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Phy involve at least partially independent processes Wand, 2005 ; . The see Figure 1 ; . hiv-positive men, both with and without subjective study, reported at the 7th International Workshop, hypothesized that if lipoatrophy, had less sat than controls, with legs and lower trunk more lipodystrophy and lipoatrophy are of the same syndrome, improveaffected than upper trunk. Use of stavudine Zerir ; or indinavir Crixivan ; ments in sat should inversely correlate with changes in vat and that was associated with less leg sat but did not appear to be associated with factors associated with sat and vat improvements should be similar. To more vat. Nevirapine Viramune ; use was associated with less vat. do this, Dr. Carr's group evaluated 72-week data pooled from two ranfram demonstrated that peripheral and central subcutaneous lipoadomized lipoatrophy trials: mitox, evaluating a switch from stavudine trophy is more common in hiv-positive individuals than in hiv-negative or zidovudine to abacavir for 24 weeks, and rosey, evaluating the individuals. Of interest was the finding that increases in vat--lipohyaddition of rosiglitazone Avandia ; or placebo. A total of 214 patients pertrophy--were actually more common in hiv-negative men than in hivfollowed for 72 weeks were included in the analysis. positive men. This conclusion has succeeded in turning conventional wisThere was a significant, although relatively weak, positive correlation dom on its head. Is hiv-associated lipodystrophy a combination of lipoabetween the changes in limb-fat mass and vat. In other words, an introphy and lipohypertrophy, or is it just lipoatrophy? While the results of crease in limb fat in men recovering from lipoatrophy was not associfram seem to suggest the former, there are a few potential study limitaated with a reduction in vat, but rather an increase. Additional data pretions that clinicians should consider when reviewing the results. For exsented by the authors indicated that changes in limb fat and vat have ample, the hiv-negative control patients in fram were significantly heavdiffering risk factors. These data are consistent with previously reier that the hiv-positive patients. This may have contributed to the obported longitudinal results from actg servation that increases in vat were more p 0.001 8 5005, in which changes in limb and common in the control patients. Furp 0.001 p 0.001 trunk fat following initiation of antithermore, fram is a cross-sectional study. 6 retroviral therapy were found to be posLongitudinal studies, such as actg 5005 a 4 itively correlated Mulligan, 2005 ; . substudy of actg 384 ; , have demonstrat2 "The hypothesis underlying the ed an increase in truncal adiposity over 0 lipodystrophy case definition study is time with institution antiretroviral therp 0.001 that visceral fat increases and subcutaapy Mulligan, 2005 ; . p 0.001 p 0.001 8 neous fat decreases are related, " Dr. "fram also demonstrated that lipoat6 Kotler commented. "However, fram and rophy occurs, whether or not it is visible 4 data from the mitox rosey analysis into the patient or clinician, " Dr. Kotler 2 dicate that this isn't true. In fact, if they added. "Some hiv-positive individuals are related, it's in a positive way, wherewho did not think they had lipoatrophy 0 by both sat and vat increase or decrease upon entering the study were found to p 0.090 2 together. So, in effect, the splitters win have lipoatrophy on mri. What we see p 0.001 p 0.001 this round." doesn't necessarily tell the whole story. 1 In Harlem I study a lot of obese women, some of whom have elements of lipoatrophy. But the fact is, the skinniest of the 0 p 0.049 lipoatrophic but obese women have more p 0.001 p 0.001 subcutaneous body fat than I do, and no4 body has ever claimed that I have lipoatThymidine Analogues and 3 rophy. So it's really complicated." It is imLipoatrophy 2 portant to note that fram data involving "we all know that thymidine ana1 hiv-infected women are forthcoming. logues are implicated as the cause of 0 Now that we have two conflicting anlipoatrophy, " Dr. Kotler said. "There's p 0.089 swers, we have to go back to the question, nothing surprising about this statement. 3 p 0.001 p 0.094 "What is lipodystrophy?" Is it something When we switch patients off of a thymithat is visible, or is it something that exdine analogue, we don't typically see a 2 ists, whether or not it is visible? This discomplete reversal of lipoatrophy. It does1 tinction is important, since Dr. Carr's n't go back to how it was. The reason for group found that subjects deemed to this incomplete recovery is unknown." 0 have lipodystrophy by the case definiIn the original 2002 mitox study pubControl LA + HIV LAHIV tion also were more likely to fit a conlished by Dr. Carr and his colleagues, sensus definition of the metabolic syn- FIGURE 1. fram: Adipose Tissue Volume by mri some basic comparisons between padrome than those without lipodystrophy. tients with and without lipoatrophy were Comparison of control subjects, hiv-infected patients with reported Carr, 2002 ; . Total fat measured clinical lipoatrophy la + , subjective lipoatrophy reported by pa17.1 kg in a control group of patients, tients and confirmed by physical examination ; , and hiv-infected compared to 12.8 kg in the patients with MITOX and ROSEY patients without clinical lipoatrophy la ; . Values are medians subjective lipoatrophy. Trunk fat weighed new data from a study conducted and confidence intervals. in at 9.1 kg in both lipoatrophic patients by Dr. Carr's group in Sydney someSource: Bacchetti P, Gripshover B, Grunfeld C, et al. Fat distribution in men with what echo the results of fram, indicat- hiv infection. J Acquir Immune Defic Syndr 40 2 ; : 121-31, 2005. Reprinted with per- and control patients. Limb fat, however, was found to be 7.3 kg in control patients ing that lipohypertrophy and lipoatro- mission of Lippincott Williams and Wilkins.
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Dr. Tseng says she first became fascinated with cancer research during a UCSF preclinical seminar, "The Molecular Biology of Cancer." Her grandfather a general and thoracic surgeon ; had struggled with and ultimately passed away from cancer during her medical school years. "My grandfather's illness showed me what it's like to have to watch as a loved one struggles with cancer, and I made a vow then to somehow make a difference in the effort to find a cure. Pancreatic cancer became my main focus when, as a medical student, I took care of a patient who was scheduled for a Whipple procedure. Unfortunately, we discovered during laparoscopic surgery that he had peritoneal mets and had to stop the surgery. Seeing his disappointment, devastation, in the recovery room was a turning point in my career." The goal of the project for which Dr. Tseng has received the PanCAN grant is to generate a risk score for pancreatic lesions, so that patients at greatest risk of pancreatic cancer can be identified early and undergo aggressive treatment for cure, while patients with benign lesions can be spared the risks of surgery and other interventions. Dr. Tseng has also been honored by the Pancreatic Cancer Alliance, a grassroots organization in Worcester, Mass, as their Pancreatic Cancer Alliance Scholar, an honor that she says "means a great deal to me, because it comes from people who have dealt with pancreatic cancer first-hand. I believe that pancreatic cancer strikes the best, and the brightest. For that reason, I determined to be part of the community that makes our way toward a cure for this disease." Dr. Tseng is married to Marc Sabatine, M.D., a cardiologist at Brigham and Women's in Boston. They have a six-month old son, Matteo and ticlopidine, because arv.
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Ah, the characteristics of the fall season! Kids are back to school and the weather is changing. Leaves are falling and the holiday season is approaching. But, common colds and fall allergies shouldn't be our only health concern this season. Many studies show that proactive prevention can keep down the risk of developing numerous health conditions and diseases. Recently, there has been a heightened focus on diseases that primarily affect women, such as breast and cervical cancer and human papillomavirus HPV ; , to name a few. The emotional and financial aftermath of dealing with these health issues can affect us all, considering these are our mothers, wives, daughters, sisters and friends. Prevention and detection are key, which is why, in this issue, we've included the article "Screenings that Women Just Won't Want to Miss." We encourage you, our readers, to become familiar with these important tests and screenings. You are officially challenged to remind yourself or the women around you of their importance. The value of doing so is priceless! A diabetes diagnosis can be scary, but you have the upper hand when you take control! Managing your blood sugar levels can help you ward off numerous health complications. Controlling diabetes doesn't have to be the end of the world. Take one step forward by reading the enclosed article "When You've Been Diagnosed with Diabetes." Last but definitely not least, the holidays are upon us. As stressful as traveling seems, it doesn't have to be. Read on to learn how to relax and release just in time for your holiday destination arrival. Seems like just when we thought it was safe to ditch the jacket, it becomes time to dig out the sweater! Enjoy the fall season and remember that prevention is critical to taking control of your health. You will relax better knowing that you did. Health and Wellness for Today, Tomorrow and Forever! Hadiya K. Reynolds Executive Editor and tegaserod.
Reflects percentage change in net sales in dollar terms, including change in average selling prices and wholesaler buying patterns. Based on a simple average of the estimated number of prescriptions in the retail and mail order channels as provided by IMS. Based on a weighted average of the estimated number of prescription units pills ; in each of the retail and mail order channels based on data provided by IMS. Erbitux and Paraplatin specifically, and parenterally administered oncology products in general, do not have prescription-level data because physicians do not write prescriptions for these products. The Company believes therapeutic category share information provided by third parties for these products may not be reliable and accordingly, none is presented here. The therapeutic categories are determined by the Company as those products considered to be in direct competition with the Company's own products. The products listed above compete in the following therapeutic categories: Abilify antipsychotics ; , Avapro Avalide angiotensin receptor blockers ; , Cefzil branded oral solid and liquid antibiotics ; , Coumadin warfarin ; , Dovonex anti-inflamatory-antipsoriasis ; , Glucophage Franchise oral antidiabetics ; , Plavix antiplatelet agents ; , Pravachol HMG CoA reductase inhibitors ; , Reyataz protease inhibitors ; , Sustiva antiretrovirals - third agents ; , Tequin branded oral solid antibiotics ; , Videx Videx EC nucleoside reverse transcriptase inhibitors ; and Zerif nucleoside reverse transcriptase inhibitors ; . In excess of 200%. Data for 2003 are not available, therefore this section is omitted.
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LACTIC ACIDOSIS AND SEVERE HEPATOMEGALY WITH STEATOSIS, INCLUDING FATAL CASES, HAVE BEEN REPORTED WITH THE USE OF NUCLEOSIDE ANALOGUES ALONE OR IN COMBINATION, INCLUDING STAVUDINE AND OTHER ANTIRETROVIRALS. FATAL LACTIC ACIDOSIS HAS BEEN REPORTED IN PREGNANT WOMEN WHO RECEIVED THE COMBINATION OF STAVUDINE AND DIDANOSINE WITH OTHER ANTIRETROVIRAL AGENTS. THE COMBINATION OF STAVUDINE AND DIDANOSINE SHOULD BE USED WITH CAUTION DURING PREGNANCY AND IS RECOMMENDED ONLY IF THE POTENTIAL BENEFIT CLEARLY OUTWEIGHS THE POTENTIAL RISK SEE WARNINGS AND PRECAUTIONS: PREGNANCY ; . FATAL AND NONFATAL PANCREATITIS HAVE OCCURRED DURING THERAPY WHEN ZERIT WAS PART OF A COMBINATION REGIMEN THAT INCLUDED DIDANOSINE, WITH OR WITHOUT HYDROXYUREA, IN BOTH TREATMENT-NAVE AND TREATMENT-EXPERIENCED PATIENTS, REGARDLESS OF DEGREE OF IMMUNOSUPPRESSION SEE WARNINGS and urso and zerit.
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ACKNOWLEDGMENTS We thank R. M. Evans Salk Institute ; , J. D. Chen University of Massachusetts ; , V. Cavailles INSERM U148, Montpellier, France ; , D. D. Moore and B. W. O'Malley Baylor College of Medicine ; , and B. Shroot and U. Reichert CIRD-Galderma ; for providing plasmids and ligands, and we thank E. Thoreau CIRD-Galderma ; for hRAR LBD coordinates, constant interest, and input. We are grateful to Hoffmann-La Roche for the gift of 9-cis RA. We thank C. Brand and B. Lefebvre for critical reading of the manuscript and B. Masselot for technical help.
Studies from clinical settings tend to find higher comorbidity rates than studies from nonclinical settings because having more than one disorder may increase the probability of seeking treatment.21 However, comorbidity is the rule rather than the exception, as is the case for many psychiatric disorders. Clinicians need to be mindful of the possible clinical impact of comorbid conditions--for example, their association with greater morbidity and the need to consider comorbidity in treatment planning. A small magnetic resonance imaging study N 16 ; found that BDD subjects had a leftward shift in caudate asymmetry and greater white matter volume than healthy controls, whereas some OCD studies have found the opposite i.e., a rightward shift in caudate asymmetry and reduced white matter volume ; .22 BDD and OCD both appear to respond preferentially to SRIs, 23, 24 but preliminary data suggest that, unlike OCD, BDD may not respond to SRI augmentation with antipsychotics.25, 26 However, additional research is needed to further examine the nature of BDD's relationship to OCD. Taken together, these findings give some support to the hypothesis that BDD may be related to OCD and is an "OCDspectrum disorder, " but that BDD and OCD are not identical. There is also a need for future studies to evaluate evidence from other sources, such as neurobiological, family, and treatment studies, to further our understanding of the concept of obsessive-compulsive spectrum disorders.
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Absences and myoclonia or JME PA 8% ; , d ; JME with myoclonic astatic seizures or JME MA 3% ; . Among 161 classic JME patients, 85% had grand mal seizures controlled with antiepileptic drugs, but myoclonic or tonicclonic or absence seizures persisted in 27.5%. Considering CAE JME, 74% 26 35 ; had tonic-clonic seizures controlled with antiepileptic drugs, absence persisted in 46%. Myoclonias were rarely persistent. In eighteen with JME PA, 17 had tonic-clonic seizures controlled, but myoclonic and absence seizures persisted in 5. All JME patients with myoclonic astatic seizures were free of tonic-clonic seizures except for one with persistent myoclonic astatic seizures. Valproate monotherapy and polytherapy was the most frequent drug taken by patients with controlled seizures in all subsyndromes. CONCLUSIONS: 1. JME subsyndromes affect patients until their third and fourth decade of life, proving JME is a lifelong epilepsy syndrome. Relapses usually occur due to sleep deprivation, fatigue, alcohol or stress. 2. Myoclonic and tonic-clonic seizures persist in drug resistant classic JME. Absences most commonly persist in CAE JME, supporting the concept of a subsyndrome different from classic JME, for example, zerit 20 mg.
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