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DISCUSSION The finding of this clinical investigation in a predominantly Chinese population are consistent with those of previous studies in insomniac: patient 4-6 ; . Previous placebo based studies have demonstrated that zopiclone given to healthy volunteers resulted in sleep with an architecture having no significant change from that obtained with placebo 7 ; . In acute insomniac patients, placebo controlled studies 8, 9 ; demonstrated sleep was significantly improved with zopidone treatment, Placebo controlled studies in middle aged chronic insomniacs 10-13 ; and geriatric patients with chronic insomnia 4, 14, 15 ; are consistent in reporting significantly improved sleep with zopidone. Nevertheless, since ours was not a clinical trial with simultaneous controls, our findings on the clinical efficacy of Zopidone in Chinese patients should be regarded as only preliminary. Moreover, a comparison of the hypnotic effects of Zopiclone with those of Benzodiazepines must ultimately depend on a controlled trial with the latter drugs. Existing benzodiazepine hypnotics tend to have a short duration of effect, leading to frequent nocturnal awakening or a long duration of activity resulting in residual "morningafter" effects, Benzodiazepines frequently give rise to residual side-effects and psychomotor impairment 16, 17 ; . In a subjective assessment of the residuals effects of zopidone it was established that at normal therapeutic doses of 7.5 mg such effects were minimal 18 ; . Lack of residual effects is very important to a large number of patients in a wide range of occupation and this is one of the properties that makes the new cyclopyrrolone interesting. Zopidone, in this study significantly increased the duration of sleep, decreased the number of nocturnal awakenings, reduced the difficulty in falling to sleep, decreased the incidence of waking earlier than required and improved the quality of sleep. For the out-patients only the reported assessments of the patient was recorded. No attempt was made to interview the sleeping partners of the patients. It is accepted that this could have provided useful confirmatory data as to the quality of sleep expressed by the patient. However 15 of the patients enroled in this study were inpatients. With these patients, throughout the trial period, observations were made by either the clinical or nursing staff during periods of zopidone induced sleep. From these reports it was concluded that the findings recorded by the patients and those observed by the staff were in close agreement. Until larger numbers of patients have been treated a cautious approach should be taken in transferring patients directly from benzodiazepines to zopiclone. In this study however it is interesting to note there were no apparent problems in such a direct transfer. There did not appear to be a higher incidence of side-effects following zopidone treatment in patients transferring directly from a benzodiazepine hypnotic than in patients who had not previously received.
Geneva: world health organization; 199 technical report series no 82 1 cao w, van de ploeg cp, plaisier ap, van der sluijs ij, habbema jd.
Anti-resorptive therapy. There are animal toxicity data to consider. When rats were administered high doses of PTH, equivalent to 360 times the human dose for a time period, equivalent to 75 human years of exposure, osteosarcoma was induced. It is highly unlikely that this rat toxicity is of concern to humans in view of the dosage and duration of exposure. Moreover, there have been no cases of osteosarcoma in any subject who has received PTH as a therapy. Recent advances in the prevention and treatment of osteoporosis are impressive. With a menu of effective drugs from which to choose, the prospects of preventing and treating this disease are brighter than ever before. PTH is the latest in this series of advances. One article i found - in the journal of the american academy of physician assistants - indicates that lipitor isn't the only statin that may prompt hair loss: zocor and mevacor are also linked to this same problem. 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Implementation Effective implementation of a regimen in overburdened midwifery or obstetrical units with little resources 10 ; will depend on the number of women willing to be tested for HIV and prepared to return for results and follow-up. Equally, compliance with depend on how easy the regimen is to follow, which would imply the use of oral dosage forms, taken during the day, with minimum adverse effects. It is very important that the health worker and the patient clearly understand the reasons for the regimen and the benefits of maintaining the course of treatment and zyprexa. Gitudinal, clinically realistic report on the capacity of an interdisciplinary, mobile outreach team with access to Section 8 housing to secure and maintain housing for homeless persons with severe mental illness. Acknowledgment This project was supported Mental Health Services SM48070. by Center for grant HD5. 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Drug companies fund to get their drugs tested for approval. In investigator-initiated research, a doctor who treats children thinks of a study that needs to be done such as evaluating the benefits of exercise in children with arthritis but that drug companies aren't usually interested in funding. Kids Get Arthritis Too takes a look at the two organizations leading the way in both kinds of research. The Pediatric Rheumatology Collaborative Study Group Not so long ago, prescribing medication for children with arthritis was largely a guessing game. "The pediatric rheumatologists were simply using data from adults, " says Giannini. "They'd say, `Well, they had good results with d-penicillamine in adults so we should try it in kids.' The trouble was they just had to guess at the [kid-size] dose." For drug manufacturers, which typically fund the studies that prove which drugs work and at what doses, initiating studies in kids hardly seemed worth the effort. Kids with arthritis represented such a small portion of the market for their drugs that they weren't likely to recoup the cost of studies in kids. Furthermore, there weren't enough kids at any one medical center or even a few centers to study a drug. Arranging a large, multi-center trial was a complicated, time-consuming and expensive proposition. In the early 1970s, a few pioneering rheumatologists came up with a solution that would help both drug companies and kids: to form a network of medical centers that would conduct trials for drug companies. Thus, the Pediatric Rheumatology Collaborative Study Group PRCSG ; , originally a network of seven centers, was started. "We went knocking on pharmaceutical company doors. We contacted the companies and said, `We have a network now and we would really be interested in doing this study for you, '" says Giannini, who is now senior scientist and chief operating officer of the growing group based in Cincinnati. "The companies looked to the pediatric rheumatologists to do the study and to get the drugs approved for kids.
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