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NQF staff prepared detailed measure evaluations using standardized criteria established in NQF's National Framework for Healthcare Quality Measurement and Reporting. Information for the measure evaluations was obtained from the measure developers, literature review, and independent research. The SC reviewed the measure evaluations and made recommendations based on the perceived strengths and weaknesses of each measure and technical reasons why the measure should or should not be recommended. The SC also clarified issues on specifications with the measure developers.
Methods this was an open study to determine the pharmacokinetics of a single bolus dose of 5 mg triptorelin acetate in four groups of six male subjects; namely in healthy subjects group i ; , in patients with varying degrees of renal insufficiency groups ii and iii ; , and in patients with hepatic insufficiency group iv.
The following codes for treatments and procedures applicable to this guideline are included below for informational purposes. Inclusion or exclusion of a procedure, diagnosis or device code s ; does not constitute or imply member coverage or provider reimbursement policy. Please refer to the member's contract benefits in effect at the time of service to determine coverage or non-coverage of these services as it applies to an individual member. HCPCS J1675 J1950 J3315 Injection, histrelin acetate, 10 mcg Injection, leuprolide acetate for depot suspension ; , per 3.75 mg Lupron Depot ; Injection, triptorelin pamoate, 3.75 mg Trelstar Depot, Trelstar LA.
Al-Omari WR, Nassir UN and Sulaiman WR 1999 ; Estrogen and lipid prole in patients with endometriosis treated by GnRH agonist. Int J Obstet Gynecol 66, 191192. Al-Omari WR, Nassir UN and Izzat B 2001 ; Estrogen `add-back' and lipid prole during GnRH agonist triptorelin ; therapy. Int J Obstet Gynecol 74, 6162. Black LJ, Sato M, Rowley ER, Magee DE, Bekele A, Williams DC, Cullinan GJ, Bendele R, Kauffmann RF and Bensch WR 1994 ; Raloxifene LY139481 HCL ; prevents bone loss and reduces serum cholesterol without causing uterine hypertrophy in ovariectomized rats. J Clin Invest 93, 6369. Broekmans FJ, Hompes PGA, Heitbrink MA, Netelenbos CC, Roos JC, Falke TM and Schoemaker J 1996a ; Two-step gonadotropin-releasing hormone agonist treatment of uterine leiomyomas: standard-dose therapy followed by reduced-dose therapy. J Obstet Gynecol 175, 12081216. Broekmans FJ, Heitbrink MA, Hompes PG, Schoute E, Falke T and Schoemaker J 1996b ; Quantitative MRI of uterine leiomyomas during triptorelin treatment: reproducibility of volume assessment and predictability of treatment response. Magn Reson Imaging 14, 11271135. Bryant HU, Glasebrook AL, Yang NN and Sato M 1996 ; A pharmacological review of raloxifene. J Bone Miner Metab 14, 19. Carr BR, Marshburn PB and Weatherall PT 1993 ; An evaluation of the effect of gonadotropin-releasing hormone analog and medroxyprogesterone acetate on uterine leiomyomata volume by magnetic resonance imaging: a prospective, randomized, double-blind, placebo-controlled, crossover trial. J Clin Endocrinol Metab 76, 12171223. Cheung T-H, Lo KW-K, Lam CW-K, Lau W-C and Lam PK-W 2000 ; A crossover study of triptolin and leuprolide acetate. Fertil Steril 74, 299305. Clemett D and Spencer CM 2000 ; Raloxifene: a review of its use in postmenopausal osteoporosis. Drugs 60, 379411. Cranney A, Tugwell P, Zytaruk N, Robinson V, Weaver B, Adachi J, Wells G, Shea B, Guyatt G, The Osteoporosis Methodology Group and The Osteoporosis Research Advisory Group 2002 ; Meta-analyses of therapies for postmenopausal osteoporosis. IV. Meta-analysis of raloxifene for the prevention and treatment of postmenopausal osteoporosis. Endocr Rev 23, 524528. Cucinelli F, Soranna L, Romualdi D, Muzj G, Mancuso S and Lanzone A 2002 ; The effect of raloxifene on glyco-insulinemic homeostasis in healthy postmenopausal women: a randomized placebo-controlled study. J Clin Endocrinol Metab 87, 41864192. DeLeo V, la Marca A, Morgante G, Lanzetta D, Setacci, C and Petraglia F 2001 ; Randomized control study of the effects of raloxifene on serum lipids and homocysteine in older women. J Obstet Gynecol 184, 350 353. Efstathiadou Z and Tsatsoulis A 2001 ; Long-term remission of ovarian hyperandrogenism after short-term treatment with a gonadotropin-releasing hormone agonist. Fertil Steril 75, 5962. Friedewald WT, Levy RI and Fredrickson DS 1972 ; Estimation of lowdensity lipoprotein cholesterol in plasma without use of the preparative ultra centrifuge. Clin Chem 18, 499502. Friedman AJ, Daly M, Juneau-Norcross M, Rein MS, Fine C, Gleason R and Leboff M 1993 ; A prospective, randomized trial of gonadotropin-releasing hormone agonist plus estrogenprogestin or progestin `add-back' regimens for women with leiomyomata uteri. J Clin Endocrinol Metab 76, 14391445. Friedman AJ, Daly M, Juneau-Norcross M, Gleason R, Rein MS and Leboff M 1994 ; Long-term medical therapy for leiomyomata uteri: a prospective.
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10. Food and Drug Admistration. Class II special controls guidance document: antimicrobial susceptibility test systems; guidance for industry and FDA. 2003. Food and Drug Administration, Washington, D.C!
The thesis is based on the following five scientific research papers, which will be referred to by their Roman numerals in the text. I. C. W. Torne, H. Agers, H. A. Nielsen, H. Madsen, and E. N. Jonsson. Population pharmacokinetic modeling of a subcutaneous depot for GnRH antagonist degarelix. Pharm. Res., 21 4 ; : 574584 2004 ; . II. C. W. Torne, H. Agers, H. Madsen, E. N. Jonsson, and H. A. Nielsen. Non-linear mixed-effects pharmacokinetic pharmacodynamic modelling in NLME using differential equations. Comput. Methods Programs Biomed., 76 1 ; : 3140 2004 ; . III. C. W. Torne, H. Agers, H. A. Nielsen, H. Madsen, and E. N. Jonsson. Pharmacokinetic Pharmacodynamic Modelling of GnRH Antagonist Degarelix: A Comparison of the Non-linear Mixed-Effects Programs NONMEM and NLME. J. Pharmacokinet. Pharmacodyn., 31 6 ; : 441461 2004 ; . IV. C. W. Torne, R. V. Overgaard, H. Agers, H. A. Nielsen, H. Madsen, and E. N. Jonsson. Stochastic Differential Equations in NONMEM: Implementation, Application, and Comparision with Ordinary Differential Equations. Pharm. Res., 22 8 ; : 12471258 2005 ; . V. C. Torne, H. Agers, T. Senderovitz, H. A. Nielsen, H. Madsen, M. O. Karlsson, and E. N. Jonsson. Mechanism-based population PK PD modeling of the hypothalamic-pituitary-gonadal axis following treatment with GnRH agonist triptorelin and GnRH antagonist degarelix. Pharm. Res., Submitted 2005 and trizivir.
Over the coming months as Elan progresses towards the more pharmaceutical focused business model the key drivers of the stock can be isolated, which will allow for a re -rating of Elan. Drug launches will increase the impact of pharmaceutical product sales on total revenues. We forecast drugs launched by Elan between 2000 and mid -2001 will account for over 0 million of revenues by 2003, 29% of total revenues. In this report we focus on Elan's pharmaceutical product pipeline, the main driver of growth going forward as pharmaceutical products contribution to revenues increases from 55% in 1999 to 84% in 2003.
NOTE: CMS will be implementing this policy in a separate CR in January 2005; however, CMS will An LTCH's ALOS will be calculated by using days and discharge data for only those patients discharged make these changes retroactive to July 1, 2004. during the cost-reporting period. 2. Satellite facilities and remote facilities of Presently, the days in the hospital and the discharge hospitals that spin off as separate hospitals dates are reported in the cost-reporting period when and seek LTCH status they occurred, as under the TEFRA system. An example of this change is as follows: If a satellite or remote location of multi-campus LTCHs "spins-off" to become an independent For a hospital on a calendar year cost report, the data LTCH, such a facility must comply with existing for the patient that was admitted on 12 15 and requirements for LTCH designation by first being discharged on 1 15 would have no impact on the certified as an independent hospital and then prefirst cost-reporting period, but would include 31 days senting discharge data to its fiscal intermediary and one discharge in calculating the ALOS for the indicating that once it became a separate, indepensecond cost-reporting period. dent hospital, it met the Average Length of Stay ALOS ; requirement for Medicare patients for at This change for cases that crosses cost-reporting least five of the next six months. periods would make the methodology for data collection for ALOS purposes consistent with the and troleandomycin.
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State laws prohibiting syringe sales without a prescription, or possession of a syringe for the purpose of injecting illegal drugs, have made sterile syringes hard to come by and led to substantial sharing and the spread of incurable diseases at epidemic levels. In minority populations that are subjected to considerable police presence, injectors avoid carrying syringes for more than a minimal period of time, in order to avoid arrest, but thereby causing needle sharing to occur with even greater regularity. An African American drug injector is almost five times as likely to be diagnosed with HIV as a white drug injector, and a Latino drug injector is more than three times more likely. Needle exchange programs, which increase the availability of sterile syringes, are an important practice for reducing HIV infection and other blood-borne diseases, such as hepatitis B and C, among the most rapidly growing population of HIV infection, injection drug users and their often unknowing sexual partners and children. Most needle exchange programs operate on a one-for-one exchange so they also reduce the occurrence of infected needles in playgrounds, streets and trash receptaclesprotecting children, sanitation workers and others from needle sticks. Needle exchanges have been operating legally and illegally in the United States since at least 1988. In the last decade, much has changed - from a beginning of a few lone individuals exchanging on the streets, there are now at least 113 programs in 80 cities and 32 states around the country, and over 17 million syringes were exchanged in 1997 the last official survey on needle exchange ; . While the debate in Washington has been fairly inactive, steps forward on the state level have been made in many areas. In fact, 68 out of 113 of the needle exchanges participating in the 1997 survey were either legal or illegal but put up with by local officials. Extensive studies by the nations leading public health and scientific agencies have shown that needle exchange programs do not raise the regularity of drug use and do not increase the number of new drug injectors. Additionally, needle exchange programs involving drug counseling and drug treatment program referrals increase the possibility of really reducing drug abuse. The policy of the American Medical Association is to encourage needle exchange programs. The decision that supported this policy statement acknowledged that syringe exchange programs reduce occurrences of HIV infection and that a harmful price due to these exchange programs has not been detected. However, the AMA is only one
Coding for Products and Services CPT 1 Codes HCPCS Level I codes, more commonly known as Current Procedural Terminology CPT ; codes, are used to bill for professional services. The CPT codes include a comprehensive list of surgical and medical procedures performed by physicians, as well as codes for medical consultations, visits, and diagnostic tests. For example, physicians administering Trelstar would use CPT codes to bill for some professional services surrounding the administration of the drug. For 2006, the American Medical Association AMA ; created new CPT codes to bill for drug administration services. Sample codes that may be used to bill for Trelstar and its administration in the physician office are shown in Table 1. Please note that individual payers may have specific coding requirements that differ from the examples given in this guide. Also, appropriate code s ; may vary by payer and site of service. HCPCS Codes HCPCS Level II codes, also known as HCPCS codes, are used to report some medical services, drugs, and supplies. For billing in the physician office setting, Medicare, Medicaid, and most private payers accept the Healthcare Common Procedure Coding System HCPCS ; for the coding of procedures and physician-administered drugs. For example, physicians administering Trelstar would use a "J" code to bill for the drug. Effective date of service January 1, 2006, providers can use the following HCPCS code to submit claims for Trelstar Depot and Trelstar LA: J3315 injection, triptorelin pamoate ; per 3.75 mg This code should be used for Medicare and most non-Medicare payers.2 Please note, billing unit amounts for J3315 are recorded in increments of 3.75 mg. For one dose of Trelstar Depot 3.75 mg ; , providers should indicate one billing unit. For one dose of Trelstar LA 11.25 mg ; , providers should indicate three billing units and trovafloxacin.
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Placebo Response Over 24 N 156 ; Hours Complete Response 71 45% ; 95 57% ; * 73 47% ; * 55 35% ; 78 51% ; * Nausea Score 5 * 4 * 6 * .05 vs placebo : The recommended dose : No emetic episodes and no rescue medication. : Median 24-h change from baseline nausea score using visual analog scale VAS ; : Score range 0 "none" to 100 "nausea as bad as it could be.
Masaki. Involvement of endothelin in the regulation of human vascular tonus. Potent vasoconstrictor effect and existence in endothelial cells. Circulation 81: 18741880, 1990. Miyauchi, T., M. Yanagisawa, K. Iida, R. Ajisaka, N. Suzuki, M. Fujino, K. Goto, T. Masaki, and Y. Sugishita. Age- and sex-related variation of plasma endothelin-1 concentration in normal and hypertensive subjects. Am. Heart J. 123: 10921093, 1992. Miyauchi, T., M. Yanagisawa, T. Tomizawa, Y. Sugishita, N. Suzuki, M. Fujino, R. Ajisaka, K. Goto, and T. Masaki. Increased plasma concentrations of endothelin-1 and big endothelin-1 in acute myocardial infarction. Lancet 2: 5354, 1989. Musch, T. I., D. B. Friedman, K. H. Pitetti, G. C. Haidet, J. Stray-Gundersen, J. H. Mitchell, and G. A. Ordway. Regional distribution of blood flow of dogs during graded dynamic exercise. J. Appl. Physiol. 63: 22692277, 1987. Musch, T. I., G. C. Haidet, G. A. Ordway, J. C. Longhurst, and J. H. Mitchell. Training effects on regional blood flow response to maximal exercise in foxhounds. J. Appl. Physiol. 62: 17241732, 1987. Norton, K. I., M. T. Jones, and R. B. Armstrong. Oxygen consumption and distribution of blood flow in rats climbing a laddermill. J. Appl. Physiol. 68: 241247, 1990. Onizuka, M., T. Miyauchi, K. Mitsui, N. Suzuki, T. Masaki, K. Goto, and M. Hori. Endothelin-1 mediates regional blood flow during and after pulmonary operations. J. Thorac. Cardiovasc. Surg. 104: 16961701, 1992. Orr, G. W., H. J. Green, R. L. Hughson, and G. W. Bennett. A computer linear regression model to determine ventilatory anaerobic threshold. J. Appl. Physiol. 52: 13491352, 1982. Palmer, R. M. J., A. G. Ferrige, and S. Moncada. Nitric oxide release accounts for the biological activity of endotheliumderived relaxing factor. Nature 327: 524526, 1987. Peuler, J. D., and G. A. Johnson. Simultaneous single isotope radioenzymatic assay of plasma norepinephrine, epinephrine and dopamine. Life Sci. 21: 625636, 1977. Prins, B. A., R. M. Hu, B. Nazario, A. Pedram, H. J. L. Frank, M. A. Weber, and E. R. Levin. Prostaglandin E2 and prostacyclin inhibit the production and secretion of endothelin from cultured endothelial cells. J. Biol. Chem. 269: 1193811944, 1994. Rubanyi, G. M., and M. A. Polokoff. Endothelins: molecular biology, biochemistry, pharmacology, physiology, and pathophysiology. Pharmacol. Rev. 46: 325415, 1994. Shen, W., M. Lundborg, J. Wang, J. M. Stewart, X. Xu, M. Ochoa, and T. H. Hintze. Role of EDRF in the regulation of regional blood flow and vascular resistance at rest and during exercise in conscious dogs. J. Appl. Physiol. 77: 165172, 1994. Suzuki, N., H. Matsumoto, C. Kitada, T. Masaki, and M. Fujino. A sensitive sandwich-enzyme immunoassay for human endothelin. J. Immunol. Methods 118: 245250, 1989. Tabuchi, Y., M. Nakamaru, H. Rakugi, M. Nagano, and T. Ogihara. Endothelin enhances adrenergic vasoconstriction in perfused rat mesenteric arteries. Biochem. Biophys. Res. Commun. 159: 13041308, 1989. Van Citters, R. L. V., and D. Franklin. Cardiovascular performance of Alaska sled dogs during exercise. Circ. Res. 24: 3342, 1969. Yanagisawa, M., H. Kurihara, S. Kimura, Y. Tomobe, M. Kobayashi, Y. Mitsui, Y. Yazaki, K. Goto, and T. Masaki. A novel potent vasoconstrictor peptide produced by vascular endothelial cells. Nature 332: 411415, 1988. Yang, Z., V. Richard, L. Segesser, E. Bauer, P. Stulz, M. Turina, and T. F. Luscher. Threshold concentrations of endothelin-1 potentiate contractions to norepinephrine and serotonin in human arteries. A new mechanism of vasospasm? Circulation 82: 188195, 1990. Yoshizumi, M., H. Kurihara, T. Sugiyama, F. Takaku, M. Yanagisawa, T. Masaki, and Y. Yazaki. Hemodynamic shear stress stimulates endothelin production by cultured endothelial cells. Biochem. Biophys. Res. Commun. 161: 859864, 1989 and truvada.
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Nurturing competency with compassion and caring in healthcare. We are gratified and encouraged by the continuing support of many, as well as the new gifts received during the period October 11, 2000 and October 3, 2001. Thank you sincerely for your part in building The Arnold P. Gold Foundation.
I V relationships are for the most part nonlinear, and IH is larger in POPC than in POPE membranes see legend to Fig. 2 ; showing that attenuation of IH through gA channels in PE bilayers occurs irrespective of [H1] and the intensity of channel current. The distinct I V profiles in 1 M vs. 50 mM HCl is not further investigated here and is consistent with the idea of diffusion limitation of H1 to from the channel. Fig. 4 shows representative I V recordings of single SS channels in bilayers with various fatty acid compositions 1 M HCl ; . The recordings in the top and bottom panels in this figure were obtained in SS channels in distinct PC and PE bilayers, respectively. Fig. 4 demonstrates that the larger gH measured in PC in relation to PE bilayers Figs. 13 ; is not dependent on the fatty acid composition of membranes see Table 1 ; . In both PC and PE bilayers gH values were significantly larger in bilayers with fully saturated fatty acid chains DiPh ; . Also, in bilayers with distinct combinations of unsaturated fatty acid chains there were no remarkable alterations of gH Table 1 ; . In Fig. 5 A, the log-log relationships between gH and [H1]x0 are illustrated for the SS- circles ; , RR-dioxolane linked gA squares, and native gA triangles ; channels in and tums.
Balasch, J., Vidal, E., Penarrubia, J. et al. 2001 ; Suppression of LH during ~ ovarian stimulation: analysing threshold values and effects on ovarian response and the outcome of assisted reproduction in down-regulated women stimulated with recombinant FSH. Hum. Reprod., 16, 16361643. Mannaerts, B., van Hooren, E. and Boerrigter, P. 2000 ; Ganirelix in assisted in reproduction: new treatment regimens and options. In Filicori, M. ed. ; Ovulation Induction, Third World Congress Bologna Italy October 1214, Parthenon, Section, 4, London, pp. 167177. The European and Middle East Orgalutran Study Group 2001 ; Comparable clinical outcome using the GnRH antagonist ganirelix or a long protocol of the GnRH agonist triptorelin for the prevention of premature LH surges in women undergoing ovarian stimulation. Hum. Reprod., 16, 644651. The European Orgalutran Study Group, Borm, G. and Mannaerts, B. 2000 ; Treatment with the gonadotrophin-releasing hormone antagonist ganirelix in women undergoing controlled ovarian hyperstimulation with recombinant follicle stimulating hormone is effective, safe and convenient: results of a controlled, randomized, multicentre trial. Hum. Reprod., 15, 14901498. The North American Ganirelix Study Group 2001 ; Efficacy and safety of ganirelix acetate Antagon Orgalutran ; versus leuprorelin acetate in women undergoing controlled ovarian hyperstimulation. Fertil. Steril., 75, 3845. Westergaard, L.G., Laursen, S.B. and Andersen, C.Y. 2000 ; Increased risk of early pregnancy loss by profound suppression of luteinizing hormone during ovarian stimulation in normogonadotrophic women undergoing assisted reproduction. Hum. Reprod., 15, 10031009.
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BY THE COURT: Well, that's my point. Is how do you earn commissions if you're unable to sell? BY THE WITNESS: We would have given him a job that would have met his salary requirements, the average weekly wage. We would have done that. BY THE COURT: Thank you. Tr.43-47 and tysabri.
Bronfenbrenner 2003: 5 ; views the family as "a whole organism that is much more than merely the sum of individuals or groups that it comprises. During the many years that the family is together, family members develop habitual patterns of behavior and repeat these behaviors a thousand times. In this way each individual becomes accustomed to act and to respond in a specific manner within the family. Each member's actions elicit a certain reaction from another family member over and over again, and over time. These repetitive sequences give the family its own form and style. Family influences may be experienced as an invisible force. This invisible force governs the behavior of the family members every time they are together. These forces include such things as spoken or unspoken expectations, rules for managing conflicts and implicitly or explicitly assigned roles and triptorelin.
It is a small user-friendly program, which can be learnt quickly. The program was apparently made for students of Wageningen University and Larenstein College, and the language and the editing of the manual Swennenhuis, 1989 ; could be improved and ubiquinone
Triptorelin ; is a synthetic GnRH agonist with a longer half-life and a higher potency compared to the naturally occurring GnRH. Compared to natural GnRH, triptorelin has the amino acid L-Glycin in position 6 replaced by D-tryptophan, which increases the affinity to the GnRH receptors in the pituitary [5]. Triptorelin is the active ingredient of GnRH agonist Decapeptyl . Decapeptyl is available as a sustained release formulation called Decapeptyl Depot [41]. Decapeptyl Depot consists of two components, i.e. microparticles including the active ingredient, triptorelin-acetate embedded in a biologically degradable polymer matrix with a residual amount of microparticles hardener, Miglyol, and the suspension medium, which is an isotonic, phosphate-buffered aqueous solution containing Polysorbate 80 and an agent for increasing viscosity.
Attract anti-tumor necrosis factor trial in rheumatoid arthritis with concomitant therapy; crp c-reactive protein; il interleukin; mtx methotrexate; ra rheumatoid arthritis; tnf tumor necrosis factor alpha; vegf vascular endothelial growth factor and ursinus
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