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EBITA margins declined to 1.84% in 1H04 due to the impact of: An intensely competitive pricing environment; A deterioration in mix towards lower margin ethical products; and Temporary labour overruns in NSW early in the fiscal year due to the use of a higher number of non-permanent staff. Overall, costs have been well controlled. Management will be implementing a number of strategies in 2H04 designed to improve revenue outcomes and improve customer service, whilst maintaining a strong focus on costs and productivity. In addition, management will implement a range of initiatives to improve trading gross profit. These initiatives include the promotion of higher margin OTC products, improved private label sales in our branded pharmacies and targeted pricing strategies on a selected product and market basis.
1. Chiu D, Shedden P, Bratina P, et al. Clinical features of moyamoya disease in the United States. Stroke 1998; 29: 1347-51. Kameyama M, Shirane R, Tsurumi Y, et al. Evaluation of cerebral blood flow and metabolism in childhood moyamoya disease: an investigation into "re-build-up" on EEG by positron CT. Childs Nerv Syst 1986; 2: 130-3. Kazumata K, Kuroda S, Houkin K, et al. Regional cerebral hemodynamics during re-build-up phenomenon in childhood moyamoya disease. Child's Nerv Syst 1996; 12: 161-5. Kurlemann G, Fahrendorf G, Wrings W, et al. Characteristic EEG findings in childhood moyamoya syndrome. Neurosurg Rev 1992; 15: 57-60. Kuroda S, Houkin K, Hoshi Y, et al. Cerebral hypoxia after hyperventilation causes "rebuild-up" phenomenon and TIA in childhood moyamoya disease. Child's Nerv Syst 1996; 12: 448-53. Matheja P, Kuwert T, Stodieck SR, et al. PET and SPECT in medically non-refractory complex partial seizures. Temporal asymmetries of glucose consumption, benzodiazepine receptor density, and blood flow. Nuklearmedizin 1998; 37: 221-6. Nariai T, Senda M, Ishii K, et al. Posthyperventilatory steal response in chronic cerebral hemodynamic stress: a positron emission tomography study. Stroke 1998; 29: 1281-92. Pietrzyk U, Herholz K, Fink G, et al. An interactive technique for three-dimensional image registration: validation for PET, SPECT, MRI and CT brain studies. J Nucl Med 1994; 35: 2011-8. Suzuki J, Kodama N. Moyamoya disease a review. Stroke 1983; 14: 104-9. Tagawa T, Naritomi H, Mimaki T, et al. Regional cerebral blood flow, clinical manifestations, and age in children with moyamoya disease. Stroke 1987; 18: 906-10. Taki W, Yonekawa Y, Kobayashi A, et al. Cerebral circulation and oxygen metabolism in moyamoya disease of ischemic type in children. Child's Nerv Syst 1988; 4: 259-62.
Morbidity in Western and South Australia for many years. Corynetoxins belong to the tunicaminyluracil group of antibiotics, which also includes the tunicamycins, and both groups of toxins are structurally very similar.7, 8 Tunicamycin has been shown experimentally to produce clinical signs in sheep identical to those seen with ARGT, 9 and inhibits the same N-acetylglucosamine-1-P transferase enzyme in rats at the same doses as corynetoxin.10 The commercial availability of tunicamycin in a pure form facilitates work on ARGT, and hence its use in this study. ARGT is characterised in sheep by the onset of nervous signs, including a staggering, stiff-legged gait, trembling and episodes of convulsion, which are separated by a short period of apparently normal physical appearance. Death can follow periods of lateral recumbency and typical `paddling' convulsions. In the field, clinical signs of ARGT may only be seen in a small proportion of an affected flock of sheep. Clinical signs of intoxication usually occur 3 to 4 days after a toxic dose has been consumed. Therefore, apparently normal sheep in a flock that has been moved to a safe paddock, from a paddock in which some sheep had shown clinical signs, may still develop clinical signs of poisoning and die if the dose is large enough. Mortality averages between 5 to 10%, but can be far larger in individual cases.11 The normal course of ARGT provides an opportunity for a treatment antidote ; to be administered during the movement of animals from toxic to non-toxic areas. Several experimental treatments have been tested previously in both pen and field trials, but none has proved sufficiently successful to warrant continued use.12-15 As a part of our work studying materials capable of binding to toxicants of small molecular weight, we have evaluated cyclodextrins for their ability to ameliorate the overt clinical condition and death associated with tunicaminyluracil poisoning. The cyclodextrins are homogeneous cyclic poly-1, 4linked glucose molecules, comprising six -CD ; , seven -CD ; and eight glucose units -CD ; .16 They are water-soluble molecules with a central cavity, the internal environment of which is hydrophobic. Molecules that are either relatively hydrophobic or have a hydrophobic structural feature, such as a fatty acid side chain, will partition into the cavity of the cyclodextrins, forming a molecular complex. This phenomenon.
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We do not have the financial support many of our competitors enjoy, who are predominantly tourist orientated and it is important to their economy that they put on a good show. Nevertheless we have had very good support from the community, local shops and local businesses. The very ethos of the Britain in Bloom campaign is the contribution of the local community and Swanland is fortunate to have many volunteers who turn out almost every week of the year to garden, water the plants and litter pick, whatever the weather.
Optimization and Evaluation of Two Multiplex Platforms to Support Clinical Testing for Pneumococcal Vaccines J. A. Raab, D. Puchalski, M. Esser, D. Sikkema, R. D. Marchese; Vaccine and Biologics Research, Merck & Co., Inc, Wayne, PA.
8: 00 9: Pathophysiology and Treatment of COPD ACPE # 168-000-05-008-L01 0.1 CEUs ; Wayne Kradjan, PharmD, BCPS, Dean and Professor, Oregon State University, College of Pharmacy At the conclusion of the session the attendees should be able to: 1. Describe the clinical presentation and techniques for determining stages of severity for the two most common pulmonary conditions that contribute to COPD. 2. Apply the Global Initiative for Chronic Obstructive Lung Disease GOLD ; treatment algorithm to determine realistic goals and the correct choice of dug therapy in a patient with COPD. 3. Describe the relative effectiveness and safety of tiatropium Spiriva ; to albuterol, long acting beta agonists, and ipratropium Atrovent ; in treatment of COPD. 4. Compare the role and effectiveness of inhaled corticosteroids in asthma and COPD. 9: 00 9: Improving Pharmaceutical Care Outcomes Through Pharmacist Intervention: Development and Implementation of a Region-Specific Prescription Adherence Intervention Protocol Peinie P. Tsai, PharmD, Pharmacy Practice Resident, Kaiser Permanente 9: 30 10: Directions in Pain Management ACPE # 168-000-05-009-L01 0.1 CEUs ; Bruce Canaday, APhA President-Elect, University of North Carolina School of Pharmacy At the conclusion of the session the attendees should be able to: 1. List and explain the 5 roles for pain management 2. Select the appropriate phramacotherapy for patients in pain 3. Anticipate, identify and manage adverse effects 11: 00 12: 00 N Preceptorship - Giving Back to the Profession ACPE # 168-000-05-005-L04 0.1 CEUs ; Deanna Moretz, Director of Advanced Experiential Education, Oregon State University College of Pharmacy At the conclusion of the session the attendees should be able to: 1. Describe essential elements that enhance student learning at an experiential site. 2. Define the responsibilities of a preceptor as they mentor future practitioners. 3. Identify methods for evaluating students that provide constructive criticism and effective feedback. 4. Examine effective problem solving techniques for dealing with challenging student personalities. 5. Provide tips for a successful clerkship experience and ssd.
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Washington Legal Foundation Citizen Petition to Exempt Internet Information from FDA Labeling Requirements Docket No. 01P-0187 ; April 13, 2001 ; . FDA Letter on Labeling Food Products Presented or Available on the Internet to Daniel J. Popeo and Paul Kamenar, Washington Legal Foundation Nov. 1, 2001 ; , available at : cfsan.fda.gov ~dms lab htm. The website lycopene is run by Heinz. The affiliation with Heinz is not obvious unless the "Team Lycopene" screen is opened and a series of miniature Heinz ketchup bottles appear as background. FDA issued a second warning letter to a supplement company that sold products from its website charging that its website promoted the products Rx Macula and Rx Macula Plus as drugs and was false or misleading labeling. Warning Letter from John B. Foret, Dir., Division of Compliance and Enforcement to R. Scott Hunter, CEO, Science-Based Health ONPLDS-03-02 ; Nov. 9, 2001.
Angiotensin II and extracellular potassium stimulate aldosterone production in adrenal glomerulosa cells by mobilizing the calcium messenger system. This response requires calcium influx across the plasma membrane, followed by calcium uptake into the mitochondria. It has been proposed that calcium is transported to the mitochondria via the lumen of the endoplasmic reticulum, acting as a kind of intracellular calcium pipeline. This hypothesis has been tested in the present study by measuring intramitochondrial calcium variations in H295R cells with a new fluorescent calcium probe, ratiometric pericam. Calyculin A, a protein phosphatase inhibitor, induced the formation of a large cortical layer of actin filaments, removing the peripheral endoplasmic reticulum away from the plasma membrane and thereby physically uncoupling the calcium channels from the pipeline. The mitochondrial calcium response to potassium was markedly reduced after calyculin treatment, but that of AngII was unaffected. Under the same conditions, potassium-stimulated pregnenolone and aldosterone production was significantly reduced, whereas the steroidogenic response to AngII remained unchanged. The inhibitory action of calyculin A on the responses to potassium was not mediated by a modification of the calcium channel activity and was not accompanied by a reduction of the cytosolic calcium response. It therefore appears that, in H295R cells, the organization of the actin cytoskeleton at the cell periphery influences the steroidogenic action of potassium, but not the response to angiotensin II. The response to potassium is proposed to be dependent on the endoplasmic reticulum-mediated transfer of calcium entering through plasma membrane calcium channels to the mitochondria. Endocrinology 144: 4575 4585 and stadol.
That occurred with 1 and 3 mg doses Diedrich et al., 1994; Felberbaum et al., 1996 ; . In another study Albano et al., 1997 ; , it was shown that patients receiving cetrorelix starting doses of 0.5 or 0.25 mg day during the follicular phase did not show any premature LH surges, as evidenced by lower LH serum levels. However, one in seven patients receiving 0.1 mg day showed a premature LH rise with progesterone elevation, and hence the 0.1 mg dose was abandoned. Results were similar in patients receiving 0.25 or 0.5 mg day in terms of clinical pregnancy and implantation rates. These investigators concluded that the minimal effective cetrorelix dose to prevent premature LH surge was 0.25 mg day. The minimal safe effective dose of ganirelix required to achieve good IVF results was also investigated The Ganirelix dose-nding study group, 1998 ; . A multiple-dose protocol with ganirelix showed the minimal effective dose to be 0.25 mg day; this inhibited premature LH secretion without compromising IVF results in stimulated cycles with recombinant FSH. Patients receiving 0.25 mg day ganirelix had the highest vital pregnancy rate per transfer 40.3% ; compared with other phase II studies doses of 0.0625 to 2 mg ; see Table I ; . Based on an analysis of the database from the ganirelix dose-nding study which examined the effect of GnRH antagonist in freezethaw cycles, it was concluded that high doses 1.0 and 2.0 mg day ; of ganirelix did not affect the biological potential of embryos to develop clinical pregnancy Kol et al., 1999.
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Less Heart Is More Douglas P. Zipes Circulation 2003; 107; 2531-2532 DOI: 10.1161 01.CIR.0000068687.46373.04.
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The box shows the selection criteria used to define the shoulder disorders studied. In general, adhesive capsulitis was defined as the presence of pain with restriction of active and passive glenohumeral joint movements, and rotator cuff tendinitis was defined by the presence of painful arc and pain with resisted movements or a normal passive range of motion. However, no standard definitions were used, and conflicting criteria often defined the same condition in different trials. Exclusion criteria were specified in 28 studies, although these also varied widely between studies. Assessment of outcome Table 1 summarises the outcomes assessed. Pain and range of motion were recorded in most trials 29 and 27 respectively ; . Only four studies included an adequate description of how range of motion was assessed measurement tool and definition of end of range ; .16 21 22 Function was assessed in eight studies and was measured either by visual analogue scale1419 26 or return to work.20 No study included a disability index. Although two studies cited a reliability study for their method of range of motion assessment, 21 35 no other reference was made to the reliability, validity, or responsiveness of the outcome measures used. Timing of assessment for the primary efficacy analysis varied between 1 and 24 weeks. Validity of individual trials Table 2 shows the overall scores for the quality of methods and for each category for each trial. The mean quality score of all trials combined was 16.8 out of a possible 40 points 42% ; . No trial scored greater than 22 out of a possible score of 40 range 9.5-22.0.
The shipboard medical OPTAR may be used to purchase all of the following items EXCEPT 1. 2. 3. x-ray units and film processors medical books and publications gun bags litters and stretchers and suboxone.
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Duoneb albuterol ipratropium ; inh. solnProventil HFA albuterol sulfate ; Pulmicort Respules budesonide ; PA * Flovent fluticasone ; Flovent Rotadisk fluticasone ; Foradil formoterol ; Intal cromolyn ; Maxair Autohaler pirbuterol ; Pulmicort Turbuhaler budesonide ; Serevent salmeterol ; Serevent Diskus salmeterol ; * Albuterol nebulizer solutions containing benzalkonium chloride are not covered. Asthma COPD, Oral Agents albuterol sulfate metaproterenol Alupent ; theophylline ext-rel. cap. Slo-Bid ; theophylline ext-rel. tabs. theophylline liquid Tilade nedocromil ; Tornalate bitolterol ; Vanceril beclomethasone ; A1B, Z4B, J5D Accolate zafirlukast ; Singulair montelukast ; Theo-24 theophylline ext-rel. ; Uniphyl theophylline ext-rel. ; Brethine terbutaline ; Cafcit caffeine citrated ; Choledyl oxtriphylline ; Qvar beclomethasone ; Spiriva tiotropium bromide ; Ventolin HFA albuterol sulfate ; Xopenex levalbuterol ; inh. soln. PA and subutex.
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At baseline, the ITT population 79 patients ; had a mean IOP of 22.5 mmHg minimum 15 mmHg, maximum31mmHg ; . After 4weeks of combination travoprost and brinzolamidetreatment, the78analysedpatientshad a mean IOP of 18.5 mmHg minimum 12 mmHg, maximum24mmHg ; .After12weeks, themeanIOP minimum 10mmHg, maximum27mmHg ; .ThemeanIOPvalues baselinevalues Figure2; p 0.0001 ; .IOPwasdecreased after 4 n 78 ; and 12 n 71 ; weeks of combined 3.9mmHg 17.4% ; and4.2mmHg 18.4% ; , respectively compared to the baseline on travoprost ophthalmic n 78 ; , and 63%ofpatientsafter12weeks n 71 ; Figure3 and sudafed.
Tistically significant tumor volume reduction 48 ; . Expression of functionally active NIS has also been reported in human glioma cells in vitro and in vivo using adenovirusmediated NIS gene delivery. Glioma cells showed an up to 112-fold increase in radioiodide uptake activity after infection with an adenovirus carrying the human NIS gene linked to the cytomegalovirus promoter. In a human glioma xenograft mouse model, intratumoral injection of this adenovirus resulted in functional NIS protein expression in vivo with an up to 25-fold increase in radioiodide accumulation compared with that in spleen 49 ; . Furthermore, Mandell et al. demonstrated in vitro and in vivo iodide accumulation in several cancer cell lines, including melanoma, liver, colon, and ovarian carcinoma cells, after retrovirus-mediated transfection with the rat NIS gene. An in vitro clonogenic assay was used to demonstrate that rat NIS-transduced cancer cell lines can be selectively killed by the accumulated 131I. Rat NIS-transduced melanoma xenografts established in athymic nude mice accumulated significantly more 123I 6.9-fold increase ; than nontransduced tumors 50 ; . Similar results were obtained by Boland et al., who expressed the rat NIS gene in several tumor cell lines cervix, prostate, breast, lung, and colon carcinoma cells ; by adenovirus-mediated gene transfer in vitro and demonstrated radioiodide uptake 125- to 225fold increase ; as well as a selective cytotoxic effect of trapped radioiodide in vitro. In cervix and breast cancer xenografts, radioiodide uptake could also be demonstrated after in vivo NIS gene delivery. On the average, 11% of the total 125I dose could be recovered per g adenovirus-infected tumors. Intraperitoneal application of therapeutic doses of only up to 90 131I did not result in a therapeutic response 51 ; . In very recent study, Nakamato et al. stably transfected a human breast cancer cell line with the rat NIS gene using electroporation and demonstrated a 44-fold increase in radioiodide uptake in vitro. Xenografts in athymic nude mice accumulated 16.7% of the total 125I dose 52 ; . These data demonstrate the potential of NIS gene transfer to induce iodide accumulation activity in tumor cells, although the therapeutic efficacy of accumulated radioiodine remains to be confirmed in vivo. NIS gene transfer using tissue-specific promoters provides a way of selectively targeting the NIS gene to malignant cells, thereby maximizing tissue-specific cytotoxicity and minimizing toxic side-effects in nonmalignant cells 53 ; . Recently, prostate cancer LNCaP ; cells were shown to be selectively killed by accumulated 131I after induction of tissue-specific iodide uptake activity by prostate-specific antigen promoterdirected NIS expression in vitro. Iodide accumulation has been confirmed in vivo in LNCaP cell xenografts in athymic nude mice and has been high enough to allow a therapeutic effect of 131I in vivo. A single therapeutic 131I dose of 3 mCi was administered and was shown to elicit a dramatic therapeutic response in NIS-transfected LNCaP cell xenografts, with an average volume reduction of more than 90% and complete tumor regression in up to 60% of the tumors 54, 55 ; . These studies clearly show for the first time that NIS gene delivery into nonthyroidal tumors is capable of inducing the accumulation of therapeutically effective radioiodine doses and might therefore represent an effective and potentially curative therapy for extrathyroidal tumors, in particular.
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