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To the Editor: The recent publication of the clinical trial by Stadtmauer et al1 showing no benefit to high-dose chemotherapy in metastatic breast cancer led us to re-examine the earlier positive report of Bezwoda et al, 2 which, notoriously, has now been withdrawn.3, 4 It is apparent that although Bezwoda claims merely that he "misrepresented" his results, he undertook detailed fabrication. He clearly describes the treatment regimen schedule for both the experimental and comparison groups in Table 1, and in Table 2 he gives precise figures for the amount of various agents said to have been received by patients 1 correct to 100 milligrams per square meter per week. Yet his audited reports revealed a completely different treatment regimen for the comparison group. Furthermore, there may be evidence in the original publication that Bezwoda's data were falsified, or at the very least, suspicious. The number of complete responses CR ; in control patients with soft tissue metastases is given as four in Table 6, whereas the total number of CRs in controls is given in Table 5 as only two. The number of CRs in experimental subjects with soft tissue metastases is similarly greater than the total number of CRs in this group. Bezwoda et al2 state that 49 patients had "two or more [metastatic] sites" and 41 patients had "more than two sites" p 2485, column 1 ; . Given that there are a total of 90 patients in the trial, all patients must have had at least two metastatic sites. Yet Table 4 gives the average number of metastatic sites per patient by group as 1.8 and 1.6, for example, side affects.
Lavoisier in the Year One, by Madison Smartt Bell, ponders the ironies of the discoverer of oxygen one of Thomas Kuhn's prime examples of revolutionary science ; losing his head to the more traditional sort of revolution. Obsessive Genius, by Barbara Goldsmith, is an insightful look at Marie Curie, and how she was able to be a female scientist when those two words were not supposed to go together. My favorite so far is Incompleteness, a bio of Kurt Gdel by Rebecca Goldstein, a philosopher, novelist, and designated genius at play in MacArthur's Park. She shows that, contrary to the Newage view Heisenberg knew that we don't know anything, Gdel proved that we can't prove anything, and Kuhn established forever that all knowledge is transitory ; , Gdel was a Platonist, attempting to demonstrate that numbers have a reality far beyond that of mere matter. Early in his autobiography, Mirror to America, John Hope Franklin remarks that he couldn't get enough access to books when he was five years old, and his father's Greek and Latin texts were not helpful. This is not the usual image of African Americans in the early part of the previous century, but Franklin was not a usual African American. Here is an existence proof of intellectual development under the harshest sort of oppression even worse than what Curie faced ; . Franklin manages to describe his dealings with stupid Caucasians in reasoned and measured tones. That calm may be even more remarkable than the book's eloquence. I a Discordian because I believe that one of the most essential distinctions is between Order and Chaos. I a Discordian heretic because I like Order. Business books tend to be on the side of Order, at least when they are not on the side of Extreme Butchness Leadership Secrets of Attila the Hun ; . Every so often.
The primary contributor to utilization growth in 2003 was an increase in therapy days for current medication users 3.5% growth in days per user ; . There was only a small expansion in the number of medication users 0.3% growth in users per eligible ; . The contribution of these factors to total drug trend is illustrated in Figure 3. Some therapeutic classes experienced utilization growth rates greater than 10%, including rheumatological 27.7% ; , osteoporosis 18.5% ; , anticoagulant antiplatelet 16.4% ; , antipsychotic 14.8% ; , lipid-lowering 12.2% ; , and seizure 11.6% ; medications. Large utilization declines were observed for estrogen progestin combination therapies -30.0% ; and prescription antihistamines -15.5%, allergy; -17.3%, cough and cold, because hcl.
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Most individuals with a brain injury will want to return to work. They may, however never be able to work on the same job they had before their injury. Most accumulate a large healthcare debt that, if they are lucky, will be paid by their insurance company or a social service like Medicaid, Worker's Comp, or Medicare. There are usually additional financial debts that the person that was injured must pay him or herself. Not having the money and a job to get the money is very stressful. Special assistance may help them return to their former job or find a new job they can do. In our society, work usually defines who we are. It contributes to our self-esteem, provides structure to our lives and identifies us. Work, either paid or volunteer, can help people with a brain injury reclaim their place and life and give them renewed independence. Those returning to work may find Work Adjustment Training WAT ; valuable. This program will help them understand what they will need to do to keep their jobs once they have them. Look in the resource section of the manual for a listing of agencies that assist with employment rehabilitation including job development, training or re-training, and on-the-job supports. These agencies may also help identify, locate and in some cases purchase assertive technology to use on the job. A vocational rehabilitation counselor can also assist them in meeting their employment needs. They can help them establish realistic vocational goals, develop a vocational rehabilitation plan, and follow up on the person's progress. They can work closely with medical professionals, employers and other resources to assist the person with brain injury in getting a meaningful job. An individual's private or work insurance company may also hire the individual a vocational rehabilitation counselor. The insurance company should be contacted directly for additional information. It is important to be aware that the Americans with Disabilities Act ADA ; applies to individuals with a traumatic brain injury disability. More specific information about the ADA can be found at the end of the resource section of this manual. Individuals may work while they are receiving Social Security, workers compensation or other benefits such as food stamps, cash assistance and Medicaid. Specific income guidelines must be followed in order to continue receiving benefits. To find out more about programs that support individuals returning to the workforce, get in touch with a Social Security representative or vocational counselor. Others may choose to return to school to prepare themselves for other job opportunities. Programs are available at community colleges and universities that assist students with tutoring, learning aids and other support services. Contact the student affairs office at the school or university for information about their special services for the disabled.
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Neuren Pharmaceuticals Ltd., of North Sydney, Australia, executed a memorandum of understanding with the Henry M. Jackson Foundation for the Advancement of Military Medicine for inclusion of U.S. Army hospital sites in the company's forthcoming Phase III trial of Glypromate to prevent neurocognitive decline following coronary artery bypass grafting surgery. The trial is scheduled to start next year. The Jackson Foundation will coordinate and review the clinical trial plans and negotiate agreements for the participation of U.S. Army hospitals. NicOx SA, of Sophia Antipolis, France, said New Yorkbased Pfizer Inc. selected a development candidate from the companies' collaboration focusing on nitric oxidedonating compounds in ophthalmology. Under the terms, Pfizer will pay 2 million US$2.3 million ; to NicOx, in exchange for an exclusive worldwide license to NicOx compounds. Including the recent payment, NicOx has received a total of 4 million in connection with this agreement, and stands to receive an additional 33 million, plus royalties. PharmaMar SA, of Madrid, Spain, said data from two research projects show that patients with a defined pattern of tumor DNA repair efficiency have a higher probability of better survival, which is expected to affect the optimization of Yondelis in studies in solid tumors. Results also showed molecular evidence that correlates extreme in vitro sensitivity to Yondelis with mutation of the p53 gene. Yondelis is a marine-derived compound in development to treat soft-tissue sarcomas and ovarian cancer. The data were presented at the 1 1th annual Connective Tissue Oncology Society meeting in Boca Raton, Fla, for example, side effect.
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Answers to questions from Sections 1-7 of Treatment training for advocates. This manual is available online in English and Russian from: HIV i-Base : i-Base Section 1 AIDS stands for: - Acquired - Immune - Deficiency - Syndrome 2. A CD4 cell is a white blood cell lymphocyte ; that signals CD8 cells to destroy a virus. HIV uses CD4 cells as factories to reproduce in. 3. A CD8 cell is a white blood cell lymphocyte ; that kills cells that are infected with viruses i.e. HIV ; . 4. The `normal' range for CD4 count in an HIV-negative adult is between 600 and 1600 5. CD4 cell is also called a helper cell, a CD4 + T-lymphocyte, CD4 + T-cell, and sometimes just T4 cell CD8 is also called a killer cell 6. CD4% is the percentage of total lymphocytes that are CD4 cells. It is used as a more stable indication of whether there has been a change in the immune system. Children are monitored using CD4%. 7. Cellular immune responses are based on CD4 and CD8 responses. Humoral immune responses are based on antibodies. 8. A surrogate marker is an indirect measure for something else that cannot be easily measured directly i.e. the CD4 count is a measure for the disease progression ; . 9. US and UK treatment guidelines recommend routine CD4 and viral load monitoring every three months, whether on treatment or not on treatment. These tests should also be done before any treatment change, and 2-4 weeks after any treatment change. i.e. 4 weeks after starting treatment. Is any one test result produces an unexpectedly high or low results, it should be repeated. In some countries with limited access to these tests, they are performed less frequently perhaps every 6 months. 10. Some guidelines WHO, UK ; would recommend starting treatment before the CD4 count has fallen below 200, while others US ; would recommend before 350. 11. A few weeks after the infection, the CD4 count usually falls, then the immune system fights back and the count goes back again but not to the levels that it was before HIV infection. From then on the CD4 count goes down gradually and it takes from 2 to 10 years usually to drop down to 200. 12. Please see graph on page 15. 13. The following OIs become more common below these CD4 levels: CD4 300 - diarrhoea from microsporidia and cryptosporidia - skin problems-candida thrush ; , dry skin, etc. 200 - PCP pneumonia ; and chest infection - toxoplasmosis-a parasitic infection that commonly causes brain lesions.
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Ratio -30% higher. Given that the apparent absorption of these filtered samples is primarily of CDOM, acnoM 355 ; can be obtained from an equation of the form acDoM 355 ; [m-l] AF, 355 ; + B. 3 ; Table 1 provides values for the slope and intercept A and B ; in Eq. 3 derived for four of the data sets with 355- and 337-nm excitation. The Monterey Bay data, which have an insufficient range of values over which to develop a meaningful regression equation, are excluded. Table 1 also has versions of Eq. 3 for the combined western North Atlantic Ocean data and the combined data from all five sites. In each case, the standard errors of the slope and intercept are also provided. We observe a positive intercept for several of these equations. This result implies that some fraction of the CDOM absorbs at 35 5 337 ; nm but does.
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Among Aboriginal and Torres Strait Islander Australians with current asthma, about 26% rated their health as excellent very good, 34% rated it as good and about 41% rated their health as fair poor Figure 5.3 ; . In contrast, more Indigenous Australians without asthma rated their health as excellent very good 38% ; and fewer rated their health as fair poor 27% ; . In general, Indigenous Australians rated their health worse than non-Indigenous Australians. In fact, Indigenous Australians without asthma rated their health slightly worse than non-Indigenous Australians with the condition and cilostazol.
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In many countries, deconcentration seemed to be the most obvious in the 1970s Champion 1989a, 1989b ; . In early 1980s, contrary to the rest of the decade, deconcentration became less dominant. In some countries, primarily in the USA, the urbanisation processes accelerated and reurbanisation appeared Ogden and Hall 2000 ; . In many other regions, however, the processes of deconcentration were still quite obvious Table 1.2 ; . Generally, the situation in the 1980s was much more complicated and diverse than in the 1970s, although it needs to be stressed that different administrative circumstances complicate clear comparisons. For example, Dahms 1995 ; found that the apparent slowdown of counterurbanisation or even its reversal was often the result of reclassification of former rural areas to urban areas. In the 1990s, the situation remained diverse. The latest European-wide research project Rees and Kupiszewski 1999 ; reported different trends for different countries in the 1990s, similarly to the previous decades. There are controversial results about migration trends from the United States. Elliot and Perry 1996 ; analysed differences among metropolitan areas in the USA in 19651990 and reported clear contrasts. 85% of all net gains of established metropolitan territories derived from the exchange with central counties, regardless of the geographic subsector. This led the authors to the conclusion that "recent patterns of metropolitan dispersion may in fact reflect an alternative form of suburbaniation rather than extended Table 1.2 Urbanisation + ; and deconcentration ; in some countries during the 1970s1990s and bactrim.
This report provides a snapshot of the physical, quality of life, and economic impact irritable bowel syndrome IBS ; has on women. It portrays these aspects through the perspectives of both IBS patients suffering with symptoms and physicians struggling to diagnose and to treat the disorder. Market research survey results revealed that once symptoms emerge, it may take more than 2 years before an IBS diagnosis is made. However, the assurance of a definitive diagnosis does not guarantee relief of symptoms because of the limited effectiveness and adverse effects of prescription and over-the-counter therapies used to treat IBS. The inadequacies of approaches mean that patients often try multiple medications and or seek care from multiple health care providers. This report is intended to help raise awareness about how patients think, feel, and live with IBS and to provide insights into physicians' beliefs and attitudes regarding this disorder. Understanding these elements should help put into perspective the vast amount of published literature discussing the causes of IBS, options for management, and recommendations for treatment. Clearly, additional research is needed to help further address the many clinical gaps that remain. This report focuses on women because of the higher prevalence of IBS in women compared with men5, 10, 11 and because differences in physiology, symptoms, psychosocial factors, and treatment response between the sexes may shape the definition and treatment of IBS in women.24 Research initiatives exploring currently untapped areas in women's health eg, the influence of reproductive hormones on the physiology and symptoms of IBS, and the influence of inflammation and enteric infections on sensitization of the female gut ; 3 are essential to advancing our understanding of this disorder. Fortunately, important strides have been made in defining IBS as a medical disorder with a physiologic cause. The limitations of conventional medications underscore the need for treatment options that effectively target the underlying causes of IBS altered intestinal movement, increased pain perception, and altered movement of fluids through the digestive tract ; to help patients manage the multiple symptoms associated with each IBS subtype. It is hoped that using published consensus recommendations for making a positive IBS diagnosis and using an evidence-based approach to manage IBS will make diagnosing and treating the disorder a simpler and quicker process. An aggressive and comprehensive professional and patient education effort that stresses the importance of a strong patientphysician relationship and reinforces the utility of a symptom-based approach is critical.
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