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Freis, E. D., Rose, J. C., Partenope, E. A., Higgins, T. F., Kelley, R. T., Schnaper, H. W., and Johnson, R. L.: The Hemodynamic Effects of Hypotensive Drugs in Man. III. Hexamethonium.
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DISCLOSURE: Jay Heidecker, None. IS IT A TRANSUDATE OR AN EXUDATE? DYSYNCHRONY BETWEEN PLEURAL FLUID PROTEIN AND LDH IN 211 INITIAL THORACENTESES Jay T. Heidecker MD * John T. Huggins MD Peter Doelken MD Steven A. Sahn MD Medical University of South Carolina, Charleston, SC PURPOSE: Though traditional cutoffs for protein levels and LDH values were reported in the 1970s to reliably distinguish between exudates and transudates, more recent ROC analyses have questioned this assumption. The purpose of this study was to determine the incidence of pleural effusions that were exudative by either protein or LDH and transudative by traditional cutoff values. Further, we wanted to identify specific diagnoses which occurred within the dysynchronous groups. METHODS: A database has been collected of all pleural procedures performed at the Medical University of South Carolina for safety purposes. We retrospectively examined this data from July 2001 to October 2004. We included all initial thoracenteses provided that the pleural protein, LDH, and serum protein values were obtained. We defined an exudate by protein as a pleural fluid protein ratio of .51 and by LDH as an LDH value of 161 2 3 of our upper limits of normal ; . We classified effusions as synchronous exudates, synchronous transudates, dysynchronous effusions with elevated protein ratios only, and dysynchronous effusions with elevated LDH levels only. We then reviewed all available clinical data and assigned diagnoses to the effusions. RESULTS: Table 1 shows the characteristics of these 211 effusions that met criteria for study. CONCLUSION: Pleural fluid dysynchrony was found in 39% of effusions. The most common causes were parapneumonic, paramalignant, and malignant, effusions. Trapped lung, entrapped lung, chylothorax and post-liver transplant effusions were dysynchronous effusions with high protein ratios and low LDH levels; these processes are characterized by minimal inflammation with abnormal pleural lymphatics. The high incidence of dysynchronous pleural effusions confirms that isolated values in the pleural fluid analysis are not consistently reliable diagnostically. CLINICAL IMPLICATIONS: Pleural fluid analysis must be used in conjunction with the clinical presentation in determining the cause of a pleural effusion. Pleural fluid dysynchrony can indicate whether an exudative effusion is primarily due to a lymphatic abnormality with elevated protein or to inflammation increased LDH ; . Traditional transudates, like CHF, rarely cause pleural fluid dysynchrony except following intense diuresis.
Oral ingestion of androgel will not result in clinically significant serum testosterone concentrations due to extensive first-pass metabolism.
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Androgel posted sales of approximately 0 million in 200 given our belief that the size of the topical testosterone market is roughly 0 million, testim will have to continue to take market share from androgel in the coming quarters to continue its impressive growth and antabuse.
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Figure 5. Progression-free survival of bcl-2negative diffuse large B-cell lymphomas in 16 HIV-positive AIDS-related lymphoma ; and in 17 HIV-negative historical group ; patients who were similarly treated with DA-EPOCH. Progression-free survival probabilities are 94% in the HIV-positive patients and 82% in the HIV-negative patients, at their respective median potential follow-up times of 53 months and 69 months and antara.
In October 2004, certain holders of warrants issued in conjunction with sale of Series I Convertible Preferred Stock of the Company exercised their warrants to purchase common stock. Certain of such warrants were due to expire at the end of September 2004, but the Company extended the exercise period of such warrants until the end of October 2004. The exercise prices of such warrants were between ##TEXT##.58 and .73 per share. As an incentive to exercise the warrants early, the Company reduced the exercise price to ##TEXT##.50 per share for all of such warrants to the extent such warrants were exercised on or before October 29, 2004. As a result, the Company raised 5, 156. In connection with the repricing of warrants to the investors, the Company recorded an imputed dividend in the amount of 3, 212 to reflect the additional benefit created for these investors. In March 2004, certain holders of warrants exercised their warrants to purchase common stock. These warrants were due to expire at the end of March 2004. The exercise prices of such warrants were ##TEXT##.40 and ##TEXT##.55 per share. As an incentive to exercise the warrants early the Company offered to reduce the exercise price of the warrants to ##TEXT##.25 per share and offered each holder the issuance of a new warrant, for a similar number of shares, at an exercise price of ##TEXT##.55 per share. As a result, the Company raised 6, 250. The newly issued warrants will expire on the last day of January 2005. In connection with the repricing of warrants and the issuance of new warrants to the investors, the Company recorded an imputed dividend in the amount of 3, 867 to reflect the additional benefit created for these investors. In June 2003, certain holders of warrants exercised their warrants to purchase common stock, these warrants were due to expire in August 2003. The exercise prices of such warrants were ##TEXT##.40 and ##TEXT##.10 per share. As an incentive to exercise the warrant early the Company offered each holder the issuance of a new warrant, for a similar number of shares, at an exercise price of ##TEXT##.55 per share. As a result, the Company raised 3, 500, through the exercise of 2, 590, 000 previously outstanding warrants, and issued 2, 590, 000 new warrants that expired on March 26, 2004, to the extent they were not exercised. In connection with the issuance of new warrants to the investors, the Company recorded an imputed dividend in the amount of 6, 342 to reflect the additional benefit created for these investors. F-19.
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In Table 3, the susceptibility data are presented for the 416 H. influenzae isolates isolated in 2002 2003. Compared with the results for isolates from 1997 1998, the percentage of isolates that were non-susceptible to amoxicillin, cefaclor, cefuroxime and clarithromycin increased slightly from 19.8% to 23.3%, from 11.6% to 15.1%, from 2.6% to 5.0%, and from 24.4% to 28.8%, respectively. Also, the proportion of b-lactamase-producing isolates increased 11.0% versus 13.7% ; . Of the 416 isolates, 40 9.6% ; were categorized as BLNAR comprising 13 3.1% ; high-BLNAR resistant to amoxicillin ; and 27 6.3% ; low-BLNAR intermediate resistant to amoxicillin ; . The high activity of cefixime against H. influenzae including b-lactamase-positive and BLNAR isolates was again confirmed: all isolates were inhibited at 0.5 mg L.
Johnsrude, Larry. "Latest Tory makeover: back to austerity, The Edmonton Journal. August 26, 2001. Klein, Ralph. Correspondence with AAMIMH. March 2000. Lucki, George. Edmonton, AB. Interview with author, July, 2001. Mar, Gary. Edmonton, AB. Interview with author, July, 2001. Mar, Gary. Written response to selected questions. August, 2001. Michelin, Lana. "CMHA lays off staff." Red Deer Advocate. April 4, 2000. Read, Sharon. Edmonton, AB. Conversation with author. December 12, 2000. Sheehan, Ken. Edmonton, AB. Conversation with author. February 29, 2000. Shurman, Donald. Edmonton, AB. Conversation with author. March 9, 2001. The Alberta Alliance on Mental Illness and Mental Health. Good People . Good Practices . System--A Discussion Paper. AAMIMH: Alberta Alliance on Mental Illness and Mental Health, February 2000. Working Together. Brochure of the Alberta Alliance on Mental Illness and Mental Health. Undated. Wowk, Roger J. "Mentally Ill Poorly Served by Board-- Little Funding Flows to Local Services." Edmonton Journal. June , 2001 and anzemet.
With good end organ function received 600 mg m2 intravenous i.v. ; cyclophosphamide, day 1, 20 mg m2 i.v. fludarabine, days 1-5, and 5 ng kg subcutaneous filgrastim, from day 8. The regimen was repeated every 28 days until maximum response or a maximum of six cycles. Overall complete response CR ; rate was 51%, and partial response rate PR ; was 41%. Of the 17 patients with CLL, 47% achieved CR, with the remaining 53% achieving PR. Of the 43 patients with NHL, 60% achieved CR, with 32% achieving PR. Significant haematologic and non-haematologic toxicities were observed, but the regimen did not prevent those patients who sought it 24 ; undergoing autologous or allogeneic stem-cell transplantation  children treated for cancer and their parents are no more likely to experience psychological problems in the long-term than children and parents in the general community. These are the conclusions of a four-year prospective study assessing the psychological adjustment of 39 children aged 2-12 years ; treated for cancer and their families. The children and their families were assessed immediately after diagnosis and then annually for the following four years, with assessments being compared with those of a cohort n 49 ; of children and families in the general community. Only at time of diagnosis was there any significant increase in the number of psychological problems experienced above that observed in the general community . References.
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This study explored the effect of testim 5 g therapy in 48 hypogonadal, hiv positive men who reported that they did not have adequate symptom relief with androgel 5 compared to androgel treated men, at the 4-week follow-up, men treated with testim reported a statistically and clinically significant improvement in their sex drive, erectile function, and satisfaction with sex life as well as being more satisfied with androgen therapy.
Dawes M, Green J, Ashuret H. 1992. Routine weighing in pregnancy. British Medical Journal 304: 487-9. Dimperio D, Frentzen B, Cruz A. 1992. Routine weighing during antenatal care: still justified? British Medical Journal 304: 460. Durnin J, Grant S, McKillop F, Fitzgerald G. 1985. Nutritional status endangered by virtually no extra intake during pregnancy. The Lancet Oct: 823-5. Enkin M, Chalmers I eds ; . 1982. Effectiveness and Satisfaction in Antenatal Care. London: Spastics International Medical Publications. Enkin M, Keirse M, Chalmers I. 1989. A Guide to Effective Care in Pregnancy and Childbirth. Oxford: Oxford University Press. Enkin M. 1992. Randomized controlled trials in the evaluation of antenatal care. International Journal of Technology Assessment and Health Care 8 suppl 1: 40-5. Essex B, Everett V. 1977. Use of an action-orientated record card for antenatal screening. Tropical Doctor July: 134-8. Faundes A, Rosenfield A, Pinotti J. 1988. Maternity care in developing countries: relevance of new technological advances. International Journal of Gynecologists and Obstetricians 26: 349-54. Fauveau V, Stewart K, Khan S, Chakraborty J. 1991. Effect on mortality of community based maternity care programme in rural Bangladesh. The Lancet November; 338: 1183-6. Field P. 1990. Effectiveness and efficacy of antenatal care. Midwifery 6: 215-23. Fortney J, Whitehorne E. 1982. Index of high-risk pregnancy. American Journal of Obstetrics and Gynecology 143 5 ; : 501-7. Garner P, Kramer M, Chalmers I. 1992. Might efforts to increase birth weight in undernourished women do more harm than good. The Lancet October; 339: 1021-2. Gehlbach S. 1988. Interpreting the Medical Literature. New York: Macmillan. Gerien N, Ross D. 1991. Is growth monitoring worthwhile? An evaluation of its use in three child health programmes in Zaire. Social Science and Medicine 32 6 ; : 667-75. Gertler P, Rahman O, Feifer C, Ashley D. 1993. Determinants of pregnancy outcomes and targeting of maternal health services in Jamaica. Social Science and Medicine 27 2 ; : 199-211. Godfrey K. 1981. Fetal monitoring in pregnancy and labour. The Practitioner 225: 1253-5; Graham W. 1991. Maternal mortality: an avoidable tragedy. THS July August pp 2. Graham W. 1992. Maternal health and the measurement trap. Social Science and Medicine 35 8 ; : 961-11. Graham W, Airey P. 1987. Measuring maternal mortality; sense and sensitivity. Health Policy and Planning 2 4 ; : 323-33. Grant A, Mohide P. 1982. Screening and diagnostic tests in antenatal care. In: Enkin M, Chalmers I eds ; . Effectiveness and Satisfaction in Antenatal Care. London: Spastics International Medical Publications. Green A. 1992. An Introduction to Health Planning in Developing Countries. Oxford: Oxford University Press. Greenwood A, Greenwood B, Bradley A et al. 1987. A prospective survey of the outcome of pregnancy in a rural area of Gambia. Bulletin of the World Health Organization 65 5 ; : 635-43. Greenwood A, Bradley A, Byass P et al. 1990. Evaluation of a primary health care programme in the Gambia. I: The impact of trained traditional birth attendants on the outcome of pregnancy. Journal of Tropical Medicine and Hygiene 93: 58-66. Greenwood A, Armstrong J, Byass P, Snow R, Greenwood B. 1992. Malaria chemoprophylaxis, birth weight and child sur and apomorphine.
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13 Bird DR, Vowles KD. Liver damage from long-term methyltestosterone. Lancet 1977; 2: 4001. Westaby D, Ogle SJ, Paradinas FJ, Randell JB, Murray-Lyon IM. Liver damage from long-term methyltestosterone. Lancet 1977; 2: 2623. Lowdell CP, Murray-Lyon IM. Reversal of liver damage due to long term methyltestosterone and safety of non-17 alpha-alkylated androgens. BMJ 1985; 291: 637. Behre HM, von Eckardstein S, Kliesch S, Nieschlag E. Long-term substitution therapy of hypogonadal men with transscrotal testosterone over 710 years. Clin Endocrinol Oxf ; 1999; 50: 62935. Unimed Pharmaceutical Products. Androgel Summary of Product Characteristics. : drugs PDR AndroGel , 2002: accessed 4 2005. Pabst G, Jaeger H. Review of methods and criteria for the evaluation of bioequivalence studies. Eur J Clin Pharmacol 1990; 38: 510 and androgel.
Send reprint requests to: Craig K. Svensson, Pharm.D., Ph.D., Department of Pharmaceutical Sciences, Wayne State University, Detroit, MI 48202. E-mail: cks wizard.pharm.wayne and aprepitant
12. Hansen TR, Bohr DF. Hypertension, transmural pressure and vascular smooth muscle response in rats. Circ Res 1975; 36: 590-598 Berecek KH, Stocker M, Gross F. Changes in renal vascular reactivity at various stages of deoxycorticosterone hypertension in rats. Circ Res 1980; 46: 619-624 Friedman SM. Evidence for an enhanced transmembrane sodium Na + ; gradient induced by aldosterone in the incubated rat tail artery. Hypertension 1982; 4: 23O-237 Moura AM, Worcel M. Direct action of aldosterone on transmembrane Na efflux from arterial smooth muscle. Hypertension 1984; 6: 425-430 Weber MA, Purdy RE, Drayer J|M. Interactions of mineralocorticoids and pressor agents in vascular smooth muscle. Hypertension 1983; 5 suppl I ; : I-41-l-46.
Mens for acute otitis media.1013, 71, 72 A recent systematic review9 of short-course antibiotics for acute otitis media showed that 44 children would need to be treated with a 10 day course of antibiotics to avoid one treatment failure due to treatment with a short course of antibiotics. Finally, despite the conventional wisdom that 10 days of antibiotic treatment are mandatory for streptococcal pharyngitis, 73 recent trials have experimented with short-term courses for this common infection; success has not been consistent.14, 74 Information on adverse events was not consistently reported in the trial reports, a deficiency we have previously observed in trials of antimicrobial chemotherapy.75, 76 However, adequate information was reported on discontinuations due to adverse events. The available data indicate that azithromycin led to few discontinuations with only 37 of 4870 0.76% ; patients discontinuing therapy due to adverse events. The rate is comparable to our observations for azithromycin in lower respiratory tract infections.15 More detailed data on toxicity would be important to record in antibiotic trials, as tolerability is an important consideration. This is even more important for upper respiratory infections where the efficacy of antibiotics has been a controversial issue and their role has been ques and apri.
Subcutaneous adipose tissue from the anterior abdominal wall ; and skeletal muscle pyramidalis ; where obtained from 10 pregnant women who delivered healthy, singleton infants at term 37 wk gestation ; after undergoing elective cesarean section indications for cesarean section were breech presentation and or previous cesarean section ; . The clinical characteristics of the subjects are collated in Table 1. Approval for this TABLE 1. Characteristics of the study group and antabuse.
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