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From sales clerks--by requesting pam- Manila in 1994 confirmed this practice of paregla. No questions were asked or pre- taking combined pills to induce menscriptions required. struation in the belief or hope that the The most popular remedy prescribed for amenorrhea was not caused by pregnantreating delayed menstruation especial- cy ; or an abortion when a pregnancy was ly in areas outside the city limits ; was an strongly suspected or confirmed ; . Among oral contraceptive brand containing mestranol and norethindrone "Easy access to hormonal methods in many Gestex, manufactured by the drug company developing countries has enabled women to Medichem ; . This drug is also indicated for treat- use these drugs to prevent pregnancy on ment of secondary their own, despite the presence of laws or amenorrhea of short duration; doctors prescribe religious edicts restricting their use." it and other formulations upon request. These pills are often referred to as "preg- the 237 women who wanted to induce nancy test pills" because of the notion-- menstruation or terminate their pregamong both women and doctors--that if nancy, 40% had already attempted to do such pills do not successfully bring on so. Sixty percent had done nothing. ; menstruation, then a woman must be Among the 40%, 12% said they had tried combined pills and this proportion was pregnant. Thus, Philippine women use pills such probably larger, since some women reas Gestex to induce menses, deliberately ported having injected or ingested an untaking twice the prescribed dosage or known compound 9% had resorted to more. The two women investigators were abdominal massage or acupressure and never informed by pharmacists or doctors 7% had taken misoprostol. The remaining about the compound's contraindications 11% had taken a variety of other drugs inor its possible effects on a developing fetus. cluding analgesics and antibiotics ; or Some of these drugs are relatively inex- herbal medicines. Most of these women pensive. Gestex, for example, costs US 75% ; had used more than one of these .00.50 per tablet. ; Other mestranol- methods to induce bleeding. These studies suggest that both women norethindrone combinations are far costlier, however, with one marketed as Pro- and health providers in the Philippines seckon ; costing US .50 per tablet. would welcome having the option of .80 Some pharmacy clerks, especially those emergency contraception. They also inworking in poorer areas, also prescribed dicate that there would likely be little comherbal potions and remedies for delayed pliance with any law restricting emergency contraception in case of potential menstruation. Anecdotal evidence suggests that prosti- claims that it is an abortifacient. tutes take other drugs, such as Fansidar an antimalarial drug ; and Methergine used to Barriers to Emergency Methods control uterine bleeding ; , which are ru- Although emergency methods may be mored to be effective for inducing menses. well suited to the Philippines, their introAn over-the-counter remedy for stomach- duction will doubtless encounter a numaches Esencia Maravillosa ; , whose active ber of obstacles, including those related ingredient is unknown, is also said to be to the country's laws, the influence of forcommonly used by low-income women be- eign agencies, medical barriers, a wide range of ethical issues and the Philippine cause it is cheap and easy to obtain. According to a community-based study political situation. in Davao conducted among urban poor women, nearly 71% said they had ever Regulatory Obstacles tried to induce menstruation.9 Most had The Philippine government's reaction to used high doses of combined pills; others the widespread use of misoprostol to inhad tried prostaglandins such as miso- duce menstruation and abortion may ilprostol, an antiulcer drug that is used in lustrate how regulations could restrict some countries with mifepristone in med- emergency contraceptives. In June 1994, ical abortion, as well as analgesics and bit- newspapers reported that the Bureau of ter herbal concoctions. Food and Drugs had confirmed the drug's Our examination of the medical records abortion-inducing effect.10 The secretary of women attending a clinic in Metro of health then directed the bureau to con77.

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Temazepam and nitrazepam than the median. Regression analysis of the ADQ STAR-PU of the five hypnotics with the IMD 2000 health deprivation and disability index3 showed a weak linear relationship R2 0.47 ; . Discussion Lower prescribing of temazepam and nitrazepam is a major factor in the improvement in the benzodiazepine prescribing indicator. Increased prescribing of newer hypnotics has, however, replaced some of the use of these drugs in all HAs except one. Total hypnotic prescribing has increased in 10 HAs, indicating inappropriate prescribing is occurring. To determine whether an HA has achieved a true improvement in hypnotic usage, prescribing of both benzodiazepines and newer drugs should be reviewed. Prescribers may feel some patients expect drug treatment for insomnia and therefore find it difficult to refuse to prescribe. A high score on the health deprivation and disability index is associated with a higher prescribing rate for hypnotics. The NHS plan aims to tackle factors leading to health inequalities, which in the long term may reduce the need for hypnotics. Details femhrt norethindrone acetate-ethinyl estradiol femhrt - femhrt side effects - femhrt information pharmacology: femhrt is a continuous dosage regimen of an estrogen-progestin combination for oral administration as hormone replacement therapy hrt. No reason; desire to be alone; suspicious; mistrusting; feeling of detachment; suicidal; indecisiveness; anxious about the future; fearful in public places; fearful in a crowd; dizziness; headaches before periods; swelling of upper eyelids; bloated abdomen; dull aching pain and bearing down pains in lower abdomen; cramping pains - better for heat; irritable bowel syndrome; urgent need to pass water; burning pain; burning pains in vagina; burning yellow vaginal discharge, with tendency to thrush; pms worse since pregnancy; prolapse of the womb; pain in womb during periods; periods irregular and may be scanty; symptoms worse at menopause; tender breasts; backache; hot feet; swollen fingers, ankles and feet. CTnI rose above 0.2 ng ml1 defining myocardial necrosis ; in 8 of 110 patients 7% ; who had a negative DSE. The negative predictive value of DSE for myocardial necrosis was 92.7% 95% CI 86.296.8% ; , which is significantly less than the lowest value reported previously P 0.001 ; .11 Subjects 1, 2 and 4 in Table 2 displayed ST-segment elevation whereas Subjects 6 and 8 displayed down-sloping ST-segment depression. One patient required re-operation. References 1. Segal SJ. The development of NORPLANT implants. Stud Fam Plann 1983; 14: 159-163. Population Council. Summary of Clinical Findings on NORPLANT Subdermal Contraceptive Implants. New York: Population Council; 1989. 3. Sivin I. International experience with NORPLANT and NORPLANT-2 contraceptives. Stud Fam Plann 1988; 19: 81-94. Frank ML, Poindexter AN, Cornin LM, et al. One-year experience with subdermal contraceptive implants in the United States. Contraception 1993; 48: 229-243. Dunson TR, Amatya RN, Krueger SL. Complications and risk factors associated with the removal of NORPLANT implants. Obstet Gynecol 1995; 85: 543-548. Frank ML, DiMaria C. Levonorgestrel subdermal implants: contraception on trial. Drug Safety 1997; 17: 360-368. Connell EB. The exploitation of autoimmune disease: breast implant litigation and its dire implications for women's health. J Women's Health 1998; 7: 329-338. Food and Drug Administration. Norplant update. Talk paper T95-42. ; August 17, 1995. 9. American Home Products. American Home Products Press Statement on Settlement of Norplant System Lawsuits press release ; . August 25, 1999. 10. Sivin I, Alvarez F, Mishell DR, et al. Contraception with two levonorgestrel rod implants: a 5-year study in the United States and Dominican Republic. Contraception 1998; 58: 275-282. Sujuan G, Mingkun D, Linde Z, et al. A fiveyear evaluation of NORPLANT II implants in China. Contraception 1994; 50: 27-34. Newton JR. New hormonal methods of contraception. Baillieres Clin Obstet Gynaecol 1996; 10: 87-101. Reifsnider E. On the horizon: new options for contraception. J Obstet Gynecol Neonatal Nurs 1997; 26: 91-100. Darney PD. Hormonal implants: contraception for a new century. J Obstet Gynecol 1994; 170: 1536-1543. Singh M, Saxena BB, Landesman R, et al. Contraceptive efficacy of bioabsorbable pellets of norethindrone NET ; as subcutaneous implants: Phase II clinical study. Adv Contracept 1985; 1: 131-149. WHO Collaborative Study of Neoplasia and Steroid Contraceptives. Breast cancer and depot-medroxyprogesterone acetate: a multinational study. Lancet 1991; 338: 833838. Kaunitz AM. Injectable contraception. Clin Obstet Gyneol 1989; 32: 356-367. Upjohn's Depo-Provera C-150 long-acting injectable contraceptive recommended for approval by advisory committee after almost 20 years of FDA consideration. The Pink Sheet 1992; 54 25 ; : 3-4 and norpramin.

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Table 3. Incidence of adverse events in treated patients Arm A TEC ; , n 35 All Grade 34 Alopecia Nausea Vomiting Skin and nail disorders Handfoot syndrome Peripheral neuropathy Mucositis Infection Fluid retention Cardiac toxicity Anemia Neutropenia Febrile neutropenia Thrombocytopenia Events leading to treatment discontinuation Any grade 34 event Any grade 4 event 95% confidence interval 35 29 21 ; 83% ; 2 6% ; 60% ; 3 9% ; 26% ; 0 9% ; 0 17% ; 0 23% ; 0 34% ; 1 3% ; 17% ; 0 9% ; 0 86% ; 0 34% ; 10 29% ; 11% ; 4 11% ; 31% ; 1 3% ; 3% ; 46% ; 9 26% ; 12%43% Arm B EC T ; , All Grade 34 28 26 ; 87% ; 5 17% ; 63% ; 3 10% ; 77% ; 5 17% ; a 57% ; 6 20% ; c 53% ; 3 10% ; e 50% ; 0 27% ; 1 3% ; 30% ; 1 3% ; 13% ; 1 3% ; 90% ; 1 3% ; 63% ; 14 47% ; 10% ; 3 10% ; 30% ; 0 10% ; 73% ; g 12 40% ; i 23%59% Arm C T EC ; , All Grade 34 33 24 ; 71% ; 1 3% ; 41% ; 2 6% ; 76% ; 7 21% ; b 59% ; 6 18% ; d 47% ; 3 9% ; f 24% ; 0 35% ; 2 6% ; 41% ; 0 6% ; 0 94% ; 1 3% ; 53% ; 10 29% ; 3% ; 1 3% ; 26% ; 1 3% ; 3% ; 68% ; h 6 18% ; j 7%35.
Table 2. National Visit Estimates With COX-2 Inhibitor or NSAID Use 1999-2002 and norvir!

Stanhope Green Stanhope Street Dublin 7 Target group Homeless families with varying support needs who are motivated to move to independent living. Will not accept People who are actively using drugs and not addressing their addiction. Age Min 18 Max None Ave 20-30 Referral procedure Agency referrals only. Phone Mon-Fri 9am5pm ; or write. Placed on waiting list. When vacancy arises application form completed and interview held. Relevant local authority must agree to house family on completion of programme. Referral agencies Accept referrals from any agency. Policies Written harassment policy, complaints procedure and confidentiality policy. Tenure and house rules Licence agreement. Must participate in programme of support with compulsory individual and group work. Resident access Must be in by midnight. Visitors Yes, up to 11pm. Overnight visitors permitted after 3 months and at the discretion of management. Tel 01 - 671 1219 671 Web focusireland.ie Fax 01 - 677 8563. Complete blood count including differential, platelets and hemoglobin CBC ; before each cycle of treatment Baseline & periodic liver function tests [serum alkaline phosphatase, GGT, ALT, AST & Bilirubin levels- serum proteins may be added if indicated], serum glucose levels & serum cortisol levels Clinical exam for symptoms of Congestive Heart Failure Baseline and periodic cardiac tests for all patients with cardiac risk factors or patients at or above the threshold dose levels [Echocardiograms, WMS studies, and or all angiography scans] Baseline liver function tests [serum alkaline phosphatase, GGT, ALT, AST & Bilirubin levels] Periodic neurological assessments after 2 years treatment ; Local Site Toxicity ratings, if incident of phlebitis LOCAL SITE TOXICITY 0. None 1. Pain 2. Pain & inflammation; phlebitis 3. Ulceration 4. Plastic surgery Upon Patient Complaint Or Clinical Event CARDIAC 0. None 1. 2. Asymptomatic, resting ejection fraction decline by 10% baseline; or abnormal cardiac function tests LVEF 50 ; with no baseline for comparison 3. Mild Congestive Heart Failure, responds to therapy 4. Severe refractory Congestive Heart Failure At cumulative dose threshold and subsequent intervals For Cardiac Toxicity Ratings: First rating at the cumulative dose threshold of 300mg m, & repeat ratings at each cumulative dose increment of 100mg m2above threshold Cumulative dose sooner for high risk patients, eg. pre-existing cardiac disease, prior chest irradiation and novantrone.

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Drinks in a 24-hour period Figure 1 ; than individuals with the ADH2 * 1 * 1 genotype, the differences were not statistically significant. This null finding may be related to the low prevalence of the ADH2 * 2 allele in this population, although a similar ADH2 * 2 prevalence is found in non-Jewish Caucasians, for whom a protective association with alcohol dependence has been observed 28, 29 ; . Studies of children with fetal alcohol syndrome have found protective associations of ADH2 * 2 in South Africans of mixed ancestry 35 ; and of ADH2 * 3 in African Americans 34, 43, 57 ; . It has been hypothesized that faster alcohol metabolism leading to a more rapid production of acetaldehyde, increased sensitivity to alcohol, and lower levels of alcohol consumption is the mechanism by which these alleles protect against both fetal alcohol syndrome and alcohol dependence. ADH2 * 3 has been associated with faster alcohol metabolism in African Americans 33 ; and a nonsignificant trend was observed in a small group of Mission Indian men 42 ; , but other studies have not found significant associations between ADH2 * 2 and alcohol metabolism 19, 58 ; or alcohol sensitivity 59 ; . In addition, there is no direct evidence that faster alcohol metabolism leads to greater production of acetaldehyde. Results from this study support the hypothesis that the protective association between ADH2 * 3 and alcohol dependence is mediated, in part, by lower levels of alcohol consumption. Additional research is needed to determine if ADH2 * 3 is also associated with elevated levels of acetaldehyde or greater sensitivity to alcohol. It is also possible that the association of ADH2 * 3 with alcohol-related behavior in this group of subjects may not be a genuine causal effect, but may be related to either linkage disequilibrium with a nearby locus or population stratification because of racial admixture. Although an attempt was made to address concerns about heterogeneity, complete data on all participants' Native American heritage were not available. Therefore, it will be important to determine the generalizability of the present findings for other Native American and nonNative American populations, particularly for African Americans, among whom ADH2 * 3 is prevalent. In conclusion, this study provides evidence that the ADH2 * 3 allele is associated with lower rates of alcohol dependence and lower rates of heavy drinking. These findings also highlight the utility of evaluating protective factors in populations with high rates of alcohol dependence. Although the prevalence of ADH2 * 3 was low in this group of Mission Indians, the high prevalence of alcohol dependence and large variability in drinking behavior in this Native American tribe made it possible to detect significant associations between this genetic polymorphism and alcohol-related behavior.

5: 28PM EP.00007 Aging rates of glassy suspensions of thermosensitive microgel particles , FRIEDER MUGELE, DIRK VAN DEN ENDE, EKO PURNOMO, University of Twente, PHYSICS OF COMPLEX FLUIDS TEAM -- We performed rheological measurements of the aging behaviour of soft microgel particle suspensions with a thermally controllable degree of glassiness. Linear measurements display aging at a rate that decreases upon approaching the glass transition. Applying the recently proposed non-linear strain rate frequency superposition SRFS ; principle, we identify the corresponding structural relaxation time at a frequency well below the range accessible in the linear measurements. Consistent with the linear measurements, we find that both the relaxation time increases with the sample life time and the corresponding aging rate vanishes at the glass transition. Except for the vicinity of the glass transition, the aging rate of the structural relaxation time agrees quantitatively with the predictions derived from the linear measurements using the soft glassy rheology model SGR ; , thereby corroborating the validity and usefulness of both the SRFS principle and the SGR model. 5: 41PM EP.00008 Particle capture by a freezing front in a binary alloy , JUSTIN KAO, ALEXANDER GOLOVIN, STEPHEN DAVIS, Northwestern University -- We examine the interaction between a particle and a nearby solidification front in a binary alloy, subject to constitutional undercooling, Gibbs-Thomson effect, hydrodynamic lubrication, and van der Waals disjoining pressure. We solve for the shape of the front and obtain the particle velocity as a function of distance from the front, and quasi-steady traveling solutions as a function of velocity. We find scaling relations for the critical speed of solidification, which separates particle rejection and particle capture. It is shown that the presence of solute e.g. impurities ; in the system can lower the critical speed for capture by an order of magnitude, with the particle-front gap becoming dominated by constitutional undercooling rather than van der Waals premelting. 5: 54PM EP.00009 Particle size concentration and meteorological parameter dynamics , ANDREW DUGGLEBY, Virginia Tech, JAMES REGENS, University of Oklahoma Health Sciences Center, KENNETH BALL, Virginia Tech -- A proper orthogonal decomposition of particle size concentration and meteorological parameter dynamics is performed on data collected from 12: 45 CDT on 18 July 2004 until 1: 00 CDT on 22 July 2004 using an Aerodynamic Particle Sizer spectrometer and a modular weather station. The sampling station was located at 60 feet above ground level on the roof of the College of Health Building on the University of Oklahoma Health Sciences Center campus in Oklahoma City, and it sampled data every 15 minutes. The effect of the meteorological conditions of temperature, humidity, pressure, wind speed, and wind direction on particle concentration dynamics is examined. Most of the dynamical fluctuations occur at particle sizes below 1 micron, temperature and humidity have the most effect on the dynamics, and the wind speed and direction have a smaller effect. Discussions will include the potential effects of rush-hour traffic and diurnal meteorological patterns on the particle size distributions and novolog.

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7.8 Pump Warranty. The pump manufacturer shall warrant the units being supplied to OWNER against defects in workmanship and materials for a period of 5 years or 10, 000 hours under normal use, operation and service. The warranty shall be in printed form and apply to all similar units. 7.9 Pump Hoist. Provide up to one portable pump hoist for pump removal. Pump hoist shall be Thern, Inc. Series 5110, portable davit crane, or equal. Hoist shall have minimum capacity of 125% of weight of pump. Provide stainless steel crane. Provide stainless steel spur gear hand winch. Base for hoist shall be stainless steel socket base flush mount. NEA Norethindrone acetate; EE ethinyl estradiol. change, relative to placebo, at the end of the study period and nutropin. Estradiol and norethindrone is also used to prevent.
The active components of the system are estradiol USP and norethindrone acetate USP. The remaining components of the system are pharmacologically inactive. CLINICAL PHARMACOLOGY Endogenous estrogens are largely responsible for the development and maintenance of the female reproductive system and secondary sexual characteristics. Although circulating estrogens exist in a dynamic equilibrium of metabolic interconversions, estradiol is the principal intracellular human estrogen and is substantially more potent than its metabolites, estrone and estriol at the receptor level. The primary source of estrogen in normally cycling adult women is the ovarian follicle, which secretes 70 to 500 mcg of estradiol daily, depending on the phase of the menstrual cycle. After menopause, most endogenous estrogen is produced by conversion of androstenedione, secreted by the adrenal cortex, to estrone by peripheral tissues. Thus, estrone and the sulfate conjugated form, estrone sulfate, are the most abundant circulating estrogens in postmenopausal women. Estrogens act through binding to nuclear receptors in estrogen-responsive tissues. To date, two estrogen receptors have been identified. These vary in proportion from tissue to tissue. Circulating estrogens modulate the pituitary secretion of the gonadotropins, luteinizing hormone LH ; , and follicle stimulating hormone FSH ; through a negative feedback mechanism. Estrogens act to reduce the elevated levels of these hormones seen in postmenopausal women. Pharmacokinetics Absorption Estradiol: Estrogens used in hormone therapy are well absorbed through the skin, mucous membranes, and gastrointestinal tract. Administration of CombiPatch every three to four days in postmenopausal women produces average steady-state estradiol serum concentrations of 45 to mL, which are equivalent to the normal ranges observed at the early follicular phase in premenopausal women. These concentrations are achieved within 12 to 24 hours following CombiPatch application. Minimal fluctuations in serum estradiol concentrations are observed following CombiPatch application, indicating consistent hormone delivery over the application interval. In one study, serum concentrations of estradiol were measured in 40 healthy, postmenopausal women throughout three consecutive CombiPatch applications to the abdomen each dose was applied for three 3.5-day periods ; . The corresponding pharmacokinetic parameters are summarized in Table I below. Table I. Mean SD ; Serum Estradiol and Estrone Concentrations pg mL ; at Steady-State Uncorrected for Baseline Levels ; Estradiol System Size 9 sq cm Dose Estradiol NETA mg per day ; 0.05 0.14 0.05 Cmax 71 32 ; 71 Estrone 72 23 ; 78 Cmin 27 17 ; 37 Cavg 45 21 ; 50 and nuvaring.

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Synopsis According to the results of a Pfizer sponsored trial involving 357 postmenopausal women taking continuous combined HRT, there is significantly less vaginal bleeding with 1 mg norethindrone acetate and 5 g ethinyl oestradiol NA EE ; than 0.625 mg conjugated equine oestrogens and 2.5 mg medroxyprogesterone acetate CEE MPA ; . At 3 months, NA EE reduced the incidence of bleeding and or spotting to a greater extent than CEE MPA 22% vs. 44% ; . NA EE also reduced the mean duration of bleeding and or spotting to a greater degree than CEE MPA p 0.001 ; . By one year, the researchers noted that NA EE showed no more bleeding than placebo. The incidence of side effects, mainly headache and breast pain, were similar in the two study arms J Obstet Gynecol 2003; 188: 92-99 and norethindrone. Tein-tyrosine kinase through its N-terminal unique domain. Oncogene. 1994; 9: 3205-3211. Morgenstern JP, Land H. Advanced mammalian gene transfer: high titre retroviral vectors with multiple drug selection markers and a complementary helper-free packaging cell line. Nucleic Acids Res. 1990; 18: 3587-3596. Mao J, Xie W, Yuan H, Simon MI, Mano H, Wu D. Tec Bmx non-receptor tyrosine kinases are involved in regulation of Rho and serum response factor by Galpha12 13. EMBO J. 1998; 17: 56385646. Hara K, Yonezawa K, Sakaue H, et al. 1-Phosphatidylinositol 3-kinase activity is required for insulin-stimulated glucose transport but not for RAS activation in CHO cells. Proc Natl Acad Sci U S A. 1994; 91: 7415-7419. Caldenhoven E, van Dijk T, Raaijmakers JA, Lammers JW, Koenderman L, De Groot RP. Activation of the STAT3 acute phase response factor transcription factor by interleukin-5. J Biol Chem. 1995; 270: 25778-25784. Yamanashi Y, Baltimore D. Identification of the Abl- and rasGAP-associated 62 kDa protein as a docking protein, Dok. Cell. 1997; 88: 205-211. Lock P, Casagranda F, Dunn AR. Independent SH2-binding sites mediate interaction of Dokrelated protein with RasGTPase-activating protein and Nck. J Biol Chem. 1999; 274: 2277522784. Ellis C, Moran M, McCormick F, Pawson T. Phos47 and olmesartan. Table 1 Growth of the thraustochytrid #3-3B a t 10 MPa pressure in 5 d. MV: Modified Vishniac's broth; 10 MPa 100 bar hydrostatic pressure Growth substrate Artemia larvae % larvae colonized ; No. of sporangia larva-'.

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