-B without success. After becoming civil claimants in the criminal proceedings against KPMG-B pending in Belgium apparently at KPMG-B's suggestion ; , Plaintiffs were given access by Belgian prosecutors to between 25 and 30 boxes of KPMG-B audit work papers for the years 1998-2001. Plaintiffs' counsel were permitted to review these documents, but were not allowed to make copies of them. These audit work papers are a subset of the documents that plaintiffs sought in their motion to compel before the court in Massachusetts, and the main focus of the court's decision. KPMG-B argued that Belgian secrecy law prohibited it from turning over any of the requested audit work papers to Plaintiffs. The court recognized that Article 458 of the Belgian Criminal Code had been applied to auditors by Article 27 of the Act of July 22, 1953 on the Establishment of the Institute of Auditors. Article 458 states, in relevant part, that: Physicians, surgeons health officers, pharmacists, midwives and all other persons whose state or profession renders them depositaries of the secrets entrusted to them and who, other than in cases in which they are called on to render testimony in legal proceedings or before a parliamentary committee and those where the law obliges such secrets to be made known, shall have disclosed same shall be liable to punishment comprising imprisonment of from one week to six months and a fine of between one hundred francs and five hundred francs. The court found, however, that exceptions to Article 458 of the Belgian Criminal Code would apply to protect KPMG-B. The court noted that a "self-defense" exception existed in the Article itself, and had been recognized by the Belgian Court de Cassation. According to Plaintiffs' expert, there had been no reported decisions in which the Institute [of Auditors] disciplined an auditor who was a defendant in a legal proceeding for violating the duty of secrecy. The court also found that, if a court order was in place directing KPMG-B to turn over the documents, the law would be "obliging" that KPMG-B reveal the "secret" information. Thus, according to the Article, KPMG-B would not be subject to penalties or sanctions under this "court order" exception. The court further noted that, because Plaintiffs had already been privy to the documents, it was questionable if they should still be considered "secrets" protected by Article 458. For these reasons, and because ultimately Belgian prosecutors may have provided the documents ; , the court ordered Defendants to produce the audit work papers. The court further found that audit manuals, which contained information concerning the client obtained through sources other than the client, were not protected from disclosure by Article 458 or the Belgian Data Protection Act. Article 458 was held to apply only to confidential information that had been entrusted to the auditor by the client. The Data Protection Act, which entitles a person to "the protection of his privacy, with regard to the processing of personal data relating to him" was held to pertain only to "personal data" such as the diaries, desk and office files, personnel files, and documents regarding compensation of individuals. Because the information in the audit manuals did not constitute "personal data, " and had not been provided by the client, the audit manuals were also ordered to be disclosed. Return to the Index of Cases.
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Polyclonal antibody Santa Cruz Biotechnology ; was raised in rabbits against an epitope corresponding to amino acids 221363 mapping the carboxy terminus of the human AT2 receptor. The eNOS-specific monoclonal antibody BD Biosciences Pharmingen, San Diego, CA ; was raised in mice. Nitrocellulose blots 20 g protein lane ; were incubated with the primary antibody at a 1: 000 AT1 and eNOS ; or 1: 2, 000 AT2 ; dilution for 2 h at room temperature. Blots were rinsed, washed, and then incubated with either a 1: 3, 000 dilution of goat anti-rabbit or a 1: 2, 000 dilution of goat anti-mouse horseradish peroxidase HRP ; -conjugated antibody Sigma ; at room temperature for 1 h. Binding of the secondary antibody was detected using a chemiluminescent system consisting of HRP hydrogen peroxide oxidation of luminol Pierce, Rockford, IL ; . Blots were then exposed to Kodak XAR X-ray film for 1 min. Films were digitized, and the difference between protein signals and background was quantitated using NIH Image National Institutes of Health, : rsb .nih. gov nih-image ; . Immunohistochemistry. Isolated vessels were fixed in formalin 10% ; and embedded in paraffin, and sections were mounted on glass slides. Sections were deparaffinized in xylenes and hydrated in an ethanol: physiological salt solution PSS ; series. After a 5-min PSS rinse, the sections were incubated in H2O2 3% in methanol ; for 30 min before rinsing with PSS 2 ; and blocking with BSA 1% in PSS ; . Sections were incubated with primary antibody, either rabbit anti-AT1, 1: 100 dilution or goat anti-AT2, 1: 100 dilution both from Santa Cruz Biotechnology ; at room temperature for 60 min. The sections were then rinsed two times for 10 min per rinse in PSS and stained using a Vectastain Elite kit Vector Labs, Burlingame, CA ; . The tissue sections were incubated for 30 min in HRP-conjugated secondary antibody at 1: 200 dilution goat anti-rabbit or donkey anti-goat antibody, as appropriate, both from Santa Cruz Biotechnology ; , rinsed two times in PSS, and then incubated for 45 min in avidin-peroxidase reagent. After rinsing two times in PSS, the sections were incubated in diaminobenzidine Sigma Chemical ; for 35 min. Sections were rinsed in PSS twice for 5 min, rinsed quickly in distilled water, counterstained with 50% hematoxylin for 2 min, dehydrated in an ethanol series, then rinsed with xylenes and mounted with glass coverslips. Incubation with secondary antibody alone was performed for each vessel type to serve as controls. Sections were then viewed under a brightfield microscope Nikon Optiphot-2 ; and imaged using a digital camera and Spot software Diagnostic Instruments, Sterling Heights, MI ; . Data analysis. Comparison of physiological parameters was made using two-way ANOVA, factoring for treatment group and timing in relation to infusion. If the overall analysis of variance identified significant differences P 0.05 ; , pairwise comparisons were made using Tukey's procedure, with P 0.05 considered significant.
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This chapter indicates the antibiotics approved by the Bro Taf Drug & Therapeutics Committee, based on local prescribing policies and advice from the Microbiology Departments in Bro Taf. The guidelines refer to the systemic use of antibiotics. For local topical antibiotic preparations, see: Chapter 7, section 7.2 - Treatment of vaginal and vulval conditions; Chapter 11 for Drugs acting on the Eye; Chapter 12 for Drugs acting on the Ear, Nose, and Oropharynx; and Chapter 13 for Drugs acting on the Skin. Requests for the new antibiotics to be included in the formulary should be supported by written guidelines as to their place in therapy.
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A further reason for the high cost of generics can be found in the PBS pricing policies. Under current regulations, generics are able to charge the PBS the same price as the brand, provided they are therapeutically equivalent. They are also able to lower their price, but there is little incentive to do so patients pay such a small amount of the drug's cost. Further, savings from generics often goes to the pharmacy in the form of manufacturer rebates rather than to the ultimate payer the PBS. To change this, the government is considering the introduction of some sort of generic tendering scheme. A similar approach in New Zealand has greatly reduced prices there, and though it is unlikely that the Australian version will be as rigid, some changes appear likely. At present, the two leading options are: 25 1. Following loss of patent protection, the generic manufacturer offering the government the lowest price will be able to offer patients a lower co-payment for three years. During this time the price of all drugs in the class are involuntarily lowered to match this lowest price without the ability to reduce the co-payment ; . This option would save the government up to A$830 million a year. 2. Following loss of patent protection, the generic manufacturer that offers the government the lowest price can offer patients a discounted co-payment for six months. During this time, the prices of other drugs in that therapeutic class are not reduced to match. This option would save the government up to A$370 million a year. As in the U.S., patent holders are attempting to undermine their emerging competition via the use of authorized generics. Among the products that have successfully eroded competitive generics via the use of "fighting generics" are Omeprazole Losec ; , Salbutamol Ventolin ; , Diltiazem Cardizem ; , Enalapril Renitec ; , Felodipine Plendil.
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You may encounter cases where the primary site is stated to be unknown. In such cases, do not make any assumptions about the primary site from any other conditions, which are specified. Instead, you should look at the morphology of the neoplasm or code to C80 Malignant neoplasm without specification of site. Refer to volume 2 section 4.2.7 paragraph E for further details. In some cases of malignancy there may be more than one primary site. [ If the sites are not in the same organ system and there is no indication that any is primary or secondary, code to malignant neoplasms of independent primary ; multiple sites C97 ; ]. A special category has been created for these cases at C97 Malignant neoplasms of independent primary ; multiple sites. A malignancy may spread to another site. This is called metastasis. The adjective `metastatic' is frequently used ambiguously - sometimes meaning a secondary FROM a primary elsewhere and sometimes meaning a primary which has given rise TO metastases. It is very difficult to resolve this situation as there are no specific rules and usage varies between countries and language. However, there are some guidelines set out in section G of 4.2.7 Volume 2, page 75 ; that can be followed. In some cases multiple sites may be recorded with no indication as to which is the primary site. Guidance on selection of the underlying cause is given in paragraph H Volume 2, page 81 ; . You may find that an infectious disease has been given as a consequence of a malignancy. This is an acceptable sequence. Malignant neoplasms can also cause certain types of circulatory diseases. The underlying cause of death will be malignancy.
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TRIAL FIBRILLATION is the most common significant cardiac arrhythmia, occurring in 1% of the US population.1 The prevalence of atrial fibrillation increases strikingly with older age; 4% of the population older than 60 years and 10% older than 80 years have atrial fibrillation. With the aging of the US population, atrial fibrillation is increasing in prevalence.2-4 Antiarrhythmic medication therapy for atrial fibrillation is targeted at 2 goals: 1 ; controlling the rate of ventricular response to minimize physiologically inefficient tachycardia, and 2 ; restoring and maintaining normal sinus rhythm.5, 6 The first goal can frequently be achieved through treatment with commonly used and relatively nontoxic medications. However, rate control is often not optimal; cardiac function continues to be compromised by a lack of coordinated atrial contractions; distressing symptoms of dyspnea, diminished effort tolerance, and palpitations may conARCH INTERN MED VOL 158, OCT 26, 1998 2144.
People who suffer from one of a specific list of medical conditions may apply for a certificate which will provide exemption from prescription charges. The conditions listed include: Diabetes controlled by medication. Epilepsy requiring continuous anti-convulsive therapy. Hypoparathroidism. To view the full list, you should pick up leaflet HC11 available from main Post Offices or visit the PPA website. People who suffer from any of the listed conditions should fill in a form at their GP surgery; this will then be forwarded to Patient Services and a small credit card certificate will be issued that is valid for 5 years.
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