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One 1 ; article titled: "Cannabis- THC and Bipolar Disorder" Included with patient's petition ; including a quote from Marijuana and Medicine: Assessing the Science Base[ Institute of Medicine], 1999 Recommendation Regarding Adding this Condition to the list of "Debilitating Medical Conditions" for Purposes of the Oregon Medical Marijuana Act Add disease to list of disease conditions pursuant to ORS 475.302 2 ; a ; COMMENTS: Based upon this evidence there is slim experimental evidence that Cannabis is a "first-line" treatment for bipolar disorder. It is worth noting that the petitioner has exhausted his medical alternatives and is prevented from accessing the medical establishment more fully because of financial limitations. ; There is good evidence that the petitioner is gaining great relief from his use of cannabis based upon his physician's assessment as well as the fact that he has remained non-hospitalized since his use began 10 years ago. It appears that Cannabis has managed the manic phase effectively after many unsuccessful medication trials. The sideeffect profile is well within acceptable range. It is reasonable to extrapolate from the petitioner's experience to conclude that there are a significant number of Oregonians who may benefit from medically monitored cannabis use RATIONALE this recommendation This patient, who suffers from the serious and potentially lethal complications of bipolar disorder, faces potentially grave harm of injury or death because of the Federal ban on the use of cannabis. He, and other's who successfully use cannabis, face the prospect of arrest, prosecution, and incarceration by Oregon law enforcement agencies because of this use. Therefore those who suffer from bipolar illness and are under the care of a primary care provider, should be allowed legal access to the Marijuana Registry Program with the following suggested provisions.
As well as bio-medical engineering, RFID printing, proactive displays and special effects printing. This was followed by a presentation on Automotive printing, very relevant in this developing country where Volkswagen, Peugeot and Kia have all recently opened factories. Peter's final presentation focused on the FESPA e-learning course that has also been delivered in Hungary. Bill's four presentations were `Choosing the right stencil for the job', followed by `Basic colour theory and colour management', `Print sequence effects in process colour printing' and `The Screenprinter's press side companion' all of which helped delegates get to grips with the complexity of the topics covered. Although all were interesting, the one that provoked the most debate was print sequence. Bill had overseen a project at Autotype where seven print sequences had been used: CYMK, KCMY, YMCK, MCYK, MYCK, YCMK and CMYK. Using the new technology of the Autotype Capillary `CP' stencil, the objective was to gather scientific data and compare the colour reproduction with that achieved digitally. Students had printed all sequences and Bill invited the delegates to discuss the results and draw their own conclusions. Members will find this and all of the other presentations in full, in the members' area of the FESPA website. After his fourth presentation, Peter thought he had finished, but as the Enfocus distributor was unable to attend at the last minute, Peter willingly stepped up to the rostrum again and delivered a brilliant dissertation on Certified PDF, which he managed to make totally comprehensible! The speakers, Zuzana and myself were all presented with gifts from the two Associations and a special presentation, for instance, can you give a dog imodium.
SS in the nicorandil-treated dogs was somewhat greater than in the saline and ISDN group, but this difference was not significant p 1 ; . Myocardial glucose extraction. Arterial and coronary venous glucose concentrations were unaltered by the repetitive ischemic-reperfusion protocol not shown ; . In contrast, the arterial-coronary venous ; glucose concentration difference and glucose uptake table 3 ; was stimulated after the first ischemic and reperfusion episode control 2 ; . The alteration in the pattern of glucose extraction was attenuated in the presence of nicorandil or ISDN. Myocardial free fatty acid FFA ; extraction. Arterial and coronary venous FFA concentrations were unaltered by multiple ischemic-reperfusion episodes data not shown ; . The arterial-coronary venous FFA concentrations and the FFA uptake during each period are shown in table 4. Baseline FFA uptake values were not significantly different between experimental groups before occlusion period 1 based on analysis of variance F ratio 1.96, df - 2 and 19, p 1 ; . It was observed that there was a progressive increase in FFA arterialcoronary venous differences and FFA uptake in subsequent control periods in untreated dogs FFA uptake: 6.65 1.85, 13.99 + 3.59, and 18.55 5.04 gmoles min 100 g, respectively ; . In contrast, nicorandil produced a progressive decrease in FFA uptake during control periods 13.35 + 5.02, 10.26 + 1.94, 6.64 + 1.23, and 7.77 - + 0.84 gmoles min 100.
Whilst the under-use of opioid drugs undoubtedly leads to unnecessary suffering48, clinicians are faced with a bewildering number of strong opioids to choose from. Carefully designed studies are needed to clarify the role of and loperamide.
Conducted by Debbie Suian, 2003 ; This article is the second in a three part series. Following a request for a presentation to psychiatry and family practice physicians regarding concurrent disorder treatment issues, consumers of an alcohol and drug outpatient service were surveyed regarding their thoughts about what doctors need to know in order to be helpful to people with concurrent disorders. The following are their responses to the second of three questions. For Part 1, see May June issue of Step Softly ; 2. What do you think doctors need to know in order to be more helpful to people with mental health and addiction issues? 1. There may be causes mental illness can lead to addiction. There are reasons for addiction. But final decision comes from the patient regarding recovery. If somebody's really depressed and using, it depression ; isn't going to get better tough love need to set limits until someone's ready to deal with their addiction, there's not much their doctor can do. Treat the addiction before the mental health part. Community resources. Be ready willing to make a referral. Sympathetic and not punitive time set aside to talk about stuff mini counselling. I always have to wait one and a half hours for a four minute meeting sometimes you don't even get into the examination room you get a consult in the hallway get a prescription and sent on your way. Family doctors the only thing they know how to use is a pen and prescription pad. Make appropriate referrals A D, therapy centres, psychiatrists. They need to know about their patients' addictions because a lot of times people won't tell them maybe drug testing but I might not like that ; . Initiate the conversation regarding drug use say, "I'm here to help not to control or judge you, but if you want to change you have to get this drug test done so then maybe I can help you, or don't come back until you get the testing done. The walk-in doctors really need to know this. It's easier to get prescription than street drugs. Some druggies can hide it, but then again, some doctors don't care. A good question. My psychiatrist would have to know that I have a hard time telling people my feelings. I have to be prompted. I went to a psychiatrist in Vancouver and he was considered one of the best excuse me a psychologist. He asked me three questions that he said were going to sound rather personal and WOW, he really helped me. I still remember the whole meeting. He asked me about my relationship. I felt like I was helping my sister by answering those questions. He made me feel like he cared and that what I had to say was important. They have to look at the whole thing not just half of it. When you look at the whole picture, it's confusing.
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Ms Shellee Anderson; April 27, 2004 Team Leader; Nutrition Policy, Division of Dockets Management, Food and Drug Administration, 5630 Fishers Lane, Room 1061 HFA-305 ; Rockville, MD 20852, USA, fdadockets oc.fda.gov , Phone 301 ; 827 6860.
Knee joint prosthesis, tibial tray: Depuy International Preservation Uni-Compartmental Knee size 1-5 Fixed-bearing Tibial Tray MHRA Ref: 2006 011 022 Summary: Return of specified lots batches of the device to the manufacturer or its representative. Advice has been given by the manufacturer regarding the use of this device Hip joint prosthesis, Femoral Stem: Depuy International a Johnson & Johnson Company Ultima TPS femoral stem & Ultima Metal-on-Metal articulation MHRA Ref: 2007 002 001 Summary: Changes have been made to patient follow up Anaesthetic & Breathing, suction: ConMed Corporation Frazier & Poole Suction Instruments Manufacturer's Ref: MDD06.078 MHRA Ref: 2006 011 023 Summary: Return of the device to the manufacturer or its representative. Laryngoscope: Timesco of London Optima XL Stubby Handle Manufacturer's Ref: VIG0008 MHRA Ref: 2006 012 001 Summary: Advice has been given by the manufacturer regarding the use of this device Infusion & transfusion administration set: Vygon UK ; Ltd Lectro Cath Plus 200cm extension line 5155.20 Manufacturer's Ref: 0702 16612 00 MHRA Ref: 2007 003 001 Summary: Return of specified lots batches of the device to the manufacturer or its representative Infusion & transfusion administration set: Vygon UK ; Ltd Lectro Cath Plus 150cm extension line 5155.15 Manufacturer's Ref: 0702 16612 00 MHRA Ref: 2007 003 008 Summary: Return of specified lots batches of the device to the manufacturer or its representative Catheter Tracheostomy: VBM Medizintechnik GmbH 13g Jet Ventilation Catheter MHRA Ref: 2006 011 001 Summary: Return of specified lots batches of the device to the manufacturer or its representative Haemotology instrumentation: Beckman Coulter UK Ltd FP1000 Cell Preparation System Manufacturer's Ref: PCA-M-R-1008 MHRA Ref: 2007 003 006 Summary: Advice has been given by the manufacturer regarding the use of this device Non-active embolisation implants endovascular coils: Boston Scientific Limited Matrix2 Detachable Coils Manufacturer's Ref: FCA 2007-03 MHRA Ref: 2007 003 006 Summary: Return of the device to the manufacturer or its representative Hospital Beds: Sidhil Ltd Solite `safe side' full length mesh side rails Manufacturer's Ref: FSN 002 07 rev0 MHRA Ref: 2006 010 025 Summary: Device to be modified. Changes updates have been made to instructions for use. Infusion & Transfusion Administration sets: Arcomedical Infusion Ltd 3101-PN3 Batch C8237 Manufacturer's Ref: 2007 03 07 MHRA Ref: 2007 003 007 Summary: Return of specified lots batches of the device to the manufacturer or its representative Endoscope surgical probe: Smith & Nephew Healthcare Limited Denervation Prove 10mm Recall Manufacturer's Ref: unk MHRA Ref: 2007 003 012 Summary: Device is to be modified Fluoroscopy Imaging System: GE OEC Medical Systems Inc GE OEC 9900 Elite Fluoroscopy System, Catalog No 887208 and 887210, Recall #Z-0042-2007 MHRA Ref: 2006 011 007 and ismo.
One clear challenge for FDA is deciding how quickly and how publicly to react to new risk information. This is the area where agency officials find themselves in a Catch-22: If FDA officials react too quickly, they may not have an authoritative answer. If they take their time to analyze and validate the data, the agency is vulnerable to attacks for being too slow to act. FDA's Galson thinks the agency can do both without compromising its reputation as the worldwide gold standard. "We will have to manage information faster; I think that's been very clear to us for some time, " Galson says. "We are speeding it up. We are improving our interactions in the Center, and with changes in information technology, there is no question that we have to get information out to the public as soon as possible, and that's good for patients and doctors as well." In an attempt to upgrade its safety communication efforts, FDA has recently chartered a new advisory group to help specifically on how to explain risks to the public See "Not the Usual Suspects: FDA seeks New Advisors for Risk Communication Committee, " The RPM Report, July August 2007. ; But going public with information much faster isn't always a good idea. In response to the closer attention from Congress and the media on drug safety issues, FDA has gone public with new safety information on several products in recent years that have sent confused messages, messages that probably accomplished very little in terms of changing medical practice--but do contribute to the agency's credibility problems. So what is FDA to do? On the one hand, the agency has Congress, the media and patients demanding more information and regulatory actions on safety issues sooner. On the other hand, drug and biotech companies are asking the agency to shed what they see to be overly cautious review standards. One possible solution is for FDA to get more involved with academic journals before new safety analyses are published. Galson took particular issue with how quickly NEJM published the Nissen analysis, noting that FDA frequently has more information than is available to the public. "I'd be very interested in working more closely with the journals, so that when they are publishing these assessments, we have the opportunity to!
TABLE 1. Mean Intensity of the Sensation Thresholds Intensity of the Sensation Threshold Mechanical mL min ; Chemical % of CO2 in air ; Hot C ; Cold C ; Control 91.0 17.5 1.2 and monoket.
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Summary Gemcitabine is the only cytotoxic agent approved by FDA for the treatment of pancreatic carcinoma. Gemcitabine has a relatively safe profile. Major side effects include bone marrow suppression and flu-like syndrome. Transient abnormalities of liver transaminase enzymes are seen in two third of patients: elevations of alkaline phosphatase and bilirubin are less common, but severe hepatic toxicity is uncommon. Four case reports regarding severe hepatic toxicity of gemcitabine leading to rapid deterioration in patients' health status and death have been reported. We report the fifth case in which liver functions were within normal limits but liver toxicity was preceded by radiological findings on the MRI. We describe a 61-year-old male with stage T4N1M0 who initially received gemcitabineoxaliplatin GemOx ; regimen was switched to gemcitabine-capecitabine every two weeks schedule ; after four months of therapy due to lack of response. Restaging CT scan after eight-weeks showed new multiple foci of low attenuation resembling simple cysts. MRI of the abdomen was performed which revealed early and active fibrosis. Hepatitis panel were negative. Subsequently the patient developed nausea, vomiting, abdominal pain and weight loss and was referred for palliative radiotherapy. Gemcitabine was discontinued and follow-up CT scan two months later showed stable lesions in the liver, for example, effects of imodium.
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Commercial jet pilots of course get their wings clipped at age 60. Yet, on that very same day they turn 60, they can slip out the side door and run, or more probably walk, to their local used-plane dealer and buy a cute little prop-job and once again take off into the wild blue yonder. Granted, older pilots may not run any red lights up there, or change lanes without signaling. But what if, all of sudden, they become a little disoriented, or really have to go to the bathroom because they didn't pack the Kmodium in their flight bag? Hey, I know, this can happen to all of us, at any age. But all I can tell you is this: The next time my mother asks me for the airplane keys, I'm not giving them to her.
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Metronidazole is the only antibiotic with an accepted role in the treatment of IBD. Its use is confined to Crohn's disease - most commonly to control anal complications such as abscesses or fistulas. It has also been shown to have some beneficial effect in Crohn's disease at other sites, particularly the large bowel. It is not known whether the effect of metronidazole is due to its antibiotic activity ie. its ability to kill bacteria ; . The most common side-effects are nausea and loss of appetite, indigestion, a metallic taste in the mouth, diarrhoea and headache occur less frequently. Prolonged treatment with metronidazole can damage the nerves in the feet and arms, leading to tingling and numbness. This is reversible on stopping the drug but may take some months to return to normal. Some people have an unpleasant reaction to alcohol flushing of the face, headache, palpitations, nausea, shortness of breath and drowsiness ; while they are taking metronidazole. It is probably best to abstain from alcohol. B. NON-SPECIFIC DRUGS 5. Anti-diarrhoeal Drugs Loperamide Imodium, Dicap ; , diphenoxylate + atropine Lomotil ; and codeine phosphate reduce diarrhoea but have no effect on the inflammation which is causing diarrhoea. They are related to narcotic drugs such as morphine but have a much lower risk of addiction, especially loperamide and Lomotil. They work mainly by reducing the contraction of the muscle in the bowel wall, slowing the movement of bowel contents through the gut. They also cause some reduction of the amount of fluid produced by the lining of the gut. These drugs should not be used in children or in a severe attack of colitis, when they may cause the bowel to enlarge and burst. They can be useful to control diarrhoea during milder attacks of IBD, or in patients who have diarrhoea even though their disease is inactive. The main side-effect is constipation. Other side-effects are unusual, although probably more common with codeine phosphate than with loperamide and Lomotil. Drowsiness, headache, mood changes and skin rashes can occur. Lomotil contains atropine, which can cause a dry and tofranil.
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If you must haul yourself out of bed for an important business meeting or a social event, or if your diarrhea is intolerable, try an over-the-counter drug like imodium or pepto-bismol.
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This month we have fully revised the Guide's chapter on Part B payments under the hospital outpatient prospective payment system OPPS ; to discuss changes made for 2006 -- see Ch. 4. For instance, combination prescription products containing at least one Part D drug component generally are considered Part D drugs if used for medically accepted indications and the product as a whole is not excluded by statute, CMS said. The agency also clarified that prescription drugs used to treat AIDS wasting and cachexia are Part D drugs, not excluded agents used for wait gain or cosmetic purposes. However, CMS has determined that prescription niacin products are excluded from Part D because they fall under a statutory exclusion for prescription vitamins. This decision becomes effective June 1 "due to the ambiguity and unique circumstances" related to niacin, the agency said.
Once the cause of the problem has been identified by the physician, changes in routine or medications may be recommended. Altering the diet according to the doctor may also help. Bowel movements often occur soon after a meal, when activity in the intestines is taking place. People with diarrhea or incontinence may find sitting on the toilet or bedpan immediately following a meal to be well timed. Interestingly, bulk formers which are used to treat constipation may also be used in the treatment of diarrhea and incontinence. While absorbing water, they help to make the stool firmer. Metamucil and Perdiem Plain are two brands that may prove useful. When used for this condition, no more than one dose a day should be taken and no extra liquid should follow this dose. With persistent diarrhea, a doctor may recommend a diarrhea medication such as kaolin and pectin Kaopectate ; , Imodium, and Lomotil. This works to slow intestinal activity. Occasionally, medication which blocks bladder spasms may have an effect on slowing down bowel muscles also. Other therapies include bowel retraining and biofeedback!
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