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37. Hall WJ. The Doctors of Time. Ann Intern Med 2000; 132: 18-24. Hall WJ, Leipzig RM, Gillock MR, Cramer DA, Kefalides PT. Update in Geriatrics. Ann Intern Med 2000; 133: 894-900. Hall WJ: Monthly essays in the ACP-ASIM "Observer" Internal Medicine: Healers for Adults 4 2001 Fewer Hassles, Better Quality: Four Promises from the College; 5 2001 What We Can Do to Prevent Error and Improve Patient Safety; 6 2001 The Secret of Happiness for Internists; 7-8 2001 How We Can Better Care for an Aging Population; 9 2001 The Link between Trust and Physician Satisfaction; 10 2001 How Can Internists Respond in the Wake of September; 11 9 2001 The Ethical Dilemma of Accepting Gifts from Drug Makers; 12 2001 Epiphanies on the Human Side of Health Care Politics; 1 2002 The Path to Attaining a `Virtuous" Professional Life; 2 2002 A Year as President; 3 2002, for example, duoneb.
Table 7 summarizes the most common primary diagnoses by transplant. The organ data is based on OPTN data as of August 1, 2003.1 The bone marrow data is based on 2002 North American data from the ABMTR IBMTR Summary Slides.5 The cornea data comes from the 2002 and 2003 Eye Banking Statistical Reports.3.
Patients with accurate information and ongoing research related to its products. This strategy streamlines company overhead and enables company employees to concentrate on clinical trials, regulatory approvals and business development. PARTNERSHIPS In December 1996, Pharmacia & Upjohn Company exclusively licensed to United Therapeutics certain patents, a patent application and know-how for the composition and production of the stable prostacyclin analog known as UT-15 now known as Remodulin ; . In January 1997, Glaxo Wellcome assigned to United Therapeutics all rights to the use of the stable prostacyclin analog known as UT-15. For pulmonary hypertension, the patent does not expire in the United States until October 2009 and until various dates from September 2009 to August 2013 in nine other countries. For congestive heart failure, the patent does not expire until May 2011 in the United States and from May 2011 to March 2012 in five other countries. Company News and tizanidine.
Ing stimulation of glucocorticoid receptors distributed systemically versus those restricted to an mntracerebral location. However, because hypophyseal portal plasma levels of DEC were not measured after icy. drug administration in the current studies, the possibility that DEC elicited a decline in PRL secretion, in part through a direct action at the pituitary, cannot be discounted at the present time. Recent studies show that the rat brain contains two distinct glucocorticoid receptor subtypes type I and type II.
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Disc rotor speed, r.p.s. Flixotide Pulmicort Combivent Bricanyl Atrovent Salmol Salbutamol Salmeterol 450 6.54 6.70 P855 Tiotrkpium administered by a pressurized metered dose inhaler pMDI ; and spacer produces a similar bronchodilator therapeutic response as that administered by the Rotahaler in adults with chronic obstructive pulmonary disease Bill Brashier 1 , Bal Trupti 1 , Purnima Mahadik 2 , Parth Gokhale 2 , G. Gogtay 2 , Sundeep Salvi 1 . 1 Clinical Research, Chest Research Foundation, Pune, India; 2 Medical Services, Cipla Ltd., Mumbai, India Tootropium is a new long-acting anticholinergic bronchodilator, which is recommended as first-line therapy in the management of COPD. It is currently available in the form of a dry powder inhaler Rotahaler ; . We have devloped a new pMDI formulation for Tiotropium. The aim of the study was to compare the timedependent bronchodilator responses 0-24hrs ; of Tiortopium delivered through the two delivery devices in patients with stable COPD. A randomized, double-blind, double-dummy, three-period, placebo-controlled, crossover, single-center study was conducted in 19 patients. Single doses of Tiotroipum 18mcg ; or placebo were administered on three separate study days with the different devices. FEV1 , FVC and SVC were measured during all study visits at several time points over 24 hrs. Inspiratory Capacity IC ; and Residual Volume RV ; were also measured. Appropriate statistical tests were applied. Results: Tiotropiim administered through both pMDI and spacer ; and Rotahaler showed significantly better mean max. changes in FEV1, FVC, and IC values compared to Placebo. Both the devices showed equivalent bronchodilator response. Conclusion: We have demonstrated for the first time that Tiotropium administered by a pMDI and spacer shows equivalent therapeutic bronchodilator response as that administered by a dry powder inhaler.
Patients with functional dyspepsia are a heterogeneous population of patients with chronic dyspeptic symptoms and no apparent morphological abnormality in routine clinical testing. They constitute more than 50% of all patients presenting at primary care with upper abdominal complaints and symptoms. From the terminology there should be a sharp and clear distinction between patients with dyspeptic symptoms uninvestigated dyspepsia ; and patients who have already undergone diagnostic workup, where functional dyspepsia is suspected. Despite the enormous importance and impact of these patients on health care systems and clinical practice relatively little is known on the etiology and patho-mechanism of this disease. Currently a disorder in the afferent function of the autonomous nervous systems and the central processing of this information is regarded as the underlying mechanism. The management of patients presenting initially with dyspeptic symptoms depends primarily on patient characteristics age, presence of alarm symptoms ; , history, duration and intensity of the complaints. Cost structures within a health care system e.g. cost of endoscopy compared to medical treatment or HpTesting ; can have influence on further diagnostic and therapeutic pathways. Empirical therapy for 46 weeks, initial endoscopy and specific therapy, Hp-test and treat, or Hp-test and endo- ; scope as well as initial acid suppressant therapy with proton pump inhibitors are current management alternatives in un-investigated dyspepsia. Treatment of functional dyspepsia is built on a positive and reliable clinical diagnosis, as well as considering and eliminating fears and concerns of the patient. After presenting an understandable disease model the necessity for medical treatment should be and ursodiol.
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Or click the first letter of a drug name: a b c advanced search drugs & medications diseases & conditions pharmaceutical news & articles pill identifier drug interactions checker medical encyclopedia medical dictionary community forums welcome guest register or sign in my viewing history my drug list my interactions lists member offers pharma news news feeds get news delivered by email merck announces 2006 financial results that demonstrate solid revenue growth whitehouse station, - business wire ; -jan 30, 2007 - merck & co, inc today announced full-year and fourth-quarter 2006 results that reflected solid sales growth and strong results from the merck schering-plough partnership and valproic.
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At the January meeting of Grampian Medicines Committee the following medicines were approved for inclusion in the Grampian Joint Formulary: Ezetimibe was provisionally approved for initiation by either hospital or GP for those patients failing to reach target cholesterol despite being on optimum doses of a statin, or for those patient where statins are inappropriate or poorly tolerated. Ezetimibe has been referred to the New and Expensive Drugs Committee for funding considerations. NB: it is important to note that, as yet, there are no outcome trials to guide ezetimibe use in primary & secondary prevention ; Evra combined contraceptive patch was approved for initiation by either hospital or GP for consideration in women who have demonstrated, or likely to have, poor compliance with oral COCs. Thought should be given to their use only if injectable and implant methods of contraception are not appropriate. Evra is almost 10 times the cost of the most commonly prescribed COC. The efficacy and side effect profile of Evra is similar to that of COCs, however, there is modest evidence of improved overall compliance. Olanzapine, orodispersible tablet ; was approved for restricted use for the treatment of acute mania and restricted to initiation by hospital consultants prior to handover to GP Tiotropium Spiriva ; inhaler was approved by the GMC and New & Expensive Drugs Committee for use in patients for the treatment of COPD. Initiation either by GP or hospital consultant.
Southwest Michigan Medical Journal is published 4 times a year. Our mission is to educate and to augment participating medical professionals' knowledge with information that is applicable to their practices and will enhance patient care. Please evaluate each of the designated articles on the evaluation form. The educational objective for each individual CME article is listed below and valacyclovir.
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Adenoviral VEGF expression in immunodeficient mice Nagy et al., 2002 ; . The inherited form of lymphedema usually affects the cutaneous lymphatics which do not have a muscular layer Casley-Smith, 1980; Rockson, 2001 ; , and thus the stimulation of collecting lymphatics may not be crucial for the treatment of this disorder. Nevertheless, an interesting biological question is whether VEGFR-3 stimulation is able to promote the growth of large collecting SMC-rich lymphatic trunks besides lymphatic capillaries or whether other growth factors are required. The SMCpositive collecting lymphatics have been shown to express VEGFR-2 rather than VEGFR-3 Veikkola et al., 2003 ; , and thus they may be more efficiently stimulated by ligands that also have affinity towards VEGFR-2 than those binding only to VEGFR-3 alone. It is also possible that increased peripheral lymph flow stimulated by VEGFR-3 ligands may indirectly promote enlargement of collecting lymphatics, analogous to the secondary effects of blood flow on blood vessel remodeling. Perhaps the most difficult practical problem regarding gene therapy for lymphedema is how to achieve the necessary widespread transduction of large tissue areas, which are devoid of functional lymphatics, in patients with primary lymphedema. FGF-4 is a blood vessel growth factor FGF-4 increased the number and size of capillaries and enhanced vascular permeability in the rabbit hindlimb ischemia model. AdFGF-4 also promoted arteriogenesis and collateral-dependent blood flow with an efficacy comparable to AdVEGF164. However, in contrast to VEGF164, recombinant FGF-4 protein neither induced vascular permeability in rabbit skin nor did it stimulate EC tube formation in vitro. Because of these biological differences we sought to examine whether endogenous rabbit VEGF was upregulated in AdFGF-4-transduced muscles, which turned out to be true. Thus, VEGF upregulation may at least partly explain the late vascular permeability effects and perhaps also vascular growth and ativan.
Table 1. Causes of pulmonary edema Cardiogenic hydrostatic normal alveolo-capillary barrier Increased hydrostatic pulmonary capillary pressures Heart failure Decreased oncotic or hydrostatic interstitial pressures Volume overload Non-cardiogenic increased permeability damaged alveolocapillary barrier Acute Respiratory Distress Syndrome ARDS ; Infections Trauma Inflammation Aspiration syndromes Hemodynamic instability Immunologic diseases Drugs Pancreatitis Inspired gases or toxins Metabolic diseases Hematological diseases DIC Neurological diseases Obstetric diseases Radiation Ventilator induced lung injury Miscellaneous, for example, tiohropium 18.
EFFICACY There are four one year randomised controlled trials RCTs ; assessing tiotropium, two compare tiotropiuum to ipratropium and two compare it to placebo. The full one year results of these are due for publication at the end of 2001 [Personal Communication: Boehringer Ingelheim]. A further two trials of six month duration compare tiotrooium to salmeterol. The 13 week interim analyses of two of the one year studies one placebo comparison and one comparing to ipratropium ; are currently available, along with several abstracts of the one year results. Both interim analyses focus on the effect of tiotropium on improvement in FEV1 responses. The first study from the Netherlands Europe ; [13] compared tiotropium 18 micrograms inhaled once daily n 191 ; to ipratropium 40 micrograms inhaled four times daily n 97 ; . The study was multicentre, randomised, double-blind and double- dummy patients received a HandiHaler and a MDI ; . Patients had a clinical diagnosis of COPD with a FEV1 of 65% predicted, were 40 years old and current or previous smokers. Participants in the study were allowed to continue on inhaled steroids or oral steroids up to 10mg prednisolone daily ; but were not allowed to use long- acting 2agonists, oral 2- agonists or sodium cromoglicate. As required salbutamol use was permitted. The study excluded patients with prostatic hypertrophy and narrow angle glaucoma. The primary endpoint was the trough FEV1 response, i.e. the change from baseline in trough FEV1. Secondary endpoints included average and peak FEV1 response, peak flow PEFR ; and as required open label salbutamol use. The mean baseline FEV1 in the tiotropium group was 1.21L and was 1.15L in the ipratropium group. Results of the primary endpoint at 13 weeks are summarised in table 1. Results from this study confirmed that tiotropium was effective when given once daily and improved statistically significantly ; trough FEV1 responses compared to ipratropium. Secondary endpoint results also favoured tiotropium with PEFR improving and bextra.
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The Issue Long-acting 2-agonists have been approved for the management of patients with chronic obstructive pulmonary disease COPD ; . The diagnostic criteria for COPD are evolving, and as many as 30% of patients with COPD may have airway obstruction that is measured with forced expiratory volume in one second FEV1 ; and that may be alleviated with bronchodilator therapy i.e., reversibility ; . In clinical practice, it may be difficult to separate patients with COPD who respond to bronchodilator therapy from those who do not. In addition, the reversibility status for many patients with COPD fluctuates over time. Potential funders of these drugs should understand the health impact associated with their use in patients who are diagnosed with COPD. This report will review the clinical implications of using long-acting 2-agonists in patients with reversible and non-reversible stable COPD. Objectives The objective of this report is to critically examine the clinical effectiveness, through a systematic review of the literature, of inhaled long-acting 2-agonists in patients with stable COPD and reversible or non-reversible airway obstruction. The report will address the following research questions: What is the effectiveness of inhaled long-acting 2-agonists versus inhaled anticholinergics ipratropium and tiotropium ; , with or without short-acting 2-agonist aerosol agents taken on an as-needed basis, for the maintenance treatment of patients with stable COPD irrespective of the degree of airway reversibility? What is the effectiveness of inhaled long-acting 2-agonists versus placebo, with or without short-acting 2-agonist aerosol agents taken on an as-needed basis, for the maintenance treatment of patients with stable COPD irrespective of the degree of airway reversibility? Methods Published and unpublished literature was obtained by searching multiple databases; handsearching selected journals, documents, and the bibliographies of selected papers; and by contacting manufacturers. Included were all published and unpublished randomized controlled trials RCTs ; of one or more weeks' duration, of parallel or crossover design, enrolling patients with a FEV1 of 75% or less than the predicted value, and a ratio of FEV1 forced vital capacity FVC ; of less than 70% of the predicted value. Two reviewers independently selected studies; assessed trial quality; extracted key data including deaths, serious or life threatening adverse events, COPD exacerbations, upper respiratory tract infections URTIs ; during treatment, hospitalizations during treatment, rescue short-acting 2-agonist use for acute symptomatic relief, symptom-free days, dyspnea, lung function tests, walk tests, and quality of life measures. Results Of the 150 potentially relevant reports identified, 54 summarizing the results of 33 unique RCTs satisfied the inclusion criteria for this review. Of these, 20 trials compared salmeterol and placebo; two compared salmeterol, ipratropium bromide, and placebo; two compared salmeterol and cialis.
Ordodi V.1, Mirica N.1, Barglazan D.1, Menabo R.2, Kaludercic N.3, Canton M3, Cristescu A.1, Muntean D.1 1 "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania; 2 Istituto Neuroscienze CNR; 3Dipartimento Chimica Biologica, Universita di Padova, Padova, Italy; daninamuntean gmail Aims: Previous studies demonstrated the contribution of reactive oxygen species ROS ; produced by monoaminooxidases MAO ; to myocardial injury caused by post-ischaemic reperfusion and the protective effects afforded by irreversible MAO inhibitors. The present study was aimed at characterizing the effects of a reversible MAO-A inhibitor, moclobemid Mocl ; , in the in vivo rat model of regional ischaemia. Methods: Anesthetized rats subjected to 30 min ischaemia by coronary ligation and 2 h reperfusion were randomized to receive: i ; no additional interventions Ctrl ; , ii ; acute administration of 4 mg kg Mocl IV 15 minutes before ischaemia MoclAc ; and iii ; chronic administration of 4 mg kg IP, daily for 3 weeks MoclChr ; . Occurrence of arrhythmias ventricular premature beats, VPBs; ventricular tachycardia, VT and ventricular fibrillation, VF ; was assessed along with of infarct size measurement by means of triphenyltetrazolium chloride staining. Results: Myocardial injury expressed as the percent of infarct to risk area ratio I R% ; was significantly reduced by both acute and chronic Mocl treatment 1.43 0.9%, 6.37 and 32.19 1.6% in MoclAc, MoclChr and Ctrl groups, respectively; mean SEM; p 0.05 ; . In addition, no arrhythmias were observed in MoclAc group arrhythmia score 0 ; , whereas 30 VPBs arrhythmia score 1 ; appeared during ischaemia in MoclChr group as compared to arrhythmia scores of 2 30 VPBs ; and 3 three episodes of VF VT ; seen in controls. Conclusion: Both acute and chronic administration of Mocl elicited remarkable cardioprotection detected as reduction of infarct size and arrhythmogenicity caused by regional ischaemia-reperfusion in rat hearts.
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