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Avandia product group sales declined to 1.2 billion Sales of Avandia products, for the treatment of type 2 diabetes, fell 29% to 780 million in the USA, with fourth quarter sales down 55% to 130 million, following publication in May of a meta-analysis. Outside the USA, sales in Europe grew 4% for the year to 227 million, and in International markets, sales declined 7% to 212 million. Other key pharmaceutical growth drivers delivered combined sales of 2.9 billion, up 25% Sales of Lamictal, for the treatment of epilepsy and bipolar disorder, grew 18% to 1.1 billion, driven by sales in the USA which were up 26% to 892 million. The company expects to respond to the FDA's approvable letter for Lamictal XR around mid-year. Sales of Valtrex, for herpes, rose 18% to 934 million, with US sales up 20% to 668 million, driven by increased use of the product for prevention of transmission. Sales in Europe grew 9% to 120 million and in International grew 13% to 146 million. Sales of Requip, for Parkinson's Disease Restless Legs Syndrome, grew 36% to 346 million. Requkp XL, a new once-daily formulation for Parkinson's Disease, has now been approved in 13 European countries and launched in 7 markets. Further European approvals are anticipated during 2008. In the USA, GSK expects a response from the FDA on its application for Requpi XL during the first half of 2008. Avodart, for benign prostatic hyperplasia enlarged prostate ; , continued to perform strongly with sales up 38% to 285 million for the year. Positive data from the CombAT study assessing use of Avodart and the alpha-blocker, tamsulosin, as combination therapy ; were recently published in the Journal of Urology. GSK has filed for a co-prescription indication in the USA, Europe and other International markets. A response is expected from the FDA during the second quarter of 2008. GSK's co-promotion income for Boniva Bonviva, the only once-monthly medicine for post-menopausal osteoporosis, was up 79% to 161 million. Arixtra, for deep vein thrombosis and pulmonary embolism, delivered strong growth with sales up 81% to 100 million. Sales grew strongly in Europe up 70% to 39 million ; , following approval last year for the treatment of specific acute coronary syndromes ACS ; . The ACS approval was supported by data showing that Arixtra had similar efficacy to Lovenox, but Arixtra patients had a significantly lower risk of bleeding and a significant mortality benefit compared to Lovenox. In the USA, GSK anticipates submitting a response to the FDA's approvable letter for a potential ACS indication in the first half of 2008. Newly launched NCEs Tykerb Tyverb, for breast cancer, achieved sales of 51 million for the year, with US sales of 36 million following successful launch of the product in March. In December, the EMEA granted a positive opinion for approval of Tyverb and a decision for approval from Japanese regulatory authorities is expected later this year. Veramyst Avamys, for allergic rhinitis, generated sales of 21 million, following launch in the USA in June 2007. In January 2008, GSK received European approval for Avamys nasal spray to treat allergic rhinitis in adults and children. A licence application is currently under review with regulatory authorities in Japan. Altabax Altargo, a first in class antibacterial for treatment of skin infections, recorded initial sales of 11 million following approval in 2007. As a novel topical antibacterial, Altabax Altargo provides physicians with an effective new treatment option, requiring half as many doses in fewer days than other topical antibiotics, and has shown a low potential for the development of resistance. Sunlight exposure Exposure of the face, hands and arms unblocked by sunscreen or glass ; for 515 minutes 46 times a week can prevent vitamin D deficiency. The elderly need most frequent exposure; men and women with dark skin need 36 times the exposure for moderately fair skin. Duration of sun exposure to produce 1000 units of cholecalciferol vitamin D3 ; in moderately fair skin varies with latitude and season. Durations specified are at 10 or daylight-saving time ; . Diet Fatty fish e.g. salmon ; , meat, eggs, liver, vitamin Dfortified foods e.g. margarine ; . Supplements.

Requip 250 mg Central nervous system CNS ; disorders Seroxat Paxil is a selective serotonin reuptake inhibitor SSRI ; approved for depression, panic, obsessive compulsive disorder and social anxiety disorder, with approvals being obtained for generalised anxiety disorder and post traumatic stress disorder. Wellbutrin is also an anti-depressant, available in the USA in normal or sustained release tablet formulations. Imigran Imitrex is a 5HT1 receptor agonist used for the treatment of severe or frequent migraine and cluster headache, and has become the reference product in this sector. Naramig Amerge is the Group's newer migraine product. Lamictal is a treatment for epilepsy. Used alone or in combination with other products, it has achieved penetration of this mature market through successful treatment of severe cases. Requjp is a specific dopamine D2-like receptor for the treatment of Parkinson's disease. Zyban is a novel, nicotine-free prescription medicine, available as a sustained-release tablet, for treating the problem of smoking addiction. Respiratory Serevent is a long-acting bronchodilator, and Ventolin a selective short-acting bronchodilator, for the treatment of asthma. Flixotide Flovent and Becotide Beclovent are inhaled steroids for the treatment of inflammation associated with bronchial asthma and chronic bronchitis. Seretide Advair, a combination of Serevent and Flixotide, offers a long-acting bronchodilator and an anti-inflammatory in a single inhaler. Flixonase Flonase and Beconase are intra-nasal preparations for the treatment of perennial and seasonal rhinitis. The Group's respiratory products are now available in a wide choice of delivery systems, including the Diskus Accuhaler, a dry powder multi-dose inhaler. Table of Contents FDA in the fourth quarter of 2007 and is currently under FDA review for the treatment of moderate-to-severe RLS; antiepileptics, such as topiramate from Johnson & Johnson, which is approved for the prevention of migraines; and serotonin norepinephrine inhibitors, such as duloxetine from Eli Lilly, which is approved for the management of painful diabetic neuropathy. We are aware that generic gabapentin is marketed by Alpharma Inc., Pfizer, Teva and IVAX Corp, among others, and that it is prescribed off-label to treat a variety of conditions. We estimate that XP19986 could have several generic drug competitors in the spasticity area. There are several drugs approved for the treatment of spasticity, such as racemic baclofen, diazepam, dantrolene sodium and tizanidine, and many therapies in development, such as Fampridine-SR from Acorda Therapeutics, Inc. and tolperisone from Avigen, Inc., that could compete with XP19986. We estimate that we have at least six competitors in the GERD therapeutic area, including Wyeth, TAP Pharmaceutical Products Inc., Novartis, Addex Pharmaceuticals and AstraZeneca. Competition for XP21279 could include generic L-Dopa carbidopa drugs and other drugs approved for the treatment of Parkinson's disease. These include a combination therapy of L-Dopa carbidopa entecapone marketed in the United States by Novartis as Stalevo ; and dopamine agonists marketed by Boehringer-Ingelheim, GSK and UCB as Mirapex, Requjp and Neupro, respectively ; . In addition, there may be other compounds of which we are not aware that are at an earlier stage of development and may compete with our product candidates. If any of those compounds are successfully developed and approved, they could compete directly with our product candidates. Many of our competitors have significantly greater financial resources and expertise in research and development, manufacturing, preclinical testing, conducting clinical trials, obtaining regulatory approvals and marketing approved products than we do. Established pharmaceutical companies may invest heavily to quickly discover and develop novel compounds that could make product candidates obsolete. Smaller or early-stage companies may also prove to be significant competitors, particularly through collaborative arrangements with large and established companies. In addition, these third parties compete with us in recruiting and retaining qualified scientific and management personnel, establishing clinical trial sites and patient registration for clinical trials, as well as in acquiring technologies and technology licenses complementary to our programs or advantageous to our business. Accordingly, our competitors may succeed in obtaining patent protection, receiving FDA approval or discovering, developing and commercializing medicines before we do. We are also aware of other companies that may currently be engaged in the discovery of medicines that will compete with the product candidates that we are developing. In addition, in the markets that we are targeting, we expect to compete against current market-leading medicines. If we are not able to compete effectively against our current and future competitors, our business will not grow and our financial condition will suffer. Off-label sale or use of generic gabapentin products could decrease sales of XP13512 and could lead to pricing pressure if such products become available at competitive prices and in dosages that are appropriate for the indications for which we or our collaborative partners are developing XP13512. Physicians are permitted to prescribe legally available drugs for uses that are not described in the drug's labeling and that differ from those uses tested and approved by the FDA. Such off-label uses are common across medical specialties. Various products are currently sold and used off-label for some of the diseases and conditions that we or our partners are targeting, and a number of companies are, or may be, developing new treatments that may be used off-label. The occurrence of such off-label uses could significantly reduce our or our partners' ability to market and sell any products that we or our partners may develop. We believe that in all countries in which we hold or have licensed rights to patents or patent applications related to XP13512, the composition-of-matter patents relating to gabapentin have expired. Off-label prescriptions written for gabapentin could adversely affect our ability to generate revenue from the sale of XP13512, if approved for commercial sale. This could result in reduced sales and pricing pressure on XP13512, if approved, which in turn would reduce our ability to generate revenue and have a negative impact on our results of operations. If we fail to attract and keep senior management and key scientific personnel, we may be unable to successfully develop or commercialize our product candidates. Our success depends on our continued ability to attract, retain and motivate highly qualified management, clinical and scientific personnel and on our ability to develop and maintain important relationships with leading clinicians. If we are not able to retain Drs. Ronald Barrett, Kenneth Cundy, Mark Gallop and David Savello, we may. Each strain was tested on 3 separate days, and the modal MICs were determined. b When the E. coli and S. aureus control strains were tested in HTM broth, MIC limits for tests in unsupplemented, cation-adjusted MHB were used. c When HTM supplements were added to one lot of MHB, the H. influenzae and E. coli control strains repeatedly failed to grow; thus, only seven lots could be evaluated with those strains. d NT, not tested; the range of concentrations tested did not permit assessment of this drug-microorganism combination.

Requip tablets DRIVER, MUST have clean DMV, mostly airport transfers. Call Ace Limo for appt. 310 ; 452-7083 GIVE OF YOURSELF volunteers wanted at the discovery shop. Help us contribute to the American cancer society by spending 4 hours per week assisting in our resale shop in Santa Monica. Contact Terry or Shaunna at 310 ; 458-4490 HIGHRISE WINDOW cleaners. Up to .00 w benefits, N ot afraid of Heights. CA ID REQ. Call 714 ; 582-1835 HUMAN RESOURCE coordinator. FT. Seeking individual to manage hiring, records, and payroll processing. Fax resume to 310 ; 450-7518 and sustiva. The only way to be sure if requip is causing any of your symptoms is stop it for a week and then restart it. With the correct dose of requip whatever dose it takes to eliminate your rls ; you should not need ultram or xanax and sinemet.

It is difficult to evaluate and monitor the success of these programmes apart from course feedback forms public health service initiatives measure exposure to the service uptake of educational material, participation in sponsored events and so on ; . Targets specific populations communities. Provides another means of educating and informing smokers and people thinking of starting smoking. Youth, Mori, women, Pacific peoples. To raise awareness of the effects of smoking through education. Health Sponsorship Council, Ministry of Health, District Health Boards, The Heart Foundation, The Cancer Society and many more organisations that are contracted to provide services. Ongoing. Ongoing. Change in attitudes and beliefs of participants; awareness of the effects of smoking within the target population.
Signs and symptoms of acute overdosage, resulting principally from overstimulation of the central nervous system and from excessive sympathomimetic effects, may include the following: vomiting, agitation, tremors, hyperreflexia, muscle twitching, convulsions may be followed by coma ; , euphoria, confusion, hallucinations, delirium, sweating, flushing, headache, hyperpyrexia, tachycardia, palpitations, cardiac arrhythmias, hypertension, mydriasis, and dryness of mucous membranes. Consult with a Certified Poison Control Center regarding treatment for up-to-date guidance and advice. Treatment consists of appropriate supportive measures. The patient must be protected against self-injury and against external stimuli that would aggravate overstimulation already present. Gastric contents may be evacuated by gastric lavage. In the presence of severe intoxication, use a carefully titrated dosage of a short-acting barbiturate before performing gastric lavage. Other measures to detoxify the gut include administration of activated charcoal and a cathartic. Intensive care must be provided to maintain adequate circulation and respiratory exchange; external cooling procedures may be required for hyperpyrexia. Efficacy of peritoneal dialysis or extracorporeal hemodialysis for methylphenidate overdosage has not been established. Dosage should be individualized according to the needs and responses of the patient. Adults Administer in divided doses 2 or 3 times daily, preferably 30 to 45 minutes before meals. Average dosage is 20 to mg daily. Some patients may require 40 to 60 mg daily. In others, 10 to 15 mg daily will be adequate. Patients who are unable to sleep if medication is taken late in the day should take the last dose before 6 p.m. Children 6 years and over ; Methylin should be initiated in small doses, with gradual weekly increments. Daily dosage above 60 mg is not recommended. If improvement is not observed after appropriate dosage adjustment over a onemonth period, the drug should be discontinued. Start with 5 mg twice daily before breakfast and lunch ; with gradual increments of 5 to mg weekly. If paradoxical aggravation of symptoms or other adverse effects occur, reduce dosage, or, if necessary, discontinue the drug. Methylin should be periodically discontinued to assess the child's condition. Improvement may be sustained when the drug is either temporarily or permanently discontinued. Drug treatment should not and need not be indefinite and usually may be discontinued after puberty. Methylin Oral Solution 5 mg per 5 ml is available as a colorless, grape flavored liquid. Bottles of 500 ml . NDC 68188-881-50 Methylin Oral Solution 10 mg per 5 ml is available as a colorless, grape flavored liquid. Bottles of 500 ml . NDC 68188-882-50 Dispense in tight container with child-resistant closure. Storage: Store at 20 to 25C 68 to 77F ; [see USP Controlled Room Temperature]. Methylin is a registered trademark of Mallinckrodt Inc. Ritalin is a registered trademark of Novartis Pharmaceuticals Corp. Manufactured for: Alliant Pharmaceuticals, Inc. 333 North Point Center East, Suite 250 Alpharetta, Georgia 30022 U.S.A. Manufactured by: Mallinckrodt Inc. St. Louis, MO 63134 U.S.A. Rev 022806 d5vl and methotrexate.
In our last Annual Report, we predicted that 2004 would be a challenging year as we felt the full impact of generic competition to Paxil and the introduction of generic Wellbutrin. GlaxoSmithKline managed this year well, thanks to the underlying strength of the business. In fact, GlaxoSmithKline is a much stronger company today than it was a year ago. Our broad-based portfolio of fast-growing products and continued focus on controlling costs enabled us to absorb the loss of more than 1.5 billion of business to generics and still achieve a one per cent increase in global pharmaceutical sales. Turnover of 20 billion grew one per cent at constant exchange rates CER ; , and we achieved our guidance of earnings per share EPS ; at least in line with business performance EPS in 2003 at CER ; . Our EPS grew two per cent to 75 pence in 2004. In 2005, we expect to see faster growth with an EPS percentage CER growth in the low double-digit range on an International Financial Reporting Standards IFRS ; basis. This is being driven by the strong growth of key products and continuing efficiencies in our operations. Our most exciting phase of growth will come when the new compounds and vaccines currently in development start contributing to our performance over the next few years. GlaxoSmithKline has one of the largest and most promising pipelines in the industry, with 140 projects in clinical development as at the end of February 2005 ; , including 88 New Chemical Entities NCEs ; , 32 Product Line Extensions and 20 vaccines. Of these compounds, 43 NCEs have moved into Phase II trials, including compounds to treat HIV, diabetes, blood disorders and multiple sclerosis, and data on at least 15 of these are expected during 2005. In 2005, we also anticipate the launch of six new products, including Rotarix for rotavirus, Vesicare for overactive bladder, Boniva for osteoporosis, Avandaryl for diabetes, Reuqip for restless legs syndrome and Entereg for post-operative bowel disorders. MIGRANAL Limit 4 rx ; RELPAX Limit 12 rx ; 5.2.1 ANXIOLYTICS alprazolam buspirone hcl diazepam lorazepam 5.2.2 SEDATIVE HYPNOTIC DRUGS flurazepam hcl temazepam triazolam zolpidem 5.3 ANTIMANIA DRUGS lithium carbonate, -citrate 5.4.1 CARBAMAZEPINES carbamazepine TEGRETOL XR TRILEPTAL 5.4.2 ANTICONVULSANT BENZODIAZEPINES clonazepam 5.4.3 HYDANTOINS phenytoin phenytoin sodium, extended DILANTIN 30mg kapseal, 50mg infatab PHENYTEK 5.4.4 VALPROIC ACID AND DERIVATIVES valproic acid DEPAKOTE, -ER 5.4.5 SUCCINIMIDES ethosuximide 5.4.6 ANTICONVULSANT BARBITURATES phenobarbital primidone 5.4.7 OTHER ANTICONVULSANTS gabapentin lamotrigine KEPPRA LAMICTAL LYRICA TOPAMAX ZONEGRAN 5.5.1.1 TERTIARY AMINES amitriptyline hcl doxepin hcl imipramine hcl 5.5.1.2 SECONDARY AMINES desipramine hcl nortriptyline hcl 5.5.1.3 SELECTIVE SEROTONIN REUPTAKE INHIBITORS citalopram hbr fluoxetine hcl fluvoxamine maleate paroxetine hcl sertraline hcl 5.5.1.4 OTHER ANTIDEPRESSANTS Step therapy required for brands budeprion sr bupropion hcl, sr mirtazapine nefazodone hcl trazodone hcl venlafaxine CYMBALTA EFFEXOR XR tier 2 at appropriate dose ; WELLBUTRIN XL 150mg 5.6 ANTIVERTIGO AND ANTIEMETIC DRUGS meclizine ondansetron Limit 12 rx ; prochlorperazine maleate trimethobenzamide hcl EMEND Limit 3 rx, tier 3 ; 5.7.1 ANTIPARKINSON ANTICHOLINERGIC DRUGS benztropine mesylate 5.7.2 OTHER ANTIPARKINSON DRUGS bromocriptine mesylate carbidopa levodopa selegiline hcl REQUIP 5.8 ANTIPSYCHOTIC DRUGS clozapine haloperidol thioridazine hcl ABILIFY GEODON RISPERDAL SEROQUEL ZYPREXA 5.9.1 CNS STIMULANT DRUGS amphetamine salt combo methylin, -er methylphenidate er, -hcl ADDERALL XR CONCERTA RITALIN LA 5.9.3 ANTIDEMENTIA DRUGS ARICEPT EXELON NAMENDA RAZADYNE, ER 5.9.4 DRUGS TO TREAT MS * AVONEX PA required ; * COPAXONE PA required, tier 3 ; * REBIF PA required ; 5.9.6 OTHER DRUGS FOR ADHD STRATTERA CHaPter 6: DerMatoloGiCal MeDiCationS 6.1 TOPICAL CORTICOSTEROID DRUGS betamethasone dipropionate, augmented and albendazole.
Stoma. c Thou art the portion of them that gaze on men, the overlordship of Dhatr, the birthplace saved, the seventeenfold Stoma. d Thou art the portion of Mitra, the overlordship of Varuna, the rain from the sky, the winds saved, the twenty-onefold Stoma. e Thou art the portion of Aditi, the overlordship of Pusan, force saved, the twenty-sevenfold Stoma. f Thou art the portion of the Vasus [1], the overlordship of the Rudras, the quadruped saved, the twenty-fourfold Stoma. g Thou art the portion of the Adityas, the overlordship of the Maruts, offspring saved, the twentyfivefold Stoma. h Thou art the portion of the god Savitr, the overlordship of Brhaspati, all the quarters saved, the fourfold Stoma. i Thou art the portion of the Yavas, the overlordship of the Ayavas, offspring saved, the fortyfourfold Stoma. k Thou art the portion of the Rbhus, the overlordship, of the All-gods, being calmed and saved, the thirty-threefold Stoma. There is no single medication or surgery that cures PD and every individual has different needs and levels of disease progression. However, there are a number of different treatments available that may help improve quality of life and delay onset of the nerve damage caused by Parkinson's. A neurologist would prescribe and try different treatments to determine the best choice for an individual. Medication: There are three different types of medications prescribed to alleviate the symptoms of Parkinson's. o Drugs used to increase or mimic function of dopamine in the brain such as carbidopa levodopa Sinemet ; and dopamine agonists--pramipexole Mirapex ; , rotigotine Neupro ; , and ropinirole Requip ; . o Drugs used to balance the chemicals in the brain by lowering excessive chemicals such as acetylcholine. o Drugs to treat non-motor issues such as anti-depressants. Surgery: There is no surgery that can cure Parkinson's, but some surgical options have been successful in improving quality of life for patients. These delicate procedures are typically reserved for individuals that have advanced disease. o Lesioning Surgeries- Small overactive areas of the brain are destroyed to prevent some of the symptoms. These techniques are rarely used in the US. o Deep Brain Stimulation DBS ; - An electrode is implanted into the brain and is used to stimulate the brain, thus reducing some of the motor symptoms of Parkinson's. This also involves implanting a pacemaker under the skin to drive the stimulation and occasional adjustments to the stimulation settings and strattera. The spa has specialized in prenatal, post-partum, Labor, and Infant Massage Training for the past ten years. Experience better pain management without medical interventions, less interventions, shorter birth time. 949-831-1988 stressbustersspa.

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Mammary glands from female Balb-c mice were incubated with growth promoting hormones for 6 days in the presence or absence of 1a OH ; There was no difference observed between the morphology of the control glands and the glands treated with 1a OH ; D5 Figure 1 ; . Neither the alveolar nor the ductal growth was affected by the presence of 1 mM the normal mammary gland culture. Normal-like breast epithelial cells, MCF-12F, were treated with different doses of 1a OH ; 0.15 mM ; as well as with a non-toxic 0.1 mM ; dose of 1a, 25 OH ; 2D3. No significant growth inhibition was observed upon treatment with 1a OH ; D5 doses of 0.11 mM Figure 2 ; . However, at doses 45 mM, 1a OH ; D5 exhibited growth suppression of MCF-12F cells. This suggested that growth inhibition of normal breast epithelial cells requires higher 1a OH ; D5 dose than is necessary for the suppression of the DMBA-induced precancerous lesions 1 mM ; in organ culture 9 ; . Interestingly, there was a slight growth stimulatory 2040% increase in cell number compared with control ; effect during the first 3 days of treatment with 1a OH ; D5 and 1a, 25 OH ; 2D3. These results suggest that 1a OH ; D5 and 1a, 25 OH ; 2D3 do not inhibit growth of normal-like MCF-12F cells and mammary glands in culture. 553. 1 age 2 a possible genetic basis to pd 3 men are more likely to develop pd 4 pesticides and herbicides influence pd development 5 reduced oestrogen levels increase the risk of pd 6 reduced folate levels associated with pd 4 demographics of pd 5 financial burden of pd 6 pathophysiology of pd 7 the market profile of pd 8 current pharmaceutical therapies of pd 9 dopamine precursers as the standard treatments for pd 1 sinemet co-careldopa ; 2 madopar co-benelopa ; 3 carbidopa and benserazide 10 dopamine agonists as treatments for pd 1 ergot-alkaloid-based agents 1 2 parlodel bromocriptine ; 1 3 dopergine lisuride ; is superior to parlodel 1 4 permax pergolide ; 11 apomorphine as additional relief for pd sufferers 1 requip ropinirole ; 1 2 sifrol mirapexin pramipexole ; is the most successful drug in pd 12 n-methyl-d-asparate receptor antagonists nmda ; 13 symmetrel amantadine ; 14 ampa acid receptor antagonist 1 talampanel 15 comt cateh-o-methyl-transferase ; 1 tasmar tolcapone ; as an adjunct therapy 1 2 comptess entacaopne ; to aid pd treatment 16 dopamine and comt combined 1 stalevo careldopa ; 17 anticholinergics antimuscarnic drugs ; 1 congentin benzatropine mesilate ; 1 2 artane trihexyphenidyl ; to control common symptoms 18 antihistamines and antidepressants can aid pd symptoms 19 monoamine oxidase b inhibitors 20 the world market for pd drugs will show significant growth to 2009 21 dopamine agonists dominate the pd drug treatment market 22 sifrol is leading drug treatment of pd 23 current surgical therapy will not become a popular treatment of pd 2 thalamotomy only used to reduce tremors 2 pallidotomy is becoming a more popular treatment for pd 2 3 deep brain stimulation aids in tremor reduction 24 emerging therapies for pd small molecule drugs 2 gene therapy as a new treatment therapy 2 3 rasagiline 2 4 azilect 25 other new drugs in development 2 1 the process of apoptosis in pd 2 pig neuron implantations as new treatments for pd 2 3 nerve growth may have a role in pd treatment 2 4 the implantation of dopamine producing cells as a novel therapy in pd 2 gdnf gene therapy as a new treatment therapy alzheimers disease 1 introduction 2 symptoms and differential diagnosis 3 the risk factors for ad 4 the demographics for ad 5 the financial burden of ad 6 type of protein as a cause for ad 1 neuronal and synaptic loss of ad 2 chromosomal mutations of ad 3 inflammation of ad 7 current ad pharmaceutical drug therapies 1 what is the ad market telling us and aricept. Although this outline is a useful generalization, it does not always apply, nor are the factors that determine the fraction of infected persons in whom the disease will develop completely understood. Age and sex appear to directly affect resistance: mortality and morbidity is much greater among infants, among females in the early adult years and among males during old age. Poor nutrition probably has an effect, but in experimental animals nutritional deficiencies must be extreme to reduce resistance. Racial differences have been offered as factors determining native resistance, with some support, 42 but differences among races in all clinical forms of TB are probably best explained as phase differences in an epidemic wave.43 All races initially exposed in an epidemic as a group are equally susceptible, but eventually the death and survival outcome select out a set of persons relatively more resistant. A growing body of evidence suggests that host genetic factors are important in determining susceptibility to TB.44-46 Other factors that bear upon native resistance include the immunologic status of the host. This is most evident among persons infected with HIV. DNA fingerprinting of M. tuberculosis isolates from TB outbreaks has shown that, among patients with AIDS exposed to an infectious source case, progressive primary TB will develop in 37% within 5 months of exposure.47 Among HIVinfected patients known to have acquired TB infection more than 2 years earlier, the annual risk of reactivation TB is closer to 10%, in contrast to lifetime risks of reactivation of 5% in immunocompetent hosts.48 Figure 3 The pathogenesis of tuberculosis in the infected host. CPH members can now access a wealth of work tools at the touch of a button, following the launch of our Extranet site. The new site will build on our successful internet presence, providing staff with instant links to a wide range of procurement information and data, including work plans and staff forums. Users will be able to take advantage of new initiatives, such as QlikView and Requip NHS, as well as more established resources including policies and procedures information and staff pages. Members can access the site by visiting : nww.nwcph.nhs Turn to page two and three respectively for more information on QlikView and Requip NHS and trileptal.

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