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Sub-group meeting on Harmonisation of SPCs There was a meeting of the Sub-group on harmonisation of SPCs. The Sub-group acknowledged that the medicinal products included in list for SPC harmonisation would be referred to the CHMP, in accordance with Article 30 1 ; of Directive 2001 83 EC, as amended, during the course of 2007. Prior to the start of the Article 30 referral procedures, the respective Marketing Authorisation Holders will be invited for pre-referral meetings at the EMEA. The Sub-group started to work on a new list of medicinal products for which a harmonised SPC should be drawn up and will consider the proposals from Member States at the next meeting of the Sub-group, scheduled to take place in June 2007. Possibility to use a medicinal product authorised in a Member State prior to its accession to the EU as reference medicinal product for the purpose of the data exclusivity period The CMD h ; has agreed a Q&A to clarify that a medicinal product authorised in a Member State prior to its accession to the EU can only be used as a reference medicinal product for the purpose of the data exclusivity period as of the date of accession of the Member State to the EU, provided that the medicinal product is in compliance with the Community acquis. EU Work sharing Project Assessment of paediatric data The Marketing Authorisation Holders for the following medicinal products, involved in the EU work sharing project - assessment of paediatric data, are requested to submit, within 60 days, national variations to implement the agreed text for inclusion in the SPC: Ciloxan ciprofloxacin Cibacen benazepril ; . Informal CMD h ; meeting - Germany An informal meeting will be held in Bonn on 7-8 May 2007. The main topics for the meeting include MSs experience with work sharing initiatives, including a proposal for work sharing for patient consultation, evaluation of referrals to the CMD h ; , MSs follow up to Article 30 and 31 referral procedures, the revision of the Variation Regulation and the impact of the Paediatric Regulation on National Competent Authorities business processes. Information on applications referred to the CMD h ; in accordance with Article 29 1 ; of Directive 2001 83 EC, as amended Please find below information on the Name of the products in the RMS, active substances, pharmaceutical forms, procedure numbers, CMS, legal basis, grounds for referral to CMD h ; , Day 60 and outcome of the procedures, for the referrals to the CMD h ; finalised on 29.03.2007.
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Duncan RA IDSA 2000; 170 ; 795 patients with CAP 1995 - 1998: 74% pts received ceftriaxone 1999: 50% patients received levofloxacine Lenght of stay decreased 5.1 to 3.7 days ; Mortality and 30-days admission rates were stable Good economic impact but WHAT IS THE ECOLOGIC IMPACT ?.
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| Buy generic Ofl0xacin onlineFormed. Biopsy specimens should be cultured for Salmonella, Shigella, Campylobacter, mycobacteria, CMV, and HSV. Histologic evaluation should include staining for mycobacteria, fungi, protozoans, and viral inclusions. Bacterial causes of diarrhea In non-incarcerated HIV-infected persons in the U.S., the most common bacterial causes of diarrhea are Salmonella, C. difficile, MAC, Shigella, and Campylobacter. The overall incidence of bacterial colitis has been reduced in this country by the widespread use of trimethoprim sulfamethoxazole TMP FMX ; for Pneumocystis prophylaxis. Fever is more commonly seen in Salmonella infection than in other bacterial cause of diarrhea. Blood in the stool suggest Shigella or Campylobacter rather than Salmonella. Among those infected with HIV, Salmonella is more likely to lead to bacteremic disease and to relapse after treatment. Predictors of relapse include septicemia and low CD4 lymphocyte counts. Salmonella can be treated with TMP FMX, a quinolone, or azithromycin. Among those with CD4 counts less than 50 cells mm3 who have experienced relapsed infection with Salmonella, ongoing maintenance therapy with ciprofloxacin should be considered. If bacterial colitis is suspected, medications that decrease bowel motility such as diphenoxylate, loperamide, paregoric, and tincture of opiates should be avoided because they have been associated with the development of toxic megacolon or prolongation of infection. Clustering of cases of bacterial diarrhea caused by Salmonella, Shigella, or E. Coli 0157H7 may indicate a food borne outbreak or person-to-person transmission and should lead to an investigation. Infection with C. difficile can lead to diarrhea in patients with AIDS. Both receiving antibiotics and being hospitalized are associated with an increased risk for C. difficile infection. Diagnosis can be made by the detection of C. difficile toxin in stool. The first line treatment is oral metronidazole at a dose of 500 mg by mouth 3X day for 1014 days. Because of the concern for encouraging the development of resistant organisms, oral vancomycin should be reserved for only those patients who fail to respond to metronidazole. Disease due to MAC is uncommon among.
1. Kent HL. Epidemiology of vaginitis. J Obstet Gynecol. 1991; 165 4 Pt 2 ; 1168-76. 2. Van Kessel K, Assefi N, Marrazzo J, and Eckert L. Common complementary and alternative therapies for yeast vaginitis and bacterial vaginosis: a systemic review. Obstet and Gynecol Surv. 2003; 58 5 ; : 351-358. 3. Ozkinay E, Terek MC, Yayci M, Kaiser R, et al. The effectiveness of live lactobacilli in combination with low dose oestriol gynoflor ; to restore the vaginal flora after treatment of vaginal infections. BJOG. 2005; 112: 234-240. Eschenbach DA, Davick PR, Williams BL, et al Prevalence of hydrogen peroxide-producing Lactobacillus species in normal women and women with bacterial vaginosis. J Clin Microbiol 1989; 27: 251-256. Reid G, Bruce AW, Cook RL, Llano M. Effect on the urogenital flora of antibiotic therapy for urinary tract infection. Scand. J. Infect. Dis. 1990, 22: 43-47. Jojberg I, Cajander S, Rylander E. Morphometric characteristics of the vaginal epithelium during the menstral cycle. Gynecol Obstet Invest 1988; 26: 136-144. mayoclinic health lactobacillus NS patient-acidophilus 8. Pirotta M, Chondros P, Grover S, O'Malley P, et al. Effect of lactobacillus in preventing post-antibiotic vulvovaginal candidiasis: a randomized controlled trial. BMJ 2004; 329: 548-552. Neri A, Sabah G, Samra Z. Bacterial vaginosis in pregnancy treated with yogurt. Acta Obstet Gynecol Scand. 1993; 72: 17-19. Chimura T, Gunayama T, Murayama K et al. Ecological treatment of bacterial vaginosis. Jpn J Antibiot 1995; 48: 432-436. Parent D, Bossens M, Bayot D, Kirkpatrick C, et al. Therapy of bacterial vaginosis using exogenously-applied lactobacilli acidophili and a low dose of estriol: a placebo-controlled multicentric trial. Arzneimittelforschung 1996; 46: 68-73. Maida T. Unconventional estrogens: estril, biest, and triest. Alt Med in Gynec. 2001; 44 4 ; : 864-879 and urispas.
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About a year and a half ago, Mrs. A.'s husband fell ill and was admitted to the hospital for six days, which cost IDR3 million. Because the family did not have any savings, she was forced to sell her husband's motorcycle for IDR4.5 million. One month later, her husband fell ill again and had to return to the hospital, this time for eight days. The hospital bill totalled IDR4 million, money that she did not have. Mrs. A. was forced to sell her big portable radio for IDR450, 000 and seek assistance from her married children and other relatives. As a result of the difficulties in paying for these two hospital stays, Mrs. A. did not take him to the hospital the next time he was ill. But her husband usually visits the doctor regularly every 20 days and takes alternative medicines. Her total costs for this medical care are IDR100, 000every 20 days. To save money, sometimes Mrs. A.'s husband forgoes the visit to the doctor, and she uses a photocopy of an old prescription to get new medicine for him. Her husband's medical costs have been a drain on the household budget. In order to meet these expenses, Mrs. A. reduced the capital in her business, and she has had to ask her children and relatives for financial assistance. She gets occasional support from her mosque as her husband and son work for it from time to time. Nevertheless, Mrs. A.'s shop became smaller. After her husband's second trip to the hospital, Mrs. A. took out a microfinance loan from Diman. She invested most of this IDR500, 000 loan in her shop. The balance she used to participate in an Arisan. Currently, she participates in four different Arisans contributing a total of IDR65, 000 per month. This participation gives Mrs. A. access to lump sums of cash in case of an emergency. Mrs. A. has received a total of three microfinance loans. For the most part, she has used the money to invest in her shop and diversify her goods for sale. She has also stopped taking capital out of her business to avoid it becoming even smaller. Despite the assistance of the microfinance loans, about one year ago, Mrs. A. started to borrow from a moneylender. She borrowed IDR100, 000 for 30 days at 20 percent interest. However, once she finished paying the loan back, she immediately took another one of the same amount. She has been doing this for the past 12 months. Her husband has demanded that she stop borrowing from the moneylender because it is expensive. Their son has recently become engaged. This engagement has already cost her IDR950, 000 that she paid for partly from her microfinance loan of IDR200, 000 and partly by gifts from her other children. Now the family has to pay for the upcoming wedding. The responsibility for this expense will also fall on Mrs. A., since her engaged son does not have a steady job. She is hoping that her other children and relatives will help her out. Mrs. A.'s story demonstrates the corrosive impact of long-term illness on a family. As a result of the illness, the family's income was reduced. As medical expenses mounted, the few valuable assets that they owned were sold. Mrs. A. started to de-capitalize her shop but wisely decided to stop that. She was fortunate in that she had access to microfinance loans to help her expand her shop again. Her shop provides a small but consistent income that allows the family to meet their most basic day-to-day needs. When extra expenses come along, however, Mrs. A. is forced to look for assistance from relatives or even to resort to loans from moneylenders.
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