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More than one reason may be indicated for each patient. The P value was calculated according to Fisher's exact test. This category includes 17 patients who received daptomycin and 10 patients who received standard therapy and who had both microbiologic failure and clinical failure and 2 patients who received daptomycin and 1 patient who received standard therapy who had microbiologic failure. Seven patients who received daptomycin and five patients who received standard therapy had complications of endocarditis, six patients who received daptomycin and one patient who received standard therapy had intravascular infection, two patients who received daptomycin had osteomyelitis, two patients who received daptomycin had septic arthritis, two patients who received daptomycin and three patients who received standard therapy had undrained abscesses, and two patients who received standard therapy had infected decubitus or T-cell lymphomaassociated ulcers. Two patients in each group had osteomyelitis. In the daptomycin group, one patient had gangrene of the left leg, declined amputation, and died; metastatic breast cancer and septic thrombophlebitis developed in one 87-year-old woman, and she died. In the standard-therapy group, one patient with diabetes, chronic obstructive pulmonary disease, and obesity presented with sepsis in a leg infection, which progressed to multiorgan failure syndrome, and died; one patient with left-sided infective endocarditis died after neurologic complications developed. Indications for nonstudy antibiotics that could have been effective and may have influenced the outcome included S. aureus infection in 7 patients and other indications in 13 patients e.g., urinary tract infection or gram-negative sepsis ; . Potentially effective nonstudy antibiotics included vancomycin in 6 patients, linezolid in 2, an antistaphylococcal -lactam antibiotic in 12, a fluoroquinolone in 4, and other antibiotics with antistaphylococcal activity in 7. Patients may have received more than one potentially effective nonstudy antibiotic. Indications for nonstudy antibiotics that could have been effective and may have influenced the outcome included S. aureus infection in 13 patients and other indications in 3 patients. Nonstudy antibiotics that may have been effective included vancomycin in six patients, linezolid in four, an antistaphylococcal -lactam antibiotic in five, a fluoroquinolone in five, and other antibiotics with antistaphylococcal activity in five. Patients may have received more than one nonstudy antibiotic that may have been effective. * Treatment of patients who did not have blood obtained for culture was considered to have failed in all analyses. For 16 patients 7 who received daptomycin and 9 who received standard therapy ; , treatment failure was assessed only because of a lack of blood culture. Follow-up data on survival were available for all 7 patients who received daptomycin and for 7 of the 9 patients who received standard therapy; all 14 survived. Two patients who received standard therapy were lost to follow-up.
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Velopment, to set up manufacturing facilities and to conduct expensive clinical trials to demonstrate safety and efficacy. Due to all these costs, biogenerics are predicted to sell for only about 1020% less than the brand name product 54 ; . Despite all these tough challenges, biotech-derived products are a reality whose benefit is accepted and valued by society and patients, who should have access to medicines that are safe and effective, and not just cheap. Acknowledgments The author is indebted to Prof. Manlio Palumbo and Dr. Giulia Giaretta for helpful suggestions and careful reading of the manuscript. REFERENCES.
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Chapter 15 1 Een zacht antwoord keert de grimmigheid af; maar een smartend woord doet den toorn oprijzen. 2 De tong der wijzen maakt de wetenschap goed; maar de mond der zotten stort overvloediglijk 3 dwaasheid uit. De ogen des HEEREN zijn in alle plaatsen, beschouwende de kwaden en de 4 goeden. De medicijn der tong is een boom des levens; maar de verkeerdheid in dezelve is een 5 breuk in den geest. Een dwaas zal de tucht zijns vaders versmaden; maar die de bestraffing 6 waarneemt, zal kloekzinniglijk handelen. In het huis des rechtvaardigen is een grote schat; maar 7 in des goddelozen inkomst is beroerte. De lippen der wijzen zullen de wetenschap uitstrooien; 8 maar het hart der zotten niet alzo. Het offer der goddelozen is den HEERE een gruwel; maar het 9 gebed der oprechten is Zijn welgevallen. De weg der goddelozen is den HEERE een gruwel; 10 maar dien, die de gerechtigheid najaagt, zal Hij liefhebben. De tucht is onaangenaam voor 11 dengene die het pad verlaat; en die de bestraffing haat, zal sterven. De hel en het verderf zijn 12 voor den HEERE; hoeveel te meer de harten van des mensenkinderen? De spotter zal niet 13 liefhebben, die hem bestraft; hij zal niet gaan tot de wijzen. Een vrolijk hart zal het aangezicht.
FIG. 2. Relationship between daptomycin dose mg kg ; and Cmax A ; and dose versus AUC B ; for various doses of daptomycin. The drug was given i.p. as a single dose 2 h after neutropenic mice were infected i.m. with S. aureus and darifenacin.
PTH at 20 and 24 weeks after maxacalcitol administration P 0.05, unpaired Student's t test; Figure 1 ; . Per cent changes in intact PTH levels are shown in Figure 2. Per cent decrease in intact PTH was significantly greater in group S than in group L at 16, 20 and 24 weeks after maxacalcitol administration P 0.05, P 0.01 and P 0.05, respectively ; . Ultrasonography of the parathyroid gland at 24 weeks after initiation of maxacalcitol administration At 24 weeks after initiation of maxacalcitol administration, ultrasonography was performed again in all 25 patients. The number of detectable parathyroid glands was significantly decreased in group S [from 2.2 0.3 at baseline to 1.8 0.4 at 24 weeks P 0.05 ; ], but not significantly so in group L 3.2 0.2 at baseline vs 2.9 0.2 at 24 weeks ; . The maximum diameter of the parathyroid gland before treatment was significantly larger than the diameter of the same gland at 24 weeks 8.5 2.1 vs 5.3 5.0 mm; P 0.05, paired t-test ; in group S, although in group L that before treatment was not significantly different from that at 24 weeks 14.1 2.3 vs 13.4 2.5 mm ; . Changes in calcium and phosphate Serum calcium level corrected calcium value ; was not significantly changed after maxacalcitol administration in group S, whereas serum calcium in group L significantly increased after maxacalcitol administration P 0.05, paired Student's t-test ; . Serum calcium concentrations in group L were significantly higher than those in group S at 4, 8, 12 and 24 weeks after initiation of maxacalcitol administration Figure 3 ; . Serum calcium at 4 weeks, when the highest calcium values were observed, was significantly positively correlated with both parathyroid gland size r 0.54, P 0.01 ; and baseline calcium level r 0.61, P 0.01 ; , but not with baseline serum phosphate or intact PTH level. Serum phosphate concentrations were not significantly changed during the 24 weeks.
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10. Cubicin daptomycin ; package insert. Lexington, Mass: Cubist Pharmaceuticals, Inc.; 2003. 11. Critchley IA, Blosser-Middleton RS, Jones ME, Thornsberry C, Sahm DF, Karlowsky JA. Baseline study to determine in vitro activities of daptomycin against gram-positive pathogens isolated in the United States in 2000-2001. Antimicrob Agents Chemother. 2003; 47: 1689-1693. CDC NNIS System. National nosocomial infections surveillance NNIS ; system report, data summary from January 1992 through June 2003, issued August 2003. J Infect Control. 2003; 31: 481-498. Diekema DJ, Pfaller MA, Schmitz FJ, et al. Staphylococcal infections and resistance. Clin Infect Dis. 2001; 32: S114-S132. 14. Donskey CJ, Schreiber JR, Jacobs MR, et al. A polyclonal outbreak of predominantly VanB vancomycin-resistant enterococci in northeast Ohio. Northeast Ohio VancomycinResistant Enterococcus Surveillance Program. Clin Infect Dis. 1999; 29: 573-579 . 15. Sieradzki K, Pinho MG, Tomasz A. Inactivated pbp4 in highly glycopeptide-resistant laboratory mutants of Staphylococcus aureus. J Biol Chem. 1999; 274: 18942-18946. Hiramatsu K. Vancomycin-resistant Staphylococcus aureus: a new model of antibiotic resistance. Lancet Infect Dis. 2001; 1: 147-155.
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Across: 1. A sign of mental health. 2. Mental illness disrupts thinking, feeling and . 3. 1999 national statistic on the percentage of jail inmates with a diagnosis of mental illness. % 4. A positive symptom of schizophrenia. 5. Episode of mental illness often mistaken for a heart attack 6. If an individual displays this emotion, you should speak and act calmly. Down: 1. A US president who had mental illness. 2. The greatest danger in depression. 3. A serious, biologically-based mental illness. 4. When communicating with an individual who appears to have difficulty concentrating, your messages should be . 5. Common social situation for individuals with PTSD. 6. A symptom of depression is a sense of excessive and deferasirox.
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Currently, reliable determination of susceptibility of enterococci to daptomycin by clinical laboratories using E strips or disks would require knowledge of the calcium content of Mueller-Hinton test media, and in the case of the E strips, selecting the E test formulation to specifically complement the test medium lot. Manufacturers of prepared Mueller-Hinton agar plates should either increase the concentration of calcium in their medium or routinely provide an analysis of their medium's calcium content if daptomycin testing is contemplated by the users of the medium. An NCCLS subcommittee is currently performing studies to select a new reference lot of Mueller-Hinton agar to be used as a reference standard by media manufacturers R. Rennie, personal communication ; . The calcium content and proper performance with daptomycin will be considered in selection of the new reference agar lot. It will also be important to determine whether increasing the calcium content would result in alterations in susceptibility to certain other drug classes, e.g., aminoglycosides and tetracyclines. In summary, this study has demonstrated the very good in vitro activity of daptomycin against a diverse collection of vancomycin-nonsusceptible Enterococcus species. Susceptibility to daptomycin was not different in VRE isolates with resistance to linezolid or quinupristin-dalfopristin compared to results with isolates susceptible to those agents. However, this very encouraging activity of daptomycin against highly resistant enterococci can only be documented using susceptibility testing reagents that contain appropriate amounts of calcium. Efforts are under way to standardize the calcium content of standard Mueller-Hinton medium to allow for reliable testing of daptomycin in a clinical laboratory setting.
Correlation of daptomycin bactericidal activity and membrane depolarization in staphylococcus aureus and delavirdine.
The substantially lower expenses during the first nine months of 2002 was attributable in part to the recognition in the first quarter 2001 of 6 million of a 0 million up-front payment to cubist pharmaceuticals related to the european licensing agreement for daptomycin signed in january 2001 and subsequently terminated in september 200 in addition, gilead's expenses have decreased compared to the first nine months in 2001 due to a decrease in expenses associated with the viread clinical program and the divestiture of gilead's oncology portfolio to osi pharmaceuticals in december 200 selling, general and administrative expenses for the nine months ended september 30, 2002 were 7 million compared to 7 million for the same period in 200 the significant increase in expenses is primarily due to gilead's increased global marketing efforts and the expansion of gilead's and european sales forces to support the commercial launches of viread and hepsera.
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TABLE 1. In vitro activities of daptomycin and vancomycin in CAMHB and of daptomycin in calcium-supplemented CAMHB and demeclocycline.
The police and the Thai FDA during B.E. 2538-2545 were subjected to test for their physical characteristics such as colors, shapes, sizes, weight per unit, scoring and logoes as well as for their chemical compositions. The total of 179 samples of various appearances, of which 178 were tablets and 1 was capsule, were included in the study. Eighty different logoes were found. The three most frequent found logoes were CU, the imprint butterfly figure and B-29, respectively. The weight found were 47.2 to 453 289.2 38.2 ; milligrams per tablet. The diameter and thickness of the tablets were 5 to 10 8.4 0.4 ; and 2.0 to 7.0 4.8 0.6 ; millimeters, respectively. The color tests, thin-layer chromatography and gas chromatography were used for the identification and the determination of the amounts of the active ingredients. The results showed that 76% of the samples contained 3, 4-methylenedioxymethamphetamine MDMA ; as a single active ingredient 51% ; and in combination with other drugs 25% ; . The amounts of the hydrochloride salt of MDMA found in single and in combined formulations were 52.4 to 200.4 134.7 36.0 ; and 6.4 to 175.6 125.2 34.4 ; milligrams per tablet, respectively. The other ring-substituted amphetamine derivatives also found as the active ingredients were methylenedioxyamphetamine MDA ; , N-ethyl MDA MDE ; , N-methyl-1- 1, 3-benzodioxol-5-yl ; -2-butanamine MBDB ; and 4-Bromo-2, 5-dimethoxyphenethylamine 2C-B ; . Many other active ingredients found were amphetamine, methamphetamine, ketamine, pemoline, phenobarbital, diazepam, phenylpropanolamine, diphenhydramine, caffeine and paracetamol. The data obtained demonstrated the physical characteristics and chemical compositions profile of Ya-E which could be used as a tool for the examination and monitoring the outbreak of Ya-E in Thailand. Key words : Ya-E, MDMA, ring-substituted amphetamine derivatives.
K. De Paepe, J-P Hachem, E. Houben, J-M Lagarde, Y. Galle, D. Roseeuw, V. Rogiers, Skin microrelief topography measurements of ageing skin using a light transmission method, Skin Research and Technology, Vol. 9, Nr. 2, May 2003, "Abstract Nr. P69". Anti-wrinkle creams, anti-ageing products and all kinds of skin care products, developed to affect skin relief and reduce lines and wrinkles, are very popular and good sellers. Also for these products, it is necessary to comply with the actual cosmetic EU legislation and to substantiate the claims made. D. Brokken, LJM Schlangen, van Kemenade, A mechanical model for the skin suction experiment, Skin Research and Technology, Vol. 9, Nr. 2, May 2003, "Abstract Nr. P72". The skin suction experiment is one of the most widely used methods in dermatology and cosmetology to evaluate the mechanical properties of the skin. Usually, the skin is sucked into an aperture repeatedly by applying an intermittent partial vacuum P ; . I. Sadiq, T. Stoudemayer, A. Kligman, Blue light visualizes the degree of solar elastosis in photodamaged human facial skin, Skin Research and Technology, Vol. 9, Nr. 2, May 2003, "Abstract Nr. P74". We have utilized the short wavelength visible light blue light ; to visualize the fluorophores and chromophores of photo-aged facial skin. Topographic details of the surface can also be seen with great clarity. H. Dobrev, In vivo study of skin mechanical properties in Raynauds phenomenon, Skin Research and Technology, Vol. 9, Nr. 2, May 2003, "Abstract Nr. P76". Raynauds phenomenon is usually the first symptom on patients with systemic sclerosis and may precede skin changes by several months or years. Non-invasive measurements of skin elasticity are very sensitive and appropriate for objective and quantitative evaluation of sclerodermatous skin. H-C Kim, S-J Hong, M-H Lee, J-S Moon, Objective evaluation of severity in SLS-induced irritant dermatitis: comparing the studies between new skin color analysis technique and other bioengineering tools, Skin Research and Technology, Vol. 9, Nr. 2, May 2003, "Abstract Nr. P77". Objective: In evaluation for severity of SLS-induced irritant dermatitis, visual scoring system is wide being used as a subjective method. However, it is well known that variations exist even in the interpretations by experienced dermatologists. S. Savic, N. Cekic, S. Tamburic, J. Milic, G. Vuleta, The effect of urea from dermo-cosmetic emulsions on skin hydration and its barrier function: a vehicle-controlled study, Skin Research and Technology, Vol. 9, Nr. 2, May 2003, "Abstract Nr. P81". A number of studies have shown that, depending on the concentration, treatment with urea could improve skin barrier function, despite of its penetration enhancing properties. This controversial skin effect has not been explored systematically in terms of the effect of vehicle on the performance of urea. HK Lee, SY Ahn, JH Bae, SJ Moon, IS Chang, Comparisons of skin characteristics between men and women using non-invasive methods in young healthy Asians, Skin Research and Technology, Vol. 9, Nr. 2, May 2003, "Abstract Nr. P84". Objective: Skin has different properties depending on intrinsic effects such as inherent factors, race, gender, and so on. Besides, it has been known that skin may change because of the environmental stress such as UV, climate and life style. R. Pena Ferreira, P. Costa, F. Bahia, Visioscan VC 98 application: a comparison study between coarse and smooth skin surface, Skin Research and Technology, Vol. 9, Nr. 2, May 2003, "Abstract Nr. P91". The skin is a result of many biochemical and physical factors and these are subject to changes both internally and externally. What is aging? Most of us define aging in terms of the appearance of people and desipramine.
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Boston reports 104 new members for the year; three of which arc Institutional, and 84 of which are Associate, the rest being Active. Boston's chief effort, aside from the Convention this year, seemed to be to transfer 19 Associate members into the Active class. Their Educational Committee gave courses during the year on catalogmg, classification, bibliography, and indexing. They also initiated N.R.A. projects, which provided employment for needy librarians for the and daptomycin.
Image Analysis For the semiquantitative SPECT data analysis, two short-axial slices and a vertical long axial slice were selected for both BMIPP and 2"'T1 images. Two short-axial slices from near the cardiac base and mid-to-apical portion were divided into eight segments each. The apex was divided into two segments anterior and inferior ; using the vertical long-axial image. Thus, there were 18 segments for each patient 16 ; . Using a color-coded scale, BMIPP and 201T1 uptake in each segment were scored semiquantitatively using a five-point grading system [0, normal activity 70% or more of the maximal activity 1, mildly reduced activity between 70 and 55% of the maximal activity 2, moderately reduced activity between 55 and 45% of maximum 3, severely reduced activity between 45 and 30% of maximum and 4, absent uptake less than 30% of maximum ; ]. When the score in each segment was different for the two tracers and score improvement from stress to reinjection of 20IT1was present, the segment was considered to show discordant uptake and fill-in, respectively. A difference of more than 10% between BMIPP and 201T1uptake and between stress and reinjection 2 ; 1T1 uptake values was required to consider discordant uptake and 2'T1ill-in, respectively 12, 16, 18 ; . f and dexedrine.
On Intfnd to I vi ulnrs in I Ju f." 111 rl a n. 1111 S t n -An, H The lUroptog out of party treachery Oh ]LII v i i [KII[ ; W Tfllriling H u r Hou * e t lmv \ ur li ninil m i In. bijrt.tr n a n II. E l l can only be "done by he straight voters si i 1 oil 1 nl an pLin nts f r 1 for the claim of the Uij.lly that [i * 1 IK. P r e tbe party, and it can beet be done by the IU publicans of Shrewsbury sold out tunml tin. - * C ind rbo\ iths i %e1 ur * tr e tu mix thi in vourtklf in 1 il Hit |nint i fS b tbe young men Tbty haTe it in their t h ep |1|| ; |lh l w power to make party treachery so dig i no candidate was nominated for the as \ u hist \: n with a sink Kin I v t injil i i n Ms. Mm gnwsful and so unprofitable that e\en wmblj in this district it was current of ln lieul lit .tli bonw 1 Jimi-t lf t h montsccuutoroed to it will hurdl ; I P' ft 'hat V W Himuay of Kiritan t n , mmli Ht IIM to knuikl un.kr u, f l u iurs If tn 1 tottnuhip would accept tht ; no mi Datnn \otx of fi Hi mthtr bt i knip n n m ikinj, li anil flairs i" dare attempt it Men * ho dicker and | J us before the convention opened the | U i heii n nran uitt-d t wo mf Ip trade with the Democrals should be editor of the HeeAiysaid that Rjritan uulri bt hurt of liifji md air\ an I ttll g r u irklrik Ih nir em to wtut in tli tlur riKiin til! I hn ahorn of ll power, and they would. w o u |Te h l m nomination m b in tfi 1 r t HilL I i r the conventirn mil In t it bull * n i ; h quickly be unable to carry out anv deal | k n The editor rf the K eekly tn k p tin ; rtsklent t f inilnm't ur an uiiifurin iii ii li r 'iniK tin r j , n which they might make Raritan and B i r noftBays that ~ nidi ini'in Hitiitlt iweiirin nil I kirkin t o \ iiuiri urf i i m mi" * had not & full representation at the ion his tut Is tin, i ther k n HHII t i n i\tr\ a \n n iri m i m iir Icn jlrt n I L aed 'ventioo i n u tnav nruweuurjr couiu nave H t n i1In IM\ thin tint 1 n k pit Ls, uit wlitn reuuoEi and thatShreweburj could have l o mi tinn tint 1.
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Attended a Workshop on `Multicentric evaluation of a simple technque for DNA extraction from W. bancrofti from infected C. quinquefasciatus for PCR assay and rDNA-PCR assay for identification of A. fluviatilis" held at VCRC, Pondicherry from 24th 28th March 2003. Attended 3rd Global meet on Parasitic Diseases held at Bangalore University from Jan. 12-16, 2004 and presented a paper entitled "Detection, isolation and mass culture of L. donovani from naturally infected P. argentipes". Radio talks on "Kala-azar kin sambahak kit ka niyantran" and "Rog sambahak makkhiyan aur inka niyantran" in Hindi and the talks were broadcasted on 17th and 18th January 2004 respectively. Delivered a Guest lecture on "Molecular biology an Biotechnology" at College of Commerce, Patna on 24th July 2004. Delivered lectures on "Vector biology of kala-azar and its transmission dynamic in Indian context" and Vector bionomics of malaria, filarial and dengue and its role in disease transmission" at Academic Staff College, BHU, Varanas under 35th Orientation Course and darifenacin.
Dr. Snitman is a co-founder of Array and has served as Vice President, Business Development, and Chief Operating Officer and as a member of the board of directors since May 1998. Prior to forming Array, Dr. Snitman held various positions with Amgen Inc., including: Associate Director, New Products and Technology and Manager of Amgen's Boulder research facility. Dr. Snitman received a B.S. in chemistry from Northeastern University and obtained a Ph.D. in the synthesis of natural products from the University of Colorado. He was an NIH Postdoctoral Fellow at the Massachusetts Institute of Technology and dextromethorphan.
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This book is founded on the sound premise that the physiology of the pregnant womlan is different from that of the nonpregnant woman, and that these differences may affect the course and management of disease. When Mount Sinai Hospital opened its first Department of Obstetries in November 1952, it created 10 specialty clinics within the framework of the Departmrent of Obstetrics. These include cardiac, pulmonary, hypertensive-renal, diabetic, hematologic, neurologic, psychosomatic, obstetric-gynecologic endocrine, vaginitis, and varicose vein. This book is the result of 7 years' experience of these special clinies. It appears that there has been good communication between these special clinics and the head of the department of Obstetrics. The book is imiipressive in magnitude. There are 14 sections, 49 chapters, and 68 authors. The book is a valuable contribution to a field much in need of documentation. It is perhaps inevitable when so many authors write about so miany subjects that the quality of the section should be somewhat uneven. Many are notably good and show clearly that the authors have not been thinking only about the technicalities of the special field, but have been looking at the total coniplex of the patient, the pregnaney and the disease. Many of the bibliographies attached to each chapter are valuable sources of nmaterial. It is probably also inevitable that in such a complex volumne that there should be gaps, and there are some. For example, there are four interesting chapters on specific endocrine disorders, but there is nowhere a general discussion of the extremely important endocrine alterations associated with pregnancy, and curiously enough the word "placenta" does not occur in the index. This is a book that should be widely used by obstetricians, by internists, and by individuals in various specialized fields. It is obvious from reading these chapters that many of the workers in the special clinics regard the altered physiology of pregnancy as supplying opportunities for them to advanee knowledge of the special field. It is therefore to be expected that knowledge about the comnplications of pregnancy can be expected to change. One suspects that in a few years there will be a second edition of this book even better than the present one. One further point should be muade. This book has 619 pages, but it seems that it must have more because it is printed on a kind of paper which makes it so heavy that it is actually difficult to handle. One cannot imagine reading it in bed or carrying it home in a brief case. C. SIDNEY BURWELL, M.D.
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