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Five years ago we began a monthly journal aimed at primary care doctors in the United States. BMJ USA comprised articles selected from the weekly BMJ by a US based editor, along with commissioned commentaries and editorials. Despite the journal's popularity with readers, we couldn't attract sufficient support from the US pharmaceutical market, and last month's issue was the last. This week we start "US highlights"--assembled on the same principle as the print journal BMJ USA--but available solely in electronic form from the BMJ's website : bmj us-highlights ; . The fact that BMJ USA's editor, Douglas Kamerow, remains the BMJ's US editor provides further continuity. In addition to selecting articles of interest to US doctors, he will be working to increase the number of such articles published in the BMJ. If this cheap online model succeeds where the expensive print model failed, we could roll out "highlights" targeted at users in other countries. After the US our biggest non-UK markets for bmj are Australia, Canada, Italy, and Germany. Could such an exercise in internationalism lead to a catastrophic change in the make up of the print BMJ from the point of view of UK readers? Not necessarily--the print BMJ, which goes mainly to UK doctors, could comprise material selected from bmj for its particular interest to the UK, just as the online "US highlights" is a selection of articles of US interest. The one place to find everything we published would be, as it is now, bmj . As well as thinking more about what goes into the print BMJ, we think it's time to change its "look and feel." We've shortlisted three designs and we want readers to tell us which one they prefer. There's nothing new about consulting readers over such a crucial issue; last time we published the shortlisted designs in both the print journal and on bmj and received over 350 responses although in those days postcards and letters outnumbered emails ; BMJ 1996; 312: 232 ; . This time we're posting the designs on bmj and we'd welcome your feedback. If electronic developments have changed the way that scientific journals are interacting with their readers then it is nothing compared with how they will revolutionise the delivery of health care--once such developments have got off the ground. Connecting for Health, the UK initiative responsible for the world's largest civil IT project costing 6.2bn ; had an unhappy Christmas with its all important "spine" crashing after a software upgrade p 139 ; . It's now embarking on a charm offensive-- although many of its intended users will take a lot of convincing p 180 ; . Nearly two years ago, we published Nancy Lorenzi's advice on surmounting non-technical barriers to the introduction of information systems BMJ 2004; 328: 1146 ; . Too bad this advice from Nashville, Tennessee, wasn't heeded when it could have made a difference. Tony Delamothe deputy editor tdelamothe bmj. I was also given cytotec for induction and calcitriol. Invirase belongs to a class of anti-hiv drugs called protease inhibitors pis. 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Raises concerns about the independence of decision-making. It also raises questions about the effectiveness of committees where several members are disqualified from a discussion for example, in the 2001 annual report six out of 36 members of the Committee on Safety of Medicines had a personal interest in GlaxoSmithKline GSK ; , and a further seven had a non-personal interest ; . Lack of consumer input: there is lay representation on the Committee on Safety of Medicines which advises the MHRA and runs the Yellow Card scheme for reporting suspected adverse drug reactions. Indirect consumer reporting of adverse drug reactions via NHS Direct was piloted in 2003, and the Government has now announced that direct consumer reporting is to be piloted. However, consumer representation and championing of consumer rights are not built into the MHRA's structures and processes. Lack of public profile and impact: in its report on the then Medicines Control Agency, the National Audit Office commented, among many other issues, on the Agency's public profile. 6 It judged that the Agency needed to strengthen its public profile in order to fulfil its mission to provide information to contribute to the safe and effective use of medicines.7 The Agency does not, for example, have the public recognition that the Food and Drug Administration in the USA does. This limits its ability to get safety messages across to the public, and to engage with the public as a source of information on the effects of medicines. Secrecy: there are legal constraints, set out in the Medicines Act 1968, on what information the MHRA can make public. Pharmaceutical companies are free to withhold unpublished data from such bodies as the National Institute for Clinical Excellence, which is responsible for developing guidance for the NHS on effective treatments. This prevents independent scrutiny of MHRA decisions, and undermines public safety. The legal basis for giving and withholding information by the MHRA will change with implementation of the Freedom of Information Act. Resources: in its report, the National Audit Office commented that the Agency needed more resources for its pharmacovigilance strategy and that with more resources it could make fuller use of the General Practice Research Database which it holds. It also remarked on the amount of information with which the Agency has to deal. The amount of available information will increase with the recently established EU-wide clinical trials database and adverse drug reactions database. There is also a pressure to carry out the licensing process within specific timeframes. The capacity of the MHRA to properly evaluate the risks and benefits of medicines, both pre- and post-licensing, and to act promptly on the outcome, depends on its being adequately resourced.

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Table 1. -- Mold resistance of unseasoned pine dip-treated with various chemicals and carbamazepine. We are not aware of any company, other than our own, that offers the breadth and scope of supporting chemistry sources across the discovery and development spectrum.There are several companies which offer selected services.While we cannot control how they will grow or manage their business going forward, we can control what we do.We have set high standards for performance, ethics and customer service.We have focused our company on chemistry projects which require a high level of research, a significant problem solving component if you will.This is where our chemists excel and add value.The best business development that we can do is focusing on meeting and exceeding the high expectations set by our clients. Since the company was founded in 1991, we have worked very hard to gain acceptance and a reputation for high standards. Furthermore, we believe the merger with EnzyMed's biocatalysis technology coupled with traditional high throughput combinatorial chemistry could yield substantial future upside potential in the form of up-front service fees, milestone and royalty payments and possibly licensing agreements.The value-add is clear, it can increase the number of new lead compounds, speed drug discovery and optimization, and reduce costs associated with scale-up manufacture. Combined with all the services that AMRI offers and its high standards of excellence, we believe that AMRI stands alone in its field. Prize for clinical research from the American association. The National Cancer Institute of Canada awarded him the William E. Rawls Prize in 2001. This award is presented annually to honour and encourage a promising investigator at an early stage in their career who has undertaken studies in Canada which have led to new advances in cancer control. CONTACT: Dr. Martin Gleave The Prostate Centre at VGH 604 ; 875-4818 Dr. Kim Nguyen Chi Currently on staff as a Medical Oncologist at both the British Columbia Cancer Agency BCCA ; and the Prostate Centre at Vancouver Hospital and Health Sciences Center, Dr. Kim Nguyen Chi has been an active member of the Canadian oncology community since the late-1990's. After graduating Magna Cum Laude from the University of Ottawa's Faculty of Medicine, Dr. Chi went on to complete his Internal Medicine residency at the University of Ottawa, and become Chief Resident during his Medical Oncology Fellowship at the University of British Columbia. In 1998-1999, he received the Canadian Association of Medical Oncologists Research Fellowship. Dr. Chi has served as Principal or Lead Investigator for numerous clinical trials and remains deeply committed to clinical trial development. His articles have been published in peer reviewed medical journals and he has several research grants. Dr. Chi also serves as the Chair of the NCIC CUOG Advanced Prostate Disease Oriented Group, the Physician Coordinator for Genitourinary Systemic Group Trials at the BCCA, as well as several other local committees. He has presented at invited talks across Canada and tegretol.

C Godfrey, MB Harrison, JE Tranmer, J Medves School of Nursing, Queen's University, Kingston, Ontario OBJECTIVES: To explore and describe the symptom of pain in individuals with heart failure HF ; . METHODS: To address the research objective we conducted: 1 ; a systematic review of the literature that synthesized research related to reported pain and factors related to pain in patients with HF; 2 ; a secondary analysis of pain-related questions in the Medical Outcomes Short Form SF36 ; administered in a randomized clinical trial to determine the occurrence of pain in a cohort of patients with HF n 169 and 3 ; a qualitative inquiry with 8 individuals following a recent emergency room encounter for a HF-related complaint. RESULTS: The systematic review revealed 9 studies in which pain was a primary or secondary outcome. The prevalence of reported pain ranged between 23%75%. The only factor related specifically to pain in patients with HF was an increase in pain as death approached. Research of the seriously ill population of which patients with HF are a subset, identified anxiety, depression, more dependencies in activities of daily living, quality of life rated as poor and a higher number of comorbidities as being related to pain. Of the cohort of individuals participating in the RCT, 68% reported experiencing pain. There were no socio-demographic characteristics that distinguished individuals who reported pain from those who did not report pain. However, patients who rated their health as poor and those who experienced depression, worry and feeling a loss of control over their lives tended to report more pain. Qualitative interviews revealed that activities of daily living, participation in the community and overall quality of life were affected by pain. Emotional support was important in coping with pain. CONCLUSION: Pain is an issue for individuals with HF. Pain may be a contributing factor in the breakdown of self-management at home, and effective pain management could be a key factor in the treatment of these patients. Further research with regard to the under-recognized symptom of pain with HF is necessary, including aspects such as the relationship of pain to the stage of heart failure, a comparison of bodily pain and heart centered pain, and the role of pain in exacerbations and hospitalization.

Those who have no spleen or whose splenic function is severely impaired are at particular risk of severe malaria and, where possible, should avoid travel to malarious areas. If travel is essential, every effort should be made to avoid infection by rigorous use of antimosquito precautions and strict adherence to appropriate chemoprophyaxis. If the traveller becomes unwell during or after their visit, medical attention is required as a matter of urgency, as malarial parasitaemia in asplenic individuals may rise rapidly to very high levels e.g. greater than 50% with P.falciparum and carbimazole. An overview of health; guideline for humans and animals, which over 15 years of research and a thorough review of the medical literature has revealed. Free.

An inoculum giving semi-confluent growth of colonies after overnight incubation should be used. A denser inoculum will result in reduced zones of inhibition and a decreased inoculum will have the opposite effect. Use of an inoculum that yields semi-confluent growth has the advantage that an incorrect inoculum can readily be seen. Figure 1 shows the acceptable range of inoculum densities. The following method reliably gives semi-confluent growth. Other methods, such as photometric measurement of turbidity of suspensions, may be adequate but must be shown to be equivalent to the following and cefadroxil.

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The physiologic response to drugs is dependent on several factors, including the time course of drug adsorption, distribution, metabolism, and elimination in the body pharmacokinetics pk and the effect of drugs on the target receptor specific location where the drug binds and has its effect - pharmacodynamics pd.
Prusik M., Lewczuk B., Bulc M., Przybylska-Gornowicz B. Division of Histology, Department of Functional Morphology, Faculty of Veterinary Medicine, University of Warmia and Mazury, Olsztyn, Poland mprusik gmail Aims: The avian pineal is directly photosensitive due to the presence of photopigments, among which pinopsin seems to be one of the most important and responsible for acute influence of light on the pinealocyte activity. Up till now, pinopsin has been detected in the chicken and the Japanese quail. The purpose of our study was to check the presence and distribution of pinopsin in the pineals of domestic turkeys at various stages of postembryonic life and as in cultured pinealocytes. Methods: Pineals of 1-day-, 2-, 14-, and 56-week-old turkeys as well as monolayer cultures of turkey pineal cells were fixed and subjected to immunohistochemical staining with primary antibody against pinopsin. Results: The pinopsinimmunoreactivity was observed in apical processes of rudimentaryreceptor pinealocytes limiting the follicular lumen and in short processes originating from secretory pinealocytes laying in outer layer of the follicular wall in the pineals of turkeys from 1 day to 1 year old. The number of secretory pinealocytes with pinopsin-positive processes increased with age. In monolayer cultures, the positive staining for pinopsin was observed in pinealocytes. It was especially prominent in short cytoplasmic processes originating from cytoplasmic pools of cells. Conclusions: Pinopsin is present in turkey pineal glands during the whole period of postembryonic life and shows very specific distribution and duricef.

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This is a simple experiment but it shows that by crushing a tablet you can alter the pharmacological properties of a particular medicine. Figure 1: Kinetic parameters of membrane potential probes RBL-2H3 cells were loaded for 30 minutes with membrane potential probes and subsequently depolarized by injecting KCl to a final concentartion of 50mM. The kinetic parameters are summarized in the table * average of at least 500 measurements ; . Inset: Fluorescence response of the PanVera FRET dyes upon cell depolarization and cefdinir and cytotec. Note: g generic Table 15. Status of Other Drugs for OIs Sold in Lagos that are Useful for Treating OIs.

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The older literature has suggested that indican could interfere with the determination of bilirubin in uremic sera 9 ; . However, we detected no interference Method 2 ; when up to 50mg of the drug per liter was added to uremic and control sera. [This concentration represents the upper range of mdican concentrations seen in the sera of uremic patients 1O ; .I and omnicef.
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