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The Department of Health published a 46-page report Making Progress on Prostate Cancer last November. The Minister responsible, John Reid, pointed out that prostate cancer is the only cancer with a government spending target for research, currently running at 4.2 million per year, up from under 1 million when we started campaigning five years ago ; . All GPs now have a resource pack to help them counsel men worried about prostate cancer. We are told that 98.7% of patients with suspected prostate cancer see a consultant within two weeks of urgent GP referral and the number of consultant urologists has risen by 40% to over 500 since1997. The cancer Tsar, Mike Richards, announced that the number of new cases is rising rapidly over 35% in the last 5 years ; . Much of this is due to the more widespread use of Prostate Specific Antigen PSA ; testing, although ageing of the population is also another factor, as prostate cancer is more common in older men. The incidence is set to rise further in coming years. Prostate cancer is now the most common cancer in men, with 26, 027 new cases diagnosed in England alone in 2001. Five-year survival rates improved from around 42% in the late 1980s to 68% in the late 1990s, due in part to the effects of increased PSA testing and earlier detection. The proportion of tumours diagnosed at an early stage stages I and II ; rose from 52 per cent in 1999 to 60 per cent in 2002. Over the past four years there have been some encouraging and provera.
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The Equal Employment Opportunity Commission EEOC ; expects to release a long awaited proposed rule in June that would in effect "overturn" the infamous Erie County decision. The EEOC is expected to state that reducing or eliminating retiree health benefits when an early retiree becomes eligible for Medicare does not constitute age discrimination under the Age Discrimination in Employment Act ADEA ; . Meanwhile, the Supreme Court has agreed to hear a case involving another twist in the interpretation of ADEA. In General Dynamics v. Cline, younger workers between ages 40 and 50 are claiming reverse discrimination because they lost retiree health benefits while older workers kept them in a negotiated union contract. While a lower court ruled that ADEA was not intended to protect younger workers, an appeals court overturned the decision, stating that ADEA applies to all age discrimination. Two other appellate courts have ruled the other way. IMPACT ON EMPLOYERS: The EEOC rule will reduce potential litigation over retiree health benefits. Had the Erie County decision stood, more employers would have eliminated retiree health benefit programs or cut back health benefits for early retirees. An unfavorable Supreme Court ruling in Cline would reduce employer flexibility in benefit design and likely accelerate the decline in retiree health benefits. IMPACT ON EMPLOYEES: The EEOC rule will help to preserve retiree health benefits, particularly for early retirees, for those employed in companies still offering them. An unfavorable Cline decision would likely mean fewer current employees will be offered retiree health benefits. However, it would also mean that where companies would still offer retiree health benefits, younger workers would receive the same retiree benefits as older workers. OUTLOOK: The EEOC is expected to issue a proposed rule in June that would become final after a 60-day comment period. The Supreme Court will take up the Cline case in the fall and likely issue its decision before its session ends in early summer 2004. BACKGROUND: The EEOC rule would reverse EEOC policy, adopted in November 2000, and since suspended, that followed the decision known as the Erie County case. In that case, a federal appeals court concluded for the first time that ADEA applied not only to active workers and their benefits, but also to retirees. Furthermore, it found that tying a change in health benefits to Medicare-eligibility violates ADEA. Enacted by Congress in 1967, ADEA prohibits employers from discriminating against older workers in the terms and conditions of employment, including their benefits. ADEA does define older workers as those age 40 and above.
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Preclinical research Drug development [91] is a long and costly process. Preclinical research must necessarily identify any prohibitory property of a candidate compound which would inevitably lead to the failure of the approval procedure or withdrawal, after initial authorization, due to serious adverse effects fail early fail cheap ; . Any compound strongly and specifically metabolized by a polymorphous cytochrome carries a high risk of triggering serious undesirable effects in persons with an unfavorable polymorphism. In addition, this type of compound would be implicated in drug interactions, further compromising its future. There is a long list of historical cases: mibefradil, terfenadine, perhexiline, etc. Undesirable pharmacokinetic properties lead to the interruption of clinical trials for 3040% of all compounds tested [92]. Inversely, the development of a truly innovative molecule should not be prevented by the polymorphism of its metabolism [93]. Several methods have been developed to test in vitro drug metabolism: human recombinant cytochrome P450 proteins, liver microsomes, human hepatocyte cultures, liver slices [94]. Clinical trials When designing clinical trials, genotype can be used a priori, as an exclusion criterion. With this methodology, the study group can be smaller and more homogeneous, though less representative. Using this method, Murphy et al. [95] determined the pattern of the CYP2D6 allele in patients with major depression, using the 'poor metabolizer' trait as an exclusion criterion in order to test the effect of antidepressants. Phase I trials can thus be designed for representative populations of the principal metabolic patterns [96]. Alternatively, the genotype can be used a posteriori, as a stratification factor. Certain authors advocate the use of a 'CYP passport' for volunteers who participate regularly in clinical trials. The passport summarizes all tests performed and would optimize their exploitation [96]. It should also be recalled that ethnic origin has an effect on allelic polymorphism, and that trials conducted in Caucasians may not necessarily be extrapolated to other ethnic groups [97].
About Saw Palmetto Saw palmetto Serenoa repens ; preparations are made from the fruit of a small palm tree which is native to Florida and was a former staple food of Seminole Indians. Saw palmetto berries were widely used by Eclectic physicians of the late 19th and early 20th centuries for a variety of indications, including treating the male reproductive system. Saw palmetto extracts are widely used in Europe and in the past decade in the United States as a natural therapy to help maintain normal prostate and urinary function, particularly by treating the symptoms of BPH in men with mild to moderate cases of BPH. A meta-analysis statistical analysis of a group of studies ; of 18 clinical trials published in the Journal of the American Medical Association 2 and another on 21 clinical trials carried out on over 3000 men as reviewed by the Cochrane Collaboration 3 have confirmed the safety and efficacy of saw palmetto extract preparations in treating symptoms of BPH, usually of stage 1 and 2. The latest meta-analysis 3 concludes that the clinical literature supports the use of saw palmetto preparations in treating symptoms of BPH in stages 1 and 2, and that saw palmetto preparations have shown efficacy and greater safety when compared to conventional pharmaceutical drugs e.g., finasteride, aka Prosar ; . The safety and efficacy of saw palmetto preparations have gained international recognition by various governments and professional health groups. Saw palmetto has been approved by the German government's respected Commission E 4 and the Canadian government's Natural Health Products Directorate. 5 It is also recognized by leading scientists and physicians in Western Europe through a positive monograph by the European Scientific Cooperative on Phytotherapy ESCOP ; , which acknowledges its efficacy for symptomatic treatment of micturition urinary ; disorders in mild to moderate BPH. 6. The World Health Organization also recognizes the efficacy of saw palmetto for treating lower urinary tract symptoms secondary to BPH stages I and 2. 7 Additional recent reviews of the medical and scientific literature have concluded that saw palmetto extract preparations are safe and effective for treating symptoms of BPH. These include The ABC Clinical Guide to Herbs 8 and others. 9 The American Botanical Council has made the complete saw palmetto chapter from ABC Clinical Guide to Herbs available online in PDF format, including Clinical Overview, Patient Information Sheet, and complete monograph which reviews 19 clinical studies. You may access this resource by clicking the following link: : herbalgram files pdfs Saw Palmetto . Saw palmetto is frequently combined with other herbs that have shown benefit for prostate function to produce safe and effective preparations that have been clinically documented. For example, a leading European saw palmetto preparation also contains the root of nettle Urtica dioica ; , for which several recent randomized controlled clinical trials have shown safety and efficacy, the most recent, conducted on 257 men in Russia, was published in July 2005. 10 The large success of most saw palmetto trials has driven preparations of this traditional herb to large consumer acceptance, not only among natural health enthusiasts, but also in the mainstream market. In 2004 and 2005 retail sales of saw palmetto preparations ranked third behind only garlic and echinacea ; , according to market report articles in the ABC's quarterly, peer-reviewed article HerbalGram. 11, 12 The NEJM article cited a 2002 survey showing that about 2.5 million men were estimated to have been using saw palmetto preparations. ABC estimates that saw palmetto retails sales in all channels of trade in the U.S. may be as high as $100-120 million or possibly more. About the American Botanical Council Established in 1988, the American Botanical Council ABC ; is the leading nonprofit, member-based international organization working to educate consumers, healthcare professionals, researchers, educators, industry, and the media on the safe and effective use of herbs and medicinal plants products. ABC is located on a 2.5 acre site in Austin, Texas where it publishes HerbalGram, a peer-reviewed quarterly journal. ABC is also the publisher of The ABC Clinical Guide to Herbs, a continuing education and reference book, which contains extensive monographs on the safety and efficacy of 29 popular herbs. More information is available at.
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1. Checking of drug records -- bin card entries, posting of drugs to OP registers, correctness of entries and balances in OP antibiotics sulfonamides registers. 2. 3. 4. Checking of patient attendance records -- males, females, children, ANC, FP, total cases per month. Studying disease patterns from records and advising on supplementary drugs needed. Ensure rational use of drugs -- identify problems related to misuse of drugs and educate the staff accordingly. Justify the number of drug kits received by each rural health facility. Ensure proper storage of drugs. and redistributing them to needy stations.
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