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Increase from 2002 when revenue stood at around US$9.8 billion. Market growth is poised to grow steadily over the next few years at a compound annual growth rate of 10%. Growth rates are expected to peak towards 2010 as more drugs lose their patent protection and numerous generic equivalents of branded drugs enter the market. From an estimated US$19.0 billion in 2009, revenues are forecast to expand to US$21.2 billion in 2010. Nearly 340.9 million prescriptions, out of an estimated total of 620 million, were for generics or biogenerics in 2002. By 2003, this figure rose to almost 374.6 million of an estimated total of 624 million, representing annual cost savings of US$24.9 billion over branded medications. Such prescriptions are expected to nearly double to 684.1 million in 2010, with cost savings correspondingly set to rise to US$40.3 billion. Several factors are combining to create an environment conducive to the growth of generics. Firstly, the projected patent expiration of over 35% of the top-selling pharmaceuticals by the end of 2004 is set to generate key opportunities for generic drug manufacturers. Recent patent expirations of branded drugs include Claritin for allergy relief, Paxil for anti-depression, Diflucan as an anti-fungal and for AIDS, Noorvasc for hypertension and Mevacor and Zocor for the treatment of cholesterol. Governments are also encouraging doctors to prescribe generics and pharmacists to dispense them. Efforts are being made to promote greater awareness about the true value of generics among consumers. As direct-to-consumer DTC ; advertising of pharmaceuticals is banned in Europe, awareness about branded drugs is low. This has underlined a preference for cost-competitive generics. At the time of press, generics are gradually being recognised as critical tools for advancing competition, innovation and employment in the EU pharmaceuticals markets. On-going structural reforms are set to streamline regulatory procedures and accelerate the process of approving novel generics. New EU legislation, likely to come into effect in 2005, is also expected to support generic research and development R&D ; prior to the patent expiry of drugs.
Table 2. Cases by agent type and age.
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Nurse Prescribing Issues continued ; Dr Sue Waterworth wanted to bring up via Lynda Ramsay ; issues around nebulisers, that they were left at patients homes by the GPs and not retrieved, implication was the district nurses could supply some but they do not have any supplies. Question was asked if we PCT ought to purchase more to make up the shortfall. Group then discussed nebuliser use in general and many GPs felt that they no longer issue nebulisers due to issues around sterilisation. Basil Penney was going to take this issue to the Respiratory LIT Group for further discussion in the next couple of weeks and would then feed back to the group. No further action on this required by the Prescribing Sub Committee. Request was made for the Nurse Prescribing Update Sessions, Chris Williams has been looking at this and after the completion of his Supplementary prescribing course. In addition, Anne Henry, pharmaceutical adviser from Durham and Chester-le-Street is to be seconded to the Strategic Health Authority in January to look at Nonmedical prescribing. 11 Safe Medicines Management Group Linda Neely If any medicines issues arose, request was made to please bring to the attention of the pharmacy team as soon as possible. An example of sort of things to report was highlighted as the quality of prescribing provided by Primecare for Out of Hours. Each community pharmacy and GP practice have been given the template to report significant events on and pass back to the PCT for action. Following such reports, Primecare have responded in a positive manner to rectify issues. From the latest Safe Medicines Management Group Meeting Revaxis and Repevax were mentioned as having been mixed up due to similar names and similar types of packaging. Also reported was sulfadiazine and sulfasalazine at an EMIS practice, this appears to have been a computer error. The Walk In Centre PGD list was then distributed to those present as the date for the opening of the Walk In Centre was scheduled for January and the next Prescribing Sub Committee meeting would not happen until February. Dr Russell thanked Linda for all the hard work involved in putting together these PGDs. Dr Sloss, Consultant Microbiologist has been consulted about antibiotic PGDs. 12 County Durham and Darlington Medicines Management Group This latest meeting was attended by Dave Russell and Sally Bell. The purpose of this group is to approve any new drugs. The shared care group would also be setting up some guidance soon.
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| So, you come in and you look and you see all these minutes that you want to catch up on. You see the ones from the 7th saying it's SARS, then you see the one from the 13th saying it's not SARS, back to normal, and then you go and read what's going on in the hospital, relaxing things. The confused messages that people were given was just incredible. And it wasn't just senior administration, it was also coming from Public Health. They waffled. Everybody was waffling constantly because it was new territory, they didn't know. If it happened again, I think the thinking now would be, "let's use every precaution that we think is necessary in order to prevent outbreak, " but three years ago it was, "let's not alarm people; let's not close up; let's not affect our position and what's the spin that we can put on it?" "What can we do to get things back to normal as quickly as possible." I think the attitude of all hospitals and Public Health would be different if this happened again. That's what should come out of it, that you use as many precautions as are required to ensure that staff and patients are safe. And you go overboard with prevention. Despite the sense of dismissal and dissatisfaction among some of the staff after the meeting, the message sent to hospital officials after the meeting was that things were back on track. A May 13 email from the unit administrator of the psychiatric unit to a senior hospital official said: . thanks so much for the meeting with my staff. I know it made a difference for them. A followup in this series of emails also included the following description of the meeting by the unit manager: It went very well and I thank you for your help and support. I know the staff felt heard . Based on these emails, the message that went up the chain of command was that the meeting and the messages provided at the meeting were well received. Again, there was a disconnect between the front-line staff and upper management. The front-line staff still thought these cases were SARS and were concerned about the hospital's handling of these cases. The hospital thought that the matter had been resolved and that it was time to move forward to a return to normal. However, as the unit administrator explained, the email was intended to thank 537 and oxycodone, because norvasc tablets.
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Emilia Asadova '02 wrote two articles, "I Have a Dream., " and "Truly Irish Celebration, " which were published in English in the magazine, Time Out Tashkent. She also participated in a conference on March 10 dedicated to the U.S.-Uzbekistan Awards for Excellence in Teaching English and American Studies TEA ; , and volunteered by translating the speech of the U.S. Ambassador John Purnell. Kamol Dustmukhamedov '03 became the district leader for politics and law of the youth organization, Komolot. His responsibilities include organizing different seminars for youth leaders on topics such as discrimination, children's rights, and community service. He is also responsible for managing various community service projects, such as visits to orphanages and veterans' homes. The purpose of the seminars and community service activities is to develop concepts of democracy and civil society among schoolchildren. Nigora Dehkanova '00 and Raihon Izimbetova '98 became co-founders and directors of the Karakalpak Republican non-governmental organization NGO ; , `Kadem, ' which stands for Karakalpak Democracy, and also means "step" in Uzbek. Their mission is to contribute to the development of democratic processes in Karakalpakstan and Uzbekistan by providing non-biased information on health, economic, and social issues, to support youth initiatives to improve the community, to promote mutual understanding between Uzbekistan and its international partners in development, to provide information to help individuals develop their professional abilities and personal health and to disseminate the most recent information on educational opportunities. As one of its first acts of business, Kadem invited Peace Corps volunteers and alumni, including Yusup Karadaliev '97 and Valeriya Proskurnova '03, to celebrate International Women's Day on March 8. Saida Ismailova '01 and Yulia Thay '02 were accepted to Handong Global University, located in the city of Pohang, South Korea. They applied as foreign students from a developing country and have been admitted on a full scholarship basis. Azim Musaev '94 is working as a visa assistant in the British Embassy. Azim and more than 10 other alumni were invited to an evening reception at the residence of the British Ambassador, which was devoted to the elections of the president, general secretary, and welfare executive of Westminster International University in Tashkent. Stanislav Kim '02 was elected on March 12 general secretary of Westminster International University in Tashkent. Alexandr Pak '03 took second place in the FLEX Logo Contest, organized by the Bureau of Educational and Cultural Affairs of the U.S. State Department. Aliya Prenova '03 participated in the Open Debate Tournament held at the American University in Central Asia AUCA ; from March 26-28. The tournament was held at the AUCA Debate Club with the support of American Councils in Kyrgyzstan. Twenty-four teams participated in the tournament from Uzbekistan, Kazakhstan, and Kyrgyzstan. Aliya's team finished first in the preliminary rounds of the tournament, winning all four debates. In the quarterfinals, however, Aliya's team lost to another team from Uzbekistan. Aliya finished seventh in the competition for best speaker. Timur Chutbaev '00 also participated in the tournament and his team vanquished Aliya's team in the quarterfinals to finish in third place overall. Atabek Rimbaev '01 and Raihon Izimbetova '98 are working on organizing a Students' Union in Karakalpak State University. Raihon has created a Leadership Club in her law department and Atabek publishes monthly and pepcid.
The Company's ability to commercialize its existing or new products successfully may depend in part on the extent to which reimbursement for the costs of such products and related treatments will be available from government health administration authorities, private health insurers and other organizations. Third party payers are increasingly challenging the price of medical products, diagnostics and services. Significant uncertainty exists as to the reimbursement status of newly approved health care products, and there can be no assurance that adequate third party coverage will be available to enable the Company to maintain price levels sufficient to realize an appropriate return on its investment in product development. 2.2.9 Product Liability Claims and Uninsured Risks, for example, norvaac fda.
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The flu is a contagious disease caused by the influenza vaccine. The flu comes on suddenly with fever, headache, tiredness, dry cough, sore throat, stuffy nose and body aches. Most people recover from the flu in one to two weeks. Some people develop serious complications such as pneumonia. Complications can be serious enough to result in hospitalization and death in some cases. People over 65 years of age, those with serious chronic health problems, and very young children have an increased risk of severe illness. The flu is spread through the air when someone with the flu coughs, sneezes, or speaks. The virus enters the body by the nose, throat, and lungs resulting in the symptoms of flu. Flu vaccine offers protection against the flu and is strongly recommended for people at risk of serious illness from the flu. People who should consider the flu vaccine are: Anyone over 65 years of age Adults and children over 6 months of age who have chronic health conditions such as heart disease, asthma, kidney disease, etc. Women who will be more than 3 months pregnant during the flu season. Children and teenagers 6 mos to 18yrs ; who are on long term aspirin therapy and therefore at risk of Reye Syndrome after the flu and plavix.
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My, how time flies, it seems just like yesterday that we produced our first edition of the Sabex Bulletin and here we are with Volume two, edition one! It gives me great pleasure in this issue to introduce you to the Sabex Hospital Division sales and support team. I extremely proud of their professionalism and their exceptional contributions to the success of Sabex. now you can put faces to the names, simply turn to the backcover! We continue to depend on you, our healthcare partners, to make suggestions for each edition and I look forward to reviewing your comments and suggestions and plendil and norvasc, for instance, norvasc 10mg.
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Anthropometric Assessment 1. Body Mass Index BMI ; weight in kg ; height in m ; 2 BMI 19 0 points b. BMI 19 to 21 point c. BMI 21 to 23 points d. BMI 23 3 points 2. Mid-arm circumference MAC ; in cm a. MAC 21 0.0 points b. MAC 21 22 0.5 points c. MAC 22 1.0 points 3. Calf circumference CC ; in cm points b. CC 31 point 4. Weight loss during last 3 months a. weight loss greater than 3 kg 6.6 lb ; 0 points b. does not know 1 point c. weight loss between 1 and 3 kg 2 points d. no weight loss 3 points General Assessment 5. Lives independently not in a nursing home or hospital ; a. no 0 points b. yes 1 point 6. Takes more than 3 prescription drugs per day a. yes 0 points b. no 1 point 7. Has suffered psychological stress or acute disease in the past 3 months a. yes 0 points b. no 1 point 8. Mobility a. bed or chair bound 0 points b. able to get out of bed chair but does not go out 1 point c. goes out 2 points 9. Neuropsychological problems a. severe dementia or depression 0 points b. mild dementia 1 point c. no psychological problems 2 points 10. Pressure sores or skin ulcers a. yes 0 points b. no 1 point Dietary Assessment 11. How many full meals does the patient eat daily? a. 1 meal 0 points a. 2 meals 1 point a. 3 meals 2 points 12. Selected consumption markers for protein intake At least one serving of dairy products milk, cheese, yogurt ; per day Yes No Two or more servings of legumes or eggs per week Yes No Meat, fish, or poultry every day Yes No a. 0 yes 0.0 points b. 2 yes 0.5 points c. 3 yes 1.0 points 13. Consumes two or more servings of fruits or vegetables per day a. no 0 points b. yes 1 point 14. Has food intake declined over the past 3 months due to loss of appetite, digestive problems, chewing or swallowing difficulties? a. severe loss or appetite 0 points b. moderate loss of appetite 1 point c. no loss of appetite 2 points 15. How much fluid water, juice, coffee, tea, milk . ; consumed per day? 1 cup 8 oz. ; a. less than 3 cups 0.0 points b. 3 to cups 0.5 points c. more than 5 cups 1.0 points 16. Mode of feeding a. unable to eat without assistance 0 points b. self-fed with some difficulty 1 point c. self-fed without any problem 2 points Self-Assessment 17. Do they view themselves as having nutritional problems? a. major malnutrition 0 points b. do not know or moderate malnutrition 1 point c. no nutritional problem 2 points 18. In comparison with other people of the same age, how do they consider their health status? a. not as good 0.0 points b. do not know 0.5 points c. as good 1.0 points d. better 2.0 points.
For management of infants with diarrhea, see the section in the cdc’ s book “ health information for international travel”.
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For example, they are generally not necessary in a patient with a reasonably definite drug cause for cutaneous vasculitis and mild arthralgia, but some or all of these would be indicated for a patient with severe vasculitis or recurrent unexplained episodes.
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