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Section Overview Medical What You Will Find This section highlights the features that pertain to all or most of your health and welfare benefit options. Here is where you will find details about the coverage options offered through the healthcare organization known as UPMC Health Plan, as well as, your prescription drug and vision care benefits. Even though this handbook contains detailed information regarding your coverage, be sure to refer to any additional UPMC Health Plan materials you receive. This section describes your dental care options. Here you will learn about the: Basic life and AD&D insurance protection provided for you; Supplemental life insurance available for you, your spouse, and your dependents -- if you want to purchase this additional coverage; and Supplemental AD&D insurance available for you -- if you want to purchase this additional coverage. This section focuses on income protection during periods of short- and longterm disability. This section explains how you can participate in the flexible spending accounts. It also explains how you can use your contributions to help pay many of your health and dependent care expenses with pre-tax dollars. Here you will learn about the following programs: Adoption Assistance; Employee Assistance Program EAP Paid Time Off PTO Tuition Assistance; Voluntary Benefit Programs; Pre-tax Transportation & Parking; and Severance If you want to know how the UPMC Welfare Benefits Plan is administered, or more about your legal rights as a Plan participant, be sure to read this section.
CUN states next best alternative in all regions is 1, 3-D with chloropicrin with expected yield losses of 6 percent in California and Michigan and 29 percent in other regions. CUN states 1, 3-D with chloropicrin is considered technically feasible in California and Michigan. CUN noted that for California the distribution of yield loss across individual growers and the yield risk associated with alternatives was not accounted for the numerical economic assessment. Numerical assessment showed 14 percent decrease in net revenue. In Michigan delayed planting and harvest with the alternatives results lower average price received from missed market windows and negative net revenue.
Perspectives on Anesthesia Payment: A Nurse Anesthetist. Jeffery M. Beutler. Fall 1988.26-31. A Profile of Anesthesia Practice Patterns. DataWatch. Margo L. Rosenbach and Jerry Cromwell. Fall 1988. 118-131. Reforming Anesthesia Payment Under Medicare. Jerry Cromwell and Margo L. Rosenbach. Fall 1988. 5-19. Split Vision: Interpreting Cross-Border Differences in Health Spending. Perspectives: Canada. Robert G. Evans. Winter 1988.17-24. Health Maintenance Organizations The Changing World of Group Health Insurance. Jon Gabel, Cindy Jajich-Toth, Gregory de Lissovoy, Thomas Rice, and Howard Cohen. Summer 1988. 48-65. Defining Quality in Medical Care. Philip Caper. Spring 1988. 49-61. From Movement to Industry: The Growth of HMOs. DataWatch. Lynn R. Gruber, Maureen Shadle, and Cynthia L. Polich. Summer 1988.197-208. Medicare's Two Svstems for Payine Providers. Louis F. Rossiter and Kathryn Langwell. Summer 1988. 120132. Patient Selection in a Competitive Health System. Harold S. Luft and Robert H. Miller. Summer 1988. 97119. A Plan for Rewarding Efficient HMOs. Stanley S. Wallack, Christopher I? Tompkins, and Leonard Gruenberg. Summer 1988.80-96. The Social HMO Demonstration: Early Experience. Jay Greenberg, Walter Leutz, Merwyn Greenlick, Joelyn Malone, Sam Ervin, and Dennis Kodner. Summer 1988.66-79. Health Status Health Status and Medical Care Utilization. DataWatch. Gerry E. Hendershot. Spring 1988. 114-121. Hospitals The Care of Strangers: The Rise of America's Hospital System. UpDate. Book Review. Bruce C. Vladeck. Summer 1988. 224-226. Consumers and Hospitals: The HCFA "Death List." DataWatch. Bruce C. Vladeck, Emily J. Goodwin, Lois P. Myers, and Madeline Sinisi. Spring 1988. 122-125. Controlling Medicaid Costs in Hospitals. DataWatch. John Holahan. Maureen Lewis, and Marsha Silverberg. Fall 1988. 132-141. Defending the U.S. Approach to Health Spending. Perspectives: United States. Samuel A. Mitchell. Winter 1988.31-34. Fixing an Inefficient System. Perspectives: United States. Pete Stark. Winter 1988. 35-36. Hospital PPS Profits: Past and Prospective. DataWatch. Allen Dobson and Elizabeth W. Hop Spring 1988. 126-129. Hospital Quality in California. Letter. Robert Steinbrook. Summer 1988.235-236. Hospital Spending in the United States and Canada: A Comparison. Joseph. Newhouse, Geoffrey Anderson, and Leslie L. Roos. Winter 1988.6-16.
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Relationship of f a acidity to rancidity in homogenized raw mill~. I . A GOULD . Solubility and volatility of f a acids involved in lipolysis in homogenized raw milk. I . A GOULD AND B. C. JOHNSON . The influence of low environmental temperatures on intramammary temperatures. M ~ I COR]LXlE.50M., DWIGHT ESPE AND C. Y . CANNON . The comparative effects of continual and rotational systems of grazing on the carotene content of permanent pasture herbage and of the miltc produced therefrom. J. I . MITCHELL AND GEORGE H. WISE.
RESPONSE Notice: Due to technical requirements, provider responses appear verbatim in retyped format. DHS Elgin Mental Health 750 South State Elgin, Illinois 60123-7692 A JCAHO Accredited Hospital.
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Evidence for the effectiveness of antibiotics, in particular of antimycobacterial agents, for the maintenance of medically induced remission is lacking [el1c].
One of the ant species that can sting and attack human. One study showed that fire ants might pose the greatest risk of anaphylaxis upon stinging. Sting from a fire ant may result in a wheal followed by a sterile pustule after 12-24 hours and the pustule may undergo epidermal sloughing after one to three days. Pustules are often arranged in the shape of a ring, as fire ants pivot on a central axis as they sting repeatedly in the skin. It is crucial to remove the stinger following a Hymenoptera sting, as the venom sac can continue to exude venom if left adhered to the skin. The best method to remove the stinger is by sweeping the dull blade of a butter knife or the edge of a credit card at an angle almost parallel to the skin surface. Removal by a twister should be avoided as this may compress the venom sac, resulting in injection of additional venom into the skin. Cold compress, oral antihistamine, and mild analgesics may be sufficient for mild reactions, while subcutaneous epinephrine and systemic corticosteroid may be needed for severe reactions and anaphylaxis. Venom immunotherapy is a relatively safe and effective treatment for Hymenoptera venom hypersensitivity and is indicated for people who have had severe reactions and who have detectable venom-specific IgE present in their skin or blood and cosopt.
Muscle. It is then placed back into its original position and secured with pins. B, representative recording showing that electrical stimulation of mucosa in this preparation fails to evoke fast EPSP in submucosal neuron. C, summary of percentage of cells that had a fast EPSP in repsonse to mucosal stimulation in lesioned preparations n 1 9 ; and in normal preparations n 8 9 ; Preparations were used in an alternating sequence. Fisher's Exact Test, P 0.05.
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With India becoming TRIPS compliant, local companies are looking at drugs going off patent and also the biogenerics market so that they can produce and market the products at an affordable price. During 2002-04, as many as 20 biotech drugs have lost their patents in the US. Of the many drugs, the US patents for 13 biotech products will expire during 2005. Similarly many other blockbuster drugs are expected to lose patent protection over the next few years, paving the way for competitors to legally manufacture biogeneric versions of the biotech products and market them. This represents tremendous potential for biogeneric manufacturers. Since there is no real need to invest in drug discovery and clinical development, biogeneric manufacturers can sell these products at lower prices than the patented original drugs. Companies in developing countries like India are looking at biogenerics as a large number of biologicals are slated to go off patent and the pipeline for potential generic launches is dwindling. Considering this, the market potential for biogenerics will grow significantly in the coming years. According to Frost & Sullivan estimates, the biogenerics markets in Europe and the US alone has the potential to generate sales of .4 billion by 2011 at an average annual growth rate of 69.8 percent. The branded biologic products generated an estimated billion of sales for the biotechnology and pharmaceutical industries and represented the fastest growing group of drugs. While continued high demand, high prices, and applicability in previously untreatable conditions are behind the success of branded biologics, the absence of generic competition has meant that growth has gone unchallenged. By 2010, biologic products that accrue an estimated .2 billion worth of sales annually are expected to lose patent protection in developed pharmaceutical markets. Remicade Chimeric monoclonal antibody; anti-TNF-alpha ; , Epogen Recombinant erythropoietin ; , Enbrel Recombinant fusion protein; soluble TNF receptor linked to IgG1 ; , Aranesp Novel erythropoiesis-stimulating protein 2nd generation EPO , Epogin NeoRecormon Recombinant erythropoietin ; , Neulasta PEGylated version of Neupogen ; Avonex Recombinant interferon beta-1a ; and Pegasys Copegus Recombinant interferon alfa-2a modified with PEG monotherapy; also in combination with Copegus [ribavirin] have recorded sales of , 963 million, , 891 million, , 600 million, , 580 million, , 500 million, , 826 million, , 700 million, , 417 million and , 370 million respectively. This gives an idea about the market potential for these biotech products world over. Companies like Wockhardt, Dr Reddy's Labs and Biocon are looking at entering the regulated market in Europe, which has regulatory system in place for the biogenerics. Wockhardt has received 17 registrations for its biopharmaceuticals and 36 registrations are being pursued in various overseas markets such as Russia, South America, North Africa, Central Asia, South East Asia. It has also formed majority joint ventures in Mexico and South Africa and has set up a subsidiary in Brazil.
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Referenz 725a Neurologie, 11. Auflage ; Onofrj M., Paci C., D'Andreamatteo G., Toma L.: Olanzapine in severe Gilles de la Tourette syndrome: a 52-week double-blind cross-over study vs. low-dose pimozide. J. Neurol. 247, 443-446 2000 ; . Dipartimento di Oncologia e Neuroscienze, Universita G. D'Annunzio, Ospedale Civile, Italy. onofrj phobos ch We selected four patients with severe Gilles de la Tourette syndrome, high frequency of tics two to ten per minute ; , vocalizations, and lack of comorbidity. These patients aged 19-40 years ; underwent a 52-week double-blind cross-over study with olanzapine 5 and 10 mg daily ; vs. low-dose pimozide 2 and 4 mg daily ; . The reduction in rating scale scores for the syndrome was highly significant with 10 mg olanzapine vs. basal and vs. 2 mg pimozide, and was significant for 5 mg olanzapine vs. 4 mg pimozide. Only moderate sedation was reported by one patient during olanzapine treatment while three complained of minor motor side effects and sedation during pimozide treatment. At the end of the study all patients opted for olanzapine treatment. Publication Types: Clinical Trial Randomized Controlled Trial and crixivan.
Site c-health : pegasys rbv pegasys and copegus ; peginterferon alfa-2a belongs to the group of medications known as interferons.
PGE2 MEDIATES WOUND CLOSURE IN AECS 8. DuBois RN, Awad J, Morrow J, Roberts LJ II, and Bishop PR. Regulation of eicosanoid production and mitogenesis in rat intestinal epithelial cells by transforming growth factor-alpha and phorbol ester. J Clin Invest 93: 493498, 1994. Gruenert DC, Finkbeiner WE, and Widdicombe JH. Culture and transformation of human airway epithelial cells. J Physiol Lung Cell Mol Physiol 268: L347L360, 1995. 10. Gupta AG, Hirakata A, and Proia AD. Effect of inhibitors of arachidonic acid metabolism on corneal reepithelialization in the rat. Exp Eye Res 56: 701708, 1993. Hamasaki Y, Kitzler J, Hardman R, Nettesheim P, and Eling TE. Phorbol ester and epidermal growth factor enhance the expression of two inducible prostaglandin H synthase genes in rat tracheal epithelial cells. Arch Biochem Biophys 304: 226 234, Hatane T, Yoshida E, Kawano J, Sugiki M, Onitsuka T, and Maruyama M. Prostaglandin I2 analog enhances the expression of urokinase-type plasminogen activator and wound healing in cultured human fibroblast. Biochim Biophys Acta 1403: 189198, 1998. Hill EM, Bader T, Nettesheim P, and Eling TE. Retinoidinduced differentiation regulates prostaglandin H synthase and cPLA2 expression in tracheal epithelium. J Physiol Lung Cell Mol Physiol 270: L854L862, 1996. 14. Honn KV, Grossi IM, Fitzgerald LA, Umbarger LA, Diglio CA, and Taylor JD. Lipoxygenase products regulate IRGpIIb IIIa receptor mediated adhesion of tumor cells to endothelial cells, subendothelial matrix and fibronectin. Proc Soc Exp Biol Med 189: 130135, 1988. Joyce NC, Joyce SJ, Powell SM, and Meklir B. EGF and PGE2: effects on corneal endothelial cell migration and monolayer spreading during wound repair in vitro. Curr Eye Res 14: 601609, 1995. Joyce NC and Meklir B. PGE2: a mediator of corneal endothelial wound repair in vitro. J Physiol Cell Physiol 266: C269 C275, 1994. 17. Joyce NC, Meklir B, and Neufeld AH. In vitro pharmacologic separation of corneal endothelial migration and spreading responses. Invest Ophthalmol Vis Sci 31: 18161826, 1990. Kaneko F, Zhang JZ, Maruyama K, Nihei Y, Ono I, Iwatsuki K, and Yamamoto T. Prostaglandin I1 analogues, SM10902 and SM-10906, affect human keratinocytes and fibroblasts in vitro in a manner similar to PGE1: therapeutic potential for wound healing. Arch Dermatol Res 287: 539545, 1995. Kim JS, McKinnis VS, Nawrocki A, and White SR. Stimulation of migration and wound repair of guinea-pig airway epithelial cells in response to epidermal growth factor. J Respir Cell Mol Biol 18: 6674, 1998. Kobayashi K and Arakawa T. Arachidonic acid cascade and gastric mucosal injury, protection, and healing: topics of this decade. J Clin Gastroenterol 21: S12S17, 1995. 21. Konda Y, Nishissaki H, Nakano O, Matsuda K, Wada K, and Nagao M. Prostaglandin protects isolated guinea pig chief cells against ethanol injury via an increase in diacylglycerol. J Clin Invest 86: 18971903, 1990. Leikauf GD, Claesson HE, Doupnik CA, Hybbinette S, and Grafstrom RC. Cysteinyl leukotrienes enhance growth of human airway epithelial cells. J Physiol Lung Cell Mol Physiol 259: L255L261, 1990. 23. Lloret S and Moreno JJ. Stimulation of arachidonic acid mobilization by adherence of resident peritoneal macrophages to plastic substrate. Comp Biochem Physiol C Pharmacol Toxicol Endocrinol 113: 403408, 1996. Mitchell JA, Belvisi MG, Akarasereenont P, Robbins RA, Kwon OJ, Croxtall J, Barnes PJ, and Vane JR. Induction of cyclooxygenase-2 by cytokines in human pulmonary epithelial cells: regulation by dexamethasone. Br J Pharmacol 113: 1008 1014, Moreno JJ. Regulation of arachidonic acid release and prostaglandin formation by cell-cell adhesive interactions in wound repair. Pflugers Arch 433: 351356, 1997 and cubicin.
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The proportion of each phase present within the clinker has a marked effect on the rate at which the cement hydrates and, all other factors being equal, the rate of strength development Table 1.2 ; . Different types of cement have different amounts of each phase, which dictates their suitability for a given end use.
F. Persons with impaired humoral immunity but not cellular immunity may be vaccinated. MMWR 1999; 48 RR-06 ; : 1-5. G. Hemodialysis patients: Use special formulation of vaccine 40 ug per mL ; or two 1.0 mL per 20 ug doses given at one site. Vaccinate early in the course of renal disease. Assess antibody titers to hepatitis B surface antigen anti-HBs ; levels annually. Administer additional doses if anti-HBs levels decline to less than 10 milli-international units mIU ; mL. H. There are no data specifically on risk of severe or complicated influenza infections among persons with asplenia. However, influenza is a risk factor for secondary bacterial infections that may cause severe disease in asplenics. I. Administer meningococcal vaccine and consider Hib vaccine. J. Elective splenectomy: vaccinate at least 2 weeks before surgery and cyanocobalamin
Of government. Games stress the importance of the planners' and players' understanding and comprehension of interrelated processes. With the evolving complexity and sophistication of current simulations, there are increased opportunities to provide enhanced realism for game participants. The use of computer-generated scenarios and simulations can provide a more realistic and time-sensitive method of introducing situations for analysis. Planner decisions can be input and models run to show the effect of decisions made during a game. Distributed games available through the Internet ; offer many additional benefits, such as saving participants' time and travel expenses, more frequent training opportunities, and less time away from primary functions. They also provide a collaborative environment that reflects realistic occurrences. Games are excellent vehicles for the following and copegus.
The Royal College of Physicians guidelines advise selective case finding in primary and secondary care and referral for DXA for those at an increased risk of developing osteoporosis and therefore more likely to fracture, and where the result of the scan is likely to change clinical management.8 The high-risk groups are men and women with a previous low trauma fracture, X-ray evidence of osteopenia, glucocorticosteroid use for more than three months ; , and other clinical factors, such as height loss, kyphosis, and a low body mass index less than 19kg m2 ; . Possible secondary osteoporosis is due to primary hyperparathyroidism, poorly controlled thyrotoxicosis, malabsorption, rheumatoid arthritis, liver disease, alcoholism, and primary hypogonadism. In women, those at increased risk would also include women with untreated estrogen deficiency due to an early menopause, either naturally or surgically induced, or those women with secondary amenorrhea of more than six months, not due to pregnancy, e.g. anorexia nervosa and those who over-exercise.8 DXA scans are usually reported as a T score. The T score is used as a diagnosis and compares the individual's bone density with the average for a group of young adults at the peak of their bone density.The Z and cyclizine.
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MEDGENICS' PROTEIN THERAPY As described in the preceding section, Medgenics seeks to improve the current scenario of protein therapy by providing sustained-action protein therapy, where a single implantation can produce and deliver protein to the patient that is within the therapeutic window for at least four to six months. This technology could potentially eliminate side effects associated with bolus injections and could offer a convenient, lower-cost solution to patients requiring protein therapy. Medgenics is using its sustained-action Biopump platform technology to focus initially on improving protein therapeutics for anemia and chronic hepatitis C. More detailed descriptions of these disorders are provided in the accompanying sections. The Company believes that the Biopump technology is likely to appeal not only to those who now receive protein therapy, but also to a larger population of patients who could benefit but are unwilling to suffer the unpleasant side effects currently associated with injections. Disease Focus Areas Anemia The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative estimated that in the U.S. approximately 20 million people suffer from anemia as a result of chronic kidney disease CKD ; . Additionally, the initiative estimated that as many as 67 million people in the U.S. with hypertension and diabetes are at an increased risk for CKD and subsequently anemia. Anemia occurs when a person does not have enough red blood cells RBCs ; or hemoglobin in them. RBCs, also known as erythrocytes, carry hemoglobin, a protein that delivers oxygen from the lungs throughout the body. When the number of RBCs decreases, the heart must work harder to deliver oxygen where it is needed throughout the body. RBCs, produced in the bone marrow, are regulated by a hormone called erythropoietin EPO ; . Normally, when the body's oxygen level is decreased, it compensates by increasing its EPO production. EPO then stimulates the stem cells contained in the bone marrow to produce more RBCs and increase how quickly the RBCs mature. When this natural response is hindered through kidney disease or other causes, the body can become anemic. Approximately 90% of EPO is made in the kidneys. There are various types of anemia, including iron deficiency anemia, vitamin deficiency such as folate or vitamin B-12 ; , anemia of chronic disease e.g., Crohn's disease, end-stage renal disease [ESRD] ; or kidney failure, aplastic anemia, anemia associated with bone marrow disease such as leukemia ; , hemolytic anemia, and sickle cell anemia. There are several other more rare forms of anemia, such as thalassemia and anemia caused by defective hemoglobin. Medgenics' technology aims to treat anemia of chronic disease. The main symptom of most types of anemia is fatigue. Other signs and symptoms of anemia include weakness, pale skin, a fast heartbeat, shortness of breath, chest pain, dizziness, cognitive problems, numbness or coldness in the extremities, and headaches. Initially, anemia can be so mild it goes unnoticed; however, signs and symptoms increase as the condition evolves. If the anemia is severe enough, exhaustion and other symptoms may interfere with everyday tasks. Although anemia is often treatable, it may take several weeks to months for RBC levels to return to normal after treatment. If untreated, anemia can lead to an arrhythmia or congestive heart failure CHF ; as the heart must pump more blood to compensate for the lack of oxygen in the blood. Untreated pernicious anemia can lead to nerve damage and decreased mental function since vitamin B-12 is important not only for healthy RBCs but also for optimal nerve and brain function. Some inherited anemia, such as sickle cell anemia, can be serious and lead to life-threatening complications. A large and significant blood loss in a short time period can also result in acute severe anemia and ultimately be fatal. Current Treatment Current treatment for chronic anemia is multiple and frequent subcutaneous injections of recombinant EPO, most often in the thigh or abdomen. The recombinant EPO is generally administered to patients via injection three times per week with Amgen's EPOGEN or once a week by Amgen's Aranesp. These products and others used to treat anemia are described in greater detail in the Competition section pages 31-34 ; . Some of the shortcomings of current anemia treatments that Medgenics seeks to address are bulleted on page 25.
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And one in 36 for women, making melanoma the fourth most common cancer in men, and the third most common in women [4]. Patients presenting with AJCC American Joint Committee on Cancer ; stage I melanoma have an excellent prognosis Table 1 ; and are not generally considered for systemic adjuvant treatment. However, a significant number of patients present each year with disease categorised as high risk 50% 10 year survival ; and intermediate risk 5164% 10 year survival ; . By these criteria, patients with stage IIA, IIB and IIIA disease could be regarded as at intermediate risk, while those with IIC, IIIB and IIIC disease are at high risk Table 1 ; . In the revised AJCC staging series, 29% of the 17 600 patients fell into the intermediate-risk category, and 7% into the high-risk group [5]. A recent audit of Sydney Melanoma Unit data for 2002 reveals 8% of patients to be stage III and 3% to be stage IIC at presentation Helen Shaw, personal communication and cycloserine.
Thanks to Team Hope Arizona Tucson Volunteer Coordinator Bob Salvatore for getting this billboard space donated from "Clear Channel Outdoor Tucson". This will run from May 2004 through May 2005 and will rotate to different locations every few months and cortisone.
Samech All they that go by thee, clap their hands at thee: hissing and wagging their heads upon the daughter Jerusalem, and say: is this the city that men call so fair, where in the whole land rejoices. Ain All thee enemies gape upon thee, whispering and biting their teeth, saying: let us devour, for the time that we looked for, is come: we have found and seen it. Phe The Lord hath fulfilled the thing, that he was purposed to do: and performed that he had devised long ago: he hath destroyed, and not spared. He hath caused thine adversaries to triumph over thee, and set up the horn of thine enemy. Zade Let thine heart cry unto the Lord, O thou city of the daughter of Zion: let tears run down like a river day and night: rest not, and let not the apple of thine eye leave off. Koph Stand up and make thy prayer in the first watch of the night, pour out thine heart before the Lord: lift up thine hands for the lives of thy young children, that die of hunger in the streets. Res Behold, O' Lord, and consider, why hast thou gathered me up so clean: Shall the women eat their own fruit, even children of a spanne long: Shall the priests and the prophets be slain thus in the Sanctuary of the Lord? Sin Young and old lie behind the streets upon the ground in, my maidens and young men are fallen with the sword: whom thou in the day of thy wrathful indignation hath put to death: yes even thou hast put them to death, and not spared them. Thau and cyclosporine.
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