1 2 3 Strategies in prostate cancer prevention tend to focus on ways to slow disease progression and to prolong the time between initial diagnosis and evidence of symptomatic disease. Black race, older age, and family history are well-established risk factors for prostate cancer; data on diet, obesity, and smoking are less clearly defined. The PCPT demonstrated that finasteride could significantly reduce prostate cancer risk, yet the increase in the incidence of high-grade cancers seen on follow-up makes the ultimate role of finasteride in prostate cancer prevention uncertain. Because high-grade PIN is an early predictor of prostate cancer, preventive pharmacologic intervention strategies focusing on men with high-grade PIN are being explored. Cooked tomato-based foods, selenium, and alpha-tocopherol seem to reduce prostate cancer risk, while calcium, dairy foods, and certain dietary fats are among the factors suspected of increasing risk.
Ride 4000 men studied in clinical trials for 6 years ; show that the incidence of adverse effects does not increase with continuation of treatment.3 However, men with AGA are often severely psychologically affected by their hair loss and therefore can be more susceptible to the psychological impact of possible sexual side effects. Our study using an objective method, the IIEF-5 questionnaire, showed that erectile function of all patients remained stable after 4 to 6 months of treatment with finasteride 1 mg ; . Our results support the clinical impression that sexual side effects are actually less common than is reported in clinical trials. This discrepancy may be attributable to the fact that subjects who enrolled in the clinical trials were informed about possible changes in their sexual function and were specifically asked about such changes at every visit, resulting in a higher percentage of reported adverse events than would normally occur. Physicians who prescribe the drug on a daily basis see sexual effects much more rarely, even if they inform their patients about the possible occurrence of these rare side effects. We did not evaluate changes in the ejaculate volume in this study because this subject is not assessed by the questionnaire, although a decrease in ejaculate volume is not rare in our experience. We believe that the IIEF-5 could be routinely administered to subjects who wish to begin taking finasteride but are particularly worried about sexual side effects. In our experience, the questionnaire is well accepted by patients, who are often anxious about the possible occurrence of sexual side effects and who are eager to be carefully followed up during treatment. Accepted for publication October 8, 2003. Correspondence: Antonella Tosti, MD, Department of Dermatology, University of Bologna, Via Massarenti 1, 40138 Bologna, Italy tosti med bo.
A Pertinent to androgenic steroids, cholesterol is converted to various androgen precursors such as DHEA and DHEA-S. B Dexamethasone and other corticosteroids ; can inhibit the adrenal gland production of these androgen precursors. C The ovaries can metabolize these precursors to testosterone; through negative feedback inhibition, hormonal contraceptives can inhibit ovarian testosterone production. D 5- reductase converts testosterone to its more biologically active form dihydrotestosterone. E Both finasteride type II 5- reductase ; and dutasteride types I and II 5- reductase ; inhibit conversion of testosterone to dihydrotestosterone. F Both testosterone and dihydrotestosterone bind to the androgen receptor; spironolactone competitively inhibits binding of both of these hormones to the androgen receptor.
P Scicluna Department of Pathology, St Luke's Hospital Protein Z PZ ; is vitamin K-dependent plasma protein whose significance in disease remains unknown. Low PZ levels were associated with ischaemic stroke in young adults, though this association is still not clear. PZ deficiency was also associated in women with a first episode of early foetal loss. Aim: Detection of PZ antigen levels in patients who suffered a thrombophilicevent, including ischemic stroke, thromboembolic-events and recurrent miscarriage patients with two or more foetal losses. Methods: 153 healthy individuals were tested for PZ levels and were included in our control group. A total of 52 thrombophilic patients were enrolled and included females with history of recurrent foetal loss; patients who suffered a thromboembolic-event; and patients who suffered an ischaemic-stroke. Patients were sampled 3 months after their thrombotic episode and none of them was on oral anticoagulation. Results: Mean plasma PZ level in each group was comparable to that of control group. Difference in means was not found to be statistically significant P 0.05 ; . Occurance of PZ deficiency in each group was similar. Conclusion: Our results are similar to those obtained by other researchers except for a lower mean PZ level in controls. PZ levels are normally distributed with a broad total range in normal individuals. No relation between PZ levels and gender nor age was found. PZ deficiency was detected in 12 females who had recurrent foetal loss, in 3 patients who suffered an ischaemic stroke and in 6 patients who suffered a thromboembolic-event. Further studies are required to clarify the relation of PZ levels and disease.
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Table 2. Clinical and laboratory parameters of subjects in the control and finasteride groups before treatment, at 12 and 24 weeks of treatment, and at 16 weeks recovery * 0 wk Hemoglobin, g L Hematocrit HDL cholesterol, mmol L Total cholesterol, mmol L Diastolic BP, mm Hg Systolic BP, mm Hg Control FIN Control FIN Control FIN Control FIN Control FIN Control FIN 161 154 0.46.
Androgenic hormones have many effects on many different tissues and organs, among them the hair follicle. Dihydrotestosterone has a potent role in causing hair loss due to androgenetic alopecia See About hair loss for more information ; . Finastteride in a 1 milligram formulation Propecia ; is prescribed as a treatment for hair loss. See Nonsurgical hair loss treatment options for more information and dutasteride.
American Academy of Family Physicians familydoctor American Academy of Pain Management 13947 Mono Way #A Sonora, CA 95370 209 ; 533-9744 aapainmanage American Academy of Pain Medicine 4700 West Lake Avenue Glenview, IL 60025-1485 847 ; 375-4731 painmed American Chronic Pain Association PO. Box 850 Rocklin, CA 95677 800-533-3231 theacpa American Pain Foundation 201 North Charles Street, Suite 710 Baltimore, MD 21201-4111 1-888-615-PAIN 7246 ; painfoundation American Pain Society 4700 West Lake Avenue Glenview, IL 60025 847 ; 375-4715 ampainsoc National Foundation for the Treatment of Pain 1330 Skyline Drive #21 Monterey, CA 93940 831 ; 655-8812 paincare The National Pain Foundation painconnection.
Are reports that human prostate cancer cell lines which have become repressed by androgens can be suppressed by dihydrotestosterone and yet stimulated by finasteride when they are put into the nude mouse system, which has been used now for a number of years to assess prostate cancer cell lines. So, in this respect, we have to bear in mind that and alfuzosin.
Finasteride was generously Rahway, NJ ; . Methylcellulose supplied by Merck, was purchased from Sharp, and Dohme Sigma Chemical Co.
Diabetes and carotenoids Although obesity and physical inactivity are known to be major risk factors for type 2 diabetes, recent evidence suggests that oxidative stress may contribute to the pathogenesis of type 2 diabetes by increasing insulin resistance or impairing insulin secretion A Finnish study [1562] by Jukka Montonen and colleagues investigated dietary vitamin E, four tocopherols, four tocotrienols, vitamin C, and six carotenoids for their ability to predict type 2 diabetes. Vitamin E intake was significantly associated with a reduced risk of type 2 diabetes. Intakes of alfa-tocopherol, gama-tocopherol, delta-tocopherol, and beta-tocotrienol were inversely related to a risk of type 2 diabetes. Among single carotenoids, beta-cryptoxanthin intake was significantly associated with a reduced risk of type 2 diabetes. According to the authors of the study development of type 2 diabetes may be reduced by the intake of antioxidants in the diet. No association was evident between intake of vitamin C and type 2-diabetes risk. The carotenoid beta-cryptoxanthin, found in citrus fruits had been studied. Lycopene of tomatoes and other red fruits vegetables, used as an ingredient in both functional foods and dietary supplements was not include in the study. A study from Lu Wang and colleagues from the Brigham and Women's Hospital in Boston found little evidence for an association between dietary intake of lycopene or lycopene-containing foods and the risk of type-2 diabetes and does not protect against the risk of type-2 diabetes. [1563] Serum carotenoids alfa-carotene, beta-carotene, beta-cryptoxanthin, lutein zeaxanthin are inversely associated with type 2 diabetes and impaired glucose metabolism, beta carotene being the most active carotenoid. No significant activity was found in relation to lycopene in the study of Terry Coyne and colleagues. [1564] The development of insulin resistance in mammals with elevated expression of an antioxidant enzyme were reported in an article of McClung JP and colleagues in Proceedings of the National Academy of Sciences. They suggest that increased glutathione peroxidase 1 GPX1 ; activity may interfere with insulin function by overquenching intracellular reactive oxygen species required for insulin sensitizing. This leads to the assumption too many antioxidants in the diet could actually increase the risk of diabetes. [1565] and tamsulosin.
Data are presented as No. of patients, or as No. possibly drugrelated.
Lambert-Messerlian, G., Rudnicka, A., Hackshaw, A., D'Alton, M.E. 2003 ; Gestational age-based performance of Down syndrome screening markers results from the FASTER Trial. SMFM 2004 Ann. Mtg., Am. J. Obstet. Gynecol. 189: S193. Abstr. No. 193. A108. Malone, F.D., Wald, N.J., Canick, J.A., Ball, R.H., Nyberg, D.A., Comstock, C.H., Saade. G., Berkowitz, R.L., Gross, S.J., Dugoff, L., Craigo, S.D., Timor, I.E., Carr, S.R., Wolfe, H.M., Sullivan, L., Rudnicka, A., Hackshaw, A., Lambert-Messerlian, G., D'Alton, M.E. 2003 ; Use of overall population, center-specific, and sonographer-specific nuchal translucency medians in Down syndrome screening: which is best? Results from the FASTER Trial ; . SMFM 2004 Ann. Mtg., Am. J. Obstet. Gynecol. 189: S232. Abstr. No. 637. A109. Roberson, J., Diment, S., Anderson-Miller, A., Lambert-Messerlian, G., Canick, J. 2004 ; Maternal serum integrated screening in clinical practice. Am. Coll. Med. Genet., 2004 Ann. Clin. Genet. Mtg., Mar. 47, Orlando, FL., Abstr. No. 23. A110. Lambert-Messerlian, G., Canick, J., Malone, F., Porter, F., Nyberg, D., Comstock, C., Saade, G., Berkowitz, R., Gross, S., Dugoff, L., Craigo, S., Timor, I., Carr, S., Wolfe, H., D'Alton, M. 2004 ; First trimester levels of maternal serum hCG and inhibin A in pregnancies affected by fetal trisomy 18. Am. Coll. Med. Genet., 2004 Ann. Clin. Genet. Mtg., Mar. 4-7, Orlando, FL., Abstr. No. 62. A111. Lambert-Messerlian, G.M., Palomaki, G.E., Knight, G.J., Neveux, L.M., Canick, J.A., Haddow, J.E. 2004 ; Dimeric inhibin-A as a marker for Down syndrome in the first trimester. Am. Coll. Med. Genet., 2004 Ann. Clin. Genet. Mtg., Mar. 4-7, Orlando, FL., Abstr. No. 63. A112. Dugoff, L., Sullivan, L., Canick, J., Hobbins, J., Malone, F., Porter, F., Nyberg, D., Comstock, C., Saade, G., Eddleman, K., Gross, S., Craigo, S., Timor-Trisch, I.E., Carr, S.R., Wolfe, H.M., D'Alton, M. 2004 ; Multiple marker first and second trimester serum screening for adverse pregnancy outcome: A FASTER trial study. SMFM 2005 Ann. Mtg., Am. J. Obstet. Gynecol. 191: S47. Abstr. No. 136. A113. Dugoff, L., Faber, V., Hobbins, J., Malone, F., Canick, J., Porter, F., Luthy, D., Comstock, C., Bukowski, R., Eddleman, K., Gross, S., Craigo, S., Timor-Trisch, I., Carr, S., Wolfe, H.M., D'Alton, M.E. 2004 ; The effect of vaginal bleeding on maternal serum PAPP-A, free beta-hCG and nuchal translucency. A population based screening study the FASTER trial ; . SMFM 2005 Ann. Mtg., Am. J. Obstet. Gynecol. 191: S47. Abstr. No. 135. A114. Lambert-Messerlian, G., Dugoff, L., Vidaver, J., Canick, J., Malone, F., Porter, F., Comstock, C., Luthy, D., Bukowski, R., Eddleman, K., Gross, S., Craigo, S., Timor, I., Carr, S.R., Wolfe, H.M., D'Alton, M.E. 2004 ; First and second trimester Down syndrome screening markers in pregnancies achieved through assisted reproductive technologies ART ; : A FASTER trial study. SMFM 2005 Ann. Mtg., Am. J. Obstet. Gynecol. 191: S48. Abstr. No. 140. A115. D'Alton, M., Luthy, D., Malone, F., Canick, J., Gravett, M., Lambert-Messerlian, G., Tomlinson, M., Rosenfeld, R., Nagalla, S. 2004 ; Detection of Down syndrome by proteomic profiling of maternal serum. SMFM 2005 Ann. Mtg., Am. J. Obstet. Gynecol. 191: S2. Abstr. No. 2. A116. Malone, F., Nyberg, D.A., Vidaver, J., Ball, R., Porter, F., Comstock, C.H., Saade, G., Berkowitz, R., Gross, S., Dugoff, L., Craigo, S.D., Timor, I.E., Carr, S.R., Wolfe, H.M., Canick, J., D'Alton, M.E. 2004 ; First and second trimester evaluation of risk FASTER ; trial: the role of second trimester genetic sonography. SMFM 2005 Ann. Mtg., Am. J. Obstet. Gynecol. 191: S3. Abstr. No. 5. A117. Malone, F.D., Lambert-Messerlian, G., Canick, J., Ball, R., Nyberg, D.A., Comstock, C.H., Saade, G., Berkowitz, R.L., Gross, S.J., Dugoff, L., Craigo, S.D., Timor, I.E., Carr, S.R., Wolfe, H.M., Tripp, T., Bianchi, D., D'Alton, M.E. 2004 ; First and second trimester evaluation of risk FASTER ; trial: detection of and flavoxate.
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When pus cells are present, a course of therapy Tom 2 to as long as 12 weeks may be appropriate. In patients with II , when no pus cells are seen, a trial course of antibiotics for 1 to as long as 4 weeks seems reasonable. In some studies as many as 40% of men will improve with antibiotics. One major problem that arises is the variability of nonbacterial prostatitis to cause symptoms. As the disease waxes and wanes normally, patients can be misled to believe that the antibiotics are really helping their problem. When the drug doesn't work, the patient then believes that they have become resistant and want to try yet another drug. Sometimes after countless visits to the doctors and hundreds of dollars of medication, the problem still exists and the cultures, done over and over, still show no growth of any bacteria. What does help? Again the treatment is aimed more at reducing symptoms rather than curing them. The non-bacterial prostatitis will come and go - good months and bad months. All we can do is try to lessen the symptoms of the disease. Hot baths Hot baths are helpful for almost all men with prostatitis of any kind. These are often referred to as sitz baths and the warm water and relaxation of the bath soothe the prostate and relieves symptoms. While there is no scientific evidence proving that these "home remedies" are effective, they are not harmful and some people experience relief from symptoms while using them. Alpha blockers For those patients with difficulty starting urination or a slow stream, we can use dmgs to relax the muscles of the sphincter area sphincters are the muscular valves that hold the urine in the bladder -that's why we are not wet all the time!! ; . These drugs are called `alpha blockers'. Anti-spasmodic drugs For those patients who have urgency and frequency of urination, we can use medications to relax the muscles that surround the bladder to make it less sensitive. These drugs are referred to as `parasympathetic blockers' or anti-spasmodics. Fluids and Diet Drinking plenty of water helps. This dilutes the acidity and salt in the urine and dilutes any irritants that you might eat caffeine, cranberry, citrus acid, peppers and spices, etc ; . If the patient ingests large amounts of irritating foods, we might modulate his diet. Major culprits are acidy foods such as cranberry, cola, and coffee. Alcohol and spicy foods are also irritating to the prostate. Some patients have specific food items that are bothersome, such as onions or tomatoes. If you can identify an increase in symptoms with any food group - reduce your intake. Anti-inflammatories Non-steroidal anti-inflammatory medications may also be helpful. Ibuprofen and naproxen, both available over-the-counter now, along with stronger prescription anti-inflammatories may be of some benefit. Muscle relaxants are also helpful in some men. New categories of anti-inflammatories are being produced and some of these may have some beneficial effects against `inflammations' of the prostate. Flnasteride Proscar ; Finasteride, a drug that shrinks the prostate gland by blocking certain hormones, it can be helpful in some cases, particularly in men with larger prostates. Herbal remedies, including zinc and saw palmetto, have helped some men. The mechanism of action of various herbal remedies is poorly understood.
Of Dox 14, 16 ; . The chicken-beta-actin promoter was selected because it is active in many cell types including ES cells, and also in transgenic mice. Furthermore, it appears to be less sensitive to epigenetic silencing than many widely used viral promoters 26, 27 ; . As the research of some of us is focused on EpsteinBarr virus and B cell lymphomagenesis, the Em intron enhancer was included for efficient expression of Dox-controlled regulators in B cells. The Dox-responsive expression cassette is composed of a bidirectional promoter, driving expression of two genes in a coordinated fashion, one of which encoding the firefly luciferase, the other eGFP. The luciferase gene is flanked by SfiI sites that generate non-cohesive ends that can be used as universal cloning sites for genes of interest. Generation of noncohesive sites by digestion with SfiI guarantees that neither the vector nor the insert can self-ligate, thereby ensuring high cloning efficiency 28 ; . The luciferase gene is followed by the b-globin intron and polyadenylation site. The eGFP gene is flanked by unique SwaI and BglII sites and can be replaced by other genes, for example, the truncated version of the NGF receptor leaving the SV40 polyadenylation signal in place Figure 1 ; . The vector backbone comprises the ampicillin-resistance gene, the bacterial colE1 origin of replication, an optimized and bicalutamide.
Of course, we all know the cleaning power of vinegar. But Emily Thacker's research has uncovered a host of new moneysaving ways to keep your home, laundry, clothing, brass, copper and other possessions sparkling clean. And with less effort. You'll also delight in making and bottling your own special vinegars. It's so simple to follow Emily's recipes. Homemade vinegars make such wonderful gifts. You could even end up selling your creations to food and gift shops. And get ready for many compliments when the family and friends bite into those delicious pickle treats you make. Yes, 308 remedies and recipes are yours to enjoy on a no-risk trial basis for 90 life-improving days. Imagine, three full months without obligation to keep this exclusive, one-of-its kind book. When you read it you'll say: "Is there anything that vinegar is not good for?" To get your trial copy direct from the publisher at the special introductory price of .95 plus .98 shipping and handling total of .93 ; simply do this: Write "Vinegar Preview" on a piece of paper and mail it along with your check or money order payable to: James Direct Inc. Dept. JV891 1459 South Main Street, Box 3093 North Canton, Ohio 44720 You can charge to your VISA MasterCard by mail. Be sure to include your card number, expiration date and signature. Want to save even more? Do a favor for a relative or friend and order 2 books for only postpaid. It's such a thoughtful gift. Remember: It's not available in book stores at this time. And you're protected by the publisher's 90-Day Money Back Guarantee. SPECIAL BONUS - Act promptly and you'll also receive Brain & Health Power Foods booklet absolutely FREE. It's yours to keep just for previewing "The Vinegar Book." Supplies are limited. Order 2006 JDI JV110S today. : jamesdirect.
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Disney enforced the adults only rule, but I think they expect parents to. I think most of the 6 or so teens I saw in the adult pool probably didn't tell their parent that's where they were. My suggestion for Disney for the kids is to have more scheduled activities and let the kids choose between free time and a scheduled activity. Most of the scheduled activities were over an hour long, maybe some of shorter duration would be good for kids who want pop in and pop out more frequently."- Deb 7.3 Teens: Teens 13 to 17 aboard the Disney ships have their own place. On the Disney Magic it is called the Stack on Deck 11 where the ESPN club used to be located ; , on the Disney Wonder it is called Aloft. There teens can enjoy the company of other teens while their privacy is fiercely guarded by teen counselors. If your teens are worried about not having enough to do while aboard, not to worry! The teen schedule from the four night cruise is reproduced below and you can see that there are lots of organized teen activities during the cruise. It's important that all teens make it to the 411 meet on the first day to learn all about the activities planned for them. The time and location are in your navigator. The 7-day cruise features more teenage dance parties 80s and 90s and acetaminophen.
Evaluation of aloe vera gel gloves in the treatment of dry skin associated with occupational exposure . 20 Adverse reactions associated with an alcohol-based hand antiseptic among nurses in a neonatal intensive care unit 21 Dermal tolerance and effect on skin hydration of a new ethanol-based hand gel 21 An investigation of the effect of prolonged glove wearing on the hand skin health of dental healthcare workers 22 Goggles are more important than face masks. 22 Stress Mental disorders Stress psychopathologie . 22 Work stress and posttraumatic stress disorder in ED nurses personnel 22 Posttraumatic symptoms and disability in paramedics. 23 Modernising the 12-hour shift 23 Repercussions of work schedule congruence among full-time, part-time, and contingent nurses 23 Workload pressures in rural general practice: a qualitative investigation. 24 The effectiveness of current approaches to workplace stress management in the nursing profession: an evidence based literature review 24 A comparative study of stress and burnout among staff caregivers in nursing homes and acute geriatric wards. 24 [Physicians and nurses subjected to disciplinary actions because of substance abuse. Ten years of experience with supervision in Copenhagen] . 25 Violence Violence. 25 Legal remedies for employees if they are injured in the workplace. 25 Other Autre. 26 Miscellaneous Divers. 26 Accommodating medical school faculty with disabilities. 26 Occupational health hazards among health care workers in an obstetrics and gynaecology unit of a Nigerian teaching hospital. 26 Smoking behavior, initiating and cessation factors among Japanese nurses: a cohort study 26 [Occupational diseases among personnel of Polish hospitals, 2001] . 27 Evidence Based Medicine. 27 Documents en Franais . 27 Reglementation . 27 Avis du Conseil suprieur d'hygine publique de France : calendrier vaccinal 2003 . 27 Dcret n 2003-109 du 11 fvrier 2003 relatif la vaccination antivariolique . 27 Articles& documents en Franais . 28 Faut-il arrter le BCG ? . 28 Aprs la Bourgogne, la Champagne-Ardenne. Peut-on parler d'pidmie de burn-out chez les mdecins?. 28 Paludisme a P. falciparum apres accident exposant au sang AES ; : a propos d'un cas, une revue de litterature et considerations pour la chimioprophylaxie post-exposition. 29 [Rights and responsibilities in cases of blood exposure accidents]. 29 [Evaluation of a prevention measure against blood exposure accidents]. 29 [Blood exposure accident prevention and education-action] . 29 [HIV infection prophylaxis after exposure]. 29 [Blood exposure accidents study in Franche-Comte in 2001]. 29 [HIV and hepatitis C seroconversions in nurses] . 29.
Phenotypes was limited to those men who were eligible to undergo this surgery. Studies of men with a wider range of clinical diagnoses or pathological types may be quite different from those reported here. Finally, our case-case study design does not allow us to directly address the role of the SRD5A2 allele in the etiology of prostate cancer. Casecontrol studies are currently being undertaken to address this issue. Our findings have potential implications for prostate cancer detection, prognosis, and treatment. First, our capsular and pTNM stage findings imply that the A49T variant at SRD5A2 is associated with extraprostatic extension and or positive margins. These are pathological features that are associated with a poorer prognosis. Once cancer extends beyond the prostate, it is associated with a 40% 10-year actuarial failure rate in the absence of adjunctive postoperative treatment reviewed in Ref.30 ; . Furthermore, extraprostatic extension is correlated with the presence of advanced pathological features such as seminal vesicle invasion and lymph node metastasis, which were variables not analyzed in our study 31, 32 ; . Conversely, tumor that is pathologically confined to the prostate has an excellent prognosis, with most studies reporting 510 year progression rates of 10% in these patients 28, 33, 34 ; . The potential prognostic significance of our findings is further supported by the overrepresentation of the A49T genotype in two of the high-risk prognostic categories combined PSA-Gleason-TNM stage and combined margins-Gleason ; , that have been associated with reduced biochemical relapse-free survival 20, 21 ; . In addition to potential prognostic value, knowledge of SRD5A2 genotypes may also have applications in prostate cancer screening. Patients at risk for pathologically significant tumors could potentially benefit from increased screening and early detection of disease. Finally, the 5 -reductase inhibitor finasteride Proscar has recently been tested as a treatment in men with metastatic prostate cancer 35 ; , as well as in men with low-level postprostatectomy PSA elevation 36 ; , with promising results. Its value as a chemopreventive agent is also being assessed 37 ; . The efficacy of such interventions may be in part determined by SRD5A2 genotype. REFERENCES and methocarbamol.
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When peripheral IV access is possible without a time-critical delay, it's the most economical method of vascular access. However, when IV access is difficult, multiple attempts require multiple IV catheters and the prolonged attention of the clinician, which may delay care and transport. This delay may result in the deterioration of the patient in need of fluids and or medications via vascular access. If multiple patients are involved, time pressure further increases operator stress. The total cost of any procedure is a compilation of equipment cost, time of application and effect on transport time. Using this method of analysis, the cost of the devices is often the smallest line item. If EMS managers compare the cost of IO catheters 5 ; with the inefficient use of personnel and equipment, and patients who may arrive in the ED in a less viable condition, rapid and efficient IO access becomes economically attractive.
The pilot feasibility study currently under way combines the expertise of surgeons who treat patients with breast cancer and the scientific skills of researchers who study breast cancer tumors in the laboratory. The purpose of the pilot is to determine whether such a cooperative arrangement between the two groups will work successfully, and even more importantly, whether it will lead to the development of new chromosome-based, diagnostic tests on breast cancer that could provide important information about how to best treat different subsets of this deadly disease. Surgeon Greg R. Pahnke, M.D., medical director of the Christiana Care Breast Center, is the principal clinical investigator for the study, and Leslie J. Krueger, Ph.D., FACMG, chief of Molecular Genetics, Cellular & Tissue Transplantation in the Department of Research at Alfred I. duPont Hospital for Children, is the principal research investigator. Diana Dickson-Witmer, M.D., is a surgeon also participating in the project. "This study represents a groundbreaking cooperative effort between our two health care institutions that combines clinical expertise and resources with academic research, " Dr. Pahnke explains. "The future result of this interface will no doubt help to ensure that our patients with breast cancer continue to receive state-of-the-art care." The pilot study has two specific aims. One is to measure the concentrations of Epstein-Barr Virus EBV ; in small samples less than 1 cm ; of breast cancer tumors and to compare detected levels with EBV levels found in accompanying blood samples. If concentrated amounts of EBV are found in the cancer cells under investigation, further work will follow to determine just what role the virus plays, if any, in the cancer development. A second aspect of the study is to test new methods for detecting concentration levels of certain known cancer causing genes oncogenes ; found in breast cancer specimens and tizanidine.
Of oral contraceptive vs. cyproterone acetate-estrogen regimens in the treatment of hirsutism. Fertil Steril. 66: 216 219. Grigoriou O, Papadias C, Konidaris S, Antoniou G, Karakitsos P, Giannikos L. 1996 Comparison of flutamide and cyproterone acetate in the treatment of hirsutism: a randomized controlled trial. Gynecol Endocrinol. 10: 119 123. Erenus M, Yucelten D, Durmusoglu F, Gurbuz O. 1997 Comparison of finasteride vs. spironolactone in the treatment of idiopathic hirsutism. Fertil Steril. 68: 1000 1003. Zemtsov A, Wilson L. 1997 Successful treatment of hirsutism in HAIR-AN syndrome using flutamide, spironolactone, and birth control therapy. Arch Dermatol. 133: 431 433. Kelestimur F, Sahin Y. 1998 Comparison of diane 35 and diane 35 plus spironolactone in the treatment of hirsutism. Fertil Steril. 69: 66 69. Conn JJ, Jacobs HS. 1997 The clinical management of hirsutism. Eur J Endocrinol. 136: 339 348. Marcondes JAM, Minnani SL, Luthold WW, Wajchenberg BL, Samojlik E, Kirschner MA. 1992 Treatment of hirsutism in women with flutamide. Fertil Steril. 57: 543547. Muderris II, Bayram F, Sahin Y, Kelestimur F. 1997 A comparison between two doses of flutamide 250 mg d and 500 mg d ; in the treatment of hirsutism. Fertil Steril. 68: 644 647. Dallob AL, Sadick NS, Unger W, et al. 1994 The effect of finasteride, a 5 -reductase inhibitor, on scalp skin testosterone and dihydrotestosterone concentrations in patients with male pattern baldness. J Clin Endocrinol Metab. 79: 703706. Lobo RA, Shoupe D, Serafini P, Brinton D, Horton R. 1985 The effects of two doses of spironolactone on serum androgens and anagen hair in hirsute women. Fertil Steril. 43: 200 205. Wallace C, Labor EA, Click CL. 1993 Hepatotoxicity complicating flutamide treatment of hirsutism [Letter]. Ann Intern Med. 119: 1150. Diamanti-Kandarakis E, Mitrakou A, Raptis S, Tolis G, Duleba AJ. 1998 The effect of a pure antiandrogen receptor blocker, flutamide, on the lipid profile in the polycystic ovary syndrome. J Clin Endocrinol Metab. 83: 2699 2705. Dunaif A. 1997 Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev. 18: 774 800.
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The purpose of this manuscript is to provide clinicians, health plan decision makers, and policy makers with highlights of key findings pertaining to our current understanding of the condition of enlarged prostate EP ; from a managed care perspective. This includes a brief discussion regarding the prevalence and economic burden of EP, followed by a review of clinical characteristics and pathophysiology, with the final section on treatment approaches with a focus on pharmacologic options. This supplement is not intended to be a comprehensive review of EP, because many review articles on this subject are available elsewhere. This manuscript does, however, serve to introduce 3 additional manuscripts contained within this supplement. The first article provides the readers with a real-world comparison of dutasteride and finasteride relative to acute urinary retention and surgery attenuation rates. The second article investigates differences in discontinuation rates of alpha blockers when used in combination with dutasteride or finasteride. The last article addresses the cost implications associated with dutasteride and finasteride therapy. All 3 articles represent data from a naturalistic, managed care population. This supplement is intended to assist managed care formulary decision makers in evaluating key clinical and economic data which could help to differentiate dutasteride and finasteride. Although the information presented does not prove superiority of either product, it will answer some important questions and raise some important issues beyond ingredient cost and metaxalone and Order finasteride online.
24. Simon G, Cserep G, Limas C. Development of structural vascular changes with subpressor angiotensin II administration in rats. J Hypertens 8 1 ; : 67-73, 1995.
Amigorena S, Choquet D, Teillaud JL, Korn H and Fridman WH 1990 ; Ion channels and B cell mitogenesis. Mol Immunol 27: 1259 1268. Batra S, Popper LD and Hartley-Asp B 1991 ; Effect of calcium and calcium antagonists on 45Ca influx and cellular growth of human prostatic tumor cells. Prostate 19: 299 311. Benz I and Kohlhardt M 1994 ; Blockade of cardiac outwardly rectifying K channels by TEA and class III antiarrhythmics evidence against a single drug-sensitive channel site. Eur Biophys J 22: 437 446. Carraro JC, Raynaud JP, Koch G, Chisholm GD, Di Silverio F, Teillac P, Da Silva FC, Cauquil J, Chopin DK, Hamdy FC, et al. 1996 ; Comparison of phytotherapy Permixon ; with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1, 098 patients. Prostate 29: 231242. Catacuzzeno L, Trequattrini C, Petris A and Franciolini F 1999 ; Mechanism of verapamil block of a neuronal delayed rectifier K channel: active form of the blocker and location of its binding domain. Br J Pharmacol 126: 1699 1706. DeCoursey TE 1995 ; Mechanism of K channel block by verapamil and related compounds in rat alveolar epithelial cells. J Gen Physiol 106: 745779. Hanson DC, Nguyen A, Mather RJ, Rauer H, Koch K, Burgess LE, Rizzi JP, Donovan CB, Bruns MJ, Canniff PC, et al 1999 ; UK-78, 282, a novel piperidine compound that potently blocks the Kv1.3 voltage-gated potassium channel and inhibits human T cell activation. Br J Pharmacol 126: 17071716. Hogg RC, Trequattrini C, Catacuzzeno L, Petris A, Franciolini F and Adams DJ 1999 ; Mechanisms of verapamil inhibition of action potential firing in rat intracardiac ganglion neurons. J Pharmacol Exp Ther 289: 15021508. Horton R 1992 ; Benign prostatic hyperplasia: new insights editorial ; . J Clin Endocrinol Metab 74: 504A504C. Isaacs JT 1984 ; Antagonistic effect of androgen on prostatic cell death. Prostate 5: 545557. Keleti T and Fajszi C 1971 ; The system of double inhibitions. Math Biosci 12: 197 215. Lepple-Wienhues A, Berweck S, Bohmig M, Leo CP, Meyling B, Garbe C and Wiederholt M 1996 ; K channels and the intracellular calcium signal in human melanoma cell proliferation. J Membr Biol 151: 149 157. Meyer R, Schonherr R, Gavrilova-Ruch O, Wohlrab W and Heinemann SH 1999 ; Identification of ether a go-go and calcium-activated potassium channels in human melanoma cells. J Membr Biol 171: 107115. Nilius B and Wohlrab W 1992 ; Potassium channels and regulation of proliferation of human melanoma cells. J Physiol Lond ; 445: 537548. Pancrazio JJ, Tabbara IA and Kim YI 1993 ; Voltage-activated K conductance and cell proliferation in small-cell lung cancer. Anticancer Res 13: 12311234. Pappone PA and Ortiz-Miranda SI 1993 ; Blockers of voltage-gated K channels inhibit proliferation of cultured brown fat cells. J Physiol 264: C1014 1019 and carbamazepine.
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FC3.23.05 SIGNIFICANT INFLAMMATION IS NOT NECESSARY FOR CLEARANCE OF EXTERNAL GENITAL WARTS BY IMIQUIMOD RL Miller, TL Fox, HB Slade, M Smith, MA Tomai, 3M Pharmaceuticals, St-Paul, MN, USA. Objectives: Imiquimod IQ ; is new immune response modifier which is available for the treatment of external genital and perianal warts EGW ; . The associations of significant inflammation with the clearance of EGW was examined. Study Methods: In two randomized, placebo-controlled trials patients applied IQ 5% cream three times week until total wart clearance, or for a maximum of 16 weeks. Results: In a Phase III trial, patients with mild or no erythema at the treatment site had a complete clearance rate of 47% 29 62 ; and patients with moderate or severe erythema, 57% 25 44 ; . In mechanism of action, study, treatment of EGW with topical IQ demonstrated cytokine induction. Biopsies were taken at baseline, wk 6 and end of treatment from IQ n 16 ; placebo n 3 ; patients. RT-PCR using specific primers showed relative increases from baseline for mRNA levels of cytokines and cell markers and decreases in HPV gene products. PCR showed a decrease in HPV DNA copies cell. All IQ treated patients had 75% reduction in wart area and seven totally cleared their lesions. Three of these seven had mild erythema. One IQ patient had an 88% reduction in lesions and no erythema. Increases in mRNA for proinflammatory cytokines did not correlate with clearance of lesions. Conclusion: Local erythema is often seen during clearance EGW lesions by IQ but significant inflammation is not necessary for clearance of the lesions. FC3.23.06 A RANDOMIZED PROSPECTIVE STUDY OF COLD KNIFE, LARGE LOOP EXCISION AND NEEDLE EXCISION OF THE TRANSFORMATION ZONE FOR TREATMENT OF CERVICAL INTRAEPITHELIAL NEOPLASIA A L. Sadek, O. Istre, G B. Trolle, Dept. OB GYN, Hedmark Central Hospital, Elverum, Norway, and H. A. Schitz, Dept. OB GYN, Vestfold Central Hospital, Tnsberg, Norway. Objectives: To compare Needle excision of the transformation zone NETZ ; , in which a new, specially designed diathermy needle is used, with Large loop excision LLETZ ; and Cold knife for the treatment of CIN. Study Methods: A prospective study was done on 105 women with histologically verified CIN. They were randomized to three groups, each of 35 patients. Surgery was done under local anesthesia as outpatient procedures. There were no statistically significant differences between the groups. Follow-up time is three years; all patients were evaluated at 3, 6, 9, and 36 months after surgery. Descriptive statistical analysis, one way Anova and Pearson c2 statistics were used. Results: The following statistically significant differences between groups were seen: a ; mean operating time including anesthesia NETZ 7.4 minutes, LLETZ 8.6 minutes, cold knife 17.7 minutes, p 0.001 ; , b ; conversion to general anesthesia NETZ 11%, LLETZ 22%, cold knife 37%, p 0.04 ; , c ; free resection margins NETZ 85%, LLETZ 37%, cold knife 68%, p 0.002 ; , d ; residual disease NETZ 2%, LLETZ 28%, cold knife 14%, P 0.006 ; , e ; mean postoperative duration of vaginal.
18. Cross TG, Scheel-Toellner D, Henriquez NV, Deacon E, Salmon M, Lord JM 2000 Serine threonine protein kinases and apoptosis. Exp Cell Res 256: 3441 19. Schaeffer HJ, Weber MJ 1999 Mitogen-activated protein kinases: specific messages from ubiquitous messengers. Mol Cell Biol 19: 24352444 20. Liu X, Robinson GW, Wagner KU, Garrett L, WynshawBoris A, Hennighausen L 1997 Stat5a is mandatory for adult mammary gland development and lactogenesis. Genes Dev 11: 179186 21. Miyoshi K, Shillingford JM, Smith GH, Grimm SL, Wagner KU, Oka T, Rosen JM, Robinson GW, Hennighausen L 2001 Signal transducer and activator of transcription Stat ; 5 controls the proliferation and differentiation of mammary alveolar epithelium. J Cell Biol 155: 531542 22. Lundberg AS, Weinberg RA 1999 Control of the cell cycle and apoptosis. Eur J Cancer 35: 531539 23. Wiesen J, Werb Z 2000 Proteinases, cell cycle regulation, and apoptosis during mammary gland involution minireview ; . Mol Reprod Dev 56: 534540 24. Boucher MJ, Morisset J, Vachon PH, Reed JC, Laine J, Rivard N 2000 MEK ERK signaling pathway regulates the expression of Bcl-2, Bcl-X L ; , and Mcl-1 and promotes survival of human pancreatic cancer cells. J Cell Biochem 79: 355369 25. Kopf M, Baumann H, Freer G, Freudenberg M, Lamers M, Kishimoto T, Zinkernagel R, Bluethmann H, Kohler G 1994 Impaired immune and acute-phase responses in interleukin-6-deficient mice. Nature 368: 339342 26. Ogata A, Chauhan D, Teoh G, Treon SP, Urashima M, Schlossman, RL, Anderson KC 1997 IL-6 triggers cell growth via the Ras-dependent mitogen-activated protein kinase cascade. J Immunol 159: 22122221 27. Kim H, Baumann H 1999 Dual signaling role of the protein tyrosine phosphatase SHP-2 in regulating expression of acute-phase plasma proteins by interleukin-6 cytokine receptors in hepatic cells. Mol Cell Biol 19: 53265338 28. Kim HT, Tasca S, Qiang W, Wong PK, Stoica G 2002 Induction of p53 accumulation by Moloney murine leukemia virus-ts1 infection in astrocytes via activation of extracellular signal-regulated kinases 1 2. Lab Invest 82: 693702 29. Huynh H 2002 Induction of apoptosis in rat ventral prostate by finasteride is associated with alteration in MAP kinase pathways and Bcl-2 related family of proteins. Int J Oncol 20: 12971303 30. Heermeier K, Benedict M, Li M, Furth P, Nunez G, Hennighausen L 1996 Bax and Bcl-xs are induced at the onset of apoptosis in involuting mammary epithelial cells. Mech Dev 56: 197207 31. Schorr K, Li M, Krajewski S, Reed JC, Furth PA 1999 Bcl-2 gene family and related proteins in mammary gland involution and breast cancer. J Mammary Gland Biol Neoplasia 4: 153164 32. Schorr K, Li M, Bar-Peled U, Lewis A, Heredia A, Lewis B, Knudson CM, Korsmeyer SJ, Jager R, Weiher H, Furth PA 1999 Gain of Bcl-2 is more potent than bax loss in regulating mammary epithelial cell survival in vivo. Cancer Res 59: 25412545 33. Chomczynski P, Sacchi N 1987 Single-step method of RNA isolation by acid guanidinium thiocyanate-phenolchloroform extraction. Anal Biochem 162: 156159.
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Labeled for DNA breaks and immunostained for tissue transglutaminase tTG ; , a marker of apoptosis programmed cell death ; . The percentage of epithelial cells staining for DNA breaks was 0.4 2 in control prostates, 2.8 + 0.9 in group 1, 1.7 ? 0.5 in group 2, and 0.7 2 0.3 km in group 3. Anti-tTG staining of epithelial cells was graded on a scale of O-4. In control prostates, 3 ? 1% of the ducts were grade 3 or 4 50% of epithelial cells staining ; . In finasteride-treated prostates, 2 f 2% of the prostates in group 1, 13 ? 4% of the prostates in group 2, and 0.5 2 0.5% of the prostates in group 3 were grade 3-4. These results indicate that a progressive decrease in epithelial cell size and function occurs during the first several months in the prostates of men treated with finasteride. The staining for DNA breaks and the tTG staining also indicate that an increased rate of apoptosis is occurring transiently in these prostates. We conclude that finasteride causes prostate involution through a combination of atrophy and cell death. J Clin Endocrinol Metab 81: 814-819, 1996 and buy dutasteride.
Answer: proscar finasteride ; is a drug that blocks the transformation of testosterone to dihydrotestosterone dht ; , a potent hormone within the prostate.
Candidate. For malaria there are also four early discovery projects plus the two new candidates N-t-butyl-isoquine and GW308678 pyridone which are soon to enter clinical development and CDA in late phase clinical trials. A key decision to be made is which drugs will be considered for combination with N-tert-butyl-isoquine and GW308678. In addition, the landmark findings of a new vaccine that provides protection for at least 18 months in children offers exciting new hope. Sitamaquine, for visceral leishmaniasis, is also in late-stage clinical development. In fact, there could be as many as four new medicines launched in the next 10 years. In the area of HIV GSK has several active discovery programs to develop new medicines and vaccines to treat and prevent HIV infection. Although there remain significant challenges in drug development for these neglected diseases, there is a real momentum from the global community. New approaches, such as PPPs, are capitalising on this new feeling of energy and action. These partnerships are leveraging already available capacity, expanding networks and creating rich and diverse drug pipelines, with medicines already reaching the clinic. As a company, we are very proud of the work that we are doing in the DDW group, and of the hundreds of GSK scientists and researchers who have taken up the challenge of finding new medicines and new vaccines for these diseases. It may take many years for the discoveries of today to become the therapies and prevention technologies of tomorrow. This is not, therefore, a short-term exercise, but represents a long-term, sustained effort from GSK, reflecting the successful heritage and continued commitment of the company in infectious diseases.
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K. To ensure that the ALS provider disposes on appropriate containers all trash, including paraphernalia, from the use of the Drug Box during a call. L. To participate from time to time as needed in an inventory report to ODEMSA of Drug Boxes in the agency's possession. 11. O.D.E.M.S.A.'S RESPONSIBILITES: The Old Dominion EMS Alliance agrees to the following: A. To properly prepare and mark ALS Drug Boxes for entry into the system. B. To maintain, repair or replace Drug Boxes in a timely fashion as needed and requested by hospital pharmacies. C. To provide locks, forms and other documentation as needed and requested by hospital pharmacies. Administrative Page 34.
In seasonal affective disorder, or SAD. In this disorder, individuals have a characteristic onset of depression during the winter months, with remissions or changes from depression to mania during the spring 87 ; . Depression can also appear in a very severe form. Melancholia is a severe form of depression wherein persons take virtually no interest or pleasure in activities and experience such somatic symptoms as early morning waking and weight loss. While a categorical approach to depression may be convenient for selecting homogeneous groups for research or designing a treatment strategy, it does not preclude the possibility that depression is a single disorder. As stated in a recent psychiatric diagnostic text.
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Nary drugs HOFERICOV 1999 ; , failure to observe protective terms ZENG et al. 1996 ; and the incorrect mode of sanitation. Differences between cows and goats milk suggest that analytical tests used for detection of antibiotics in cows milk are not always suitable for assessment of goats milk. This antagonism can be explained by natural inhibitors contained in the cows milk lipidic fraction which lead to the induced resistance to antibiotics K LINGER & ROSENTHAL 1997 ; . The occurrence of xenobiotic substances in eatables is generally controlled by the Food Codex of the Slovak Republic 1996 ; and the detection of inhibitors in goats milk is carried out according to the valid legislative cows milk requirements included in STN 57 0531 1995 ; until the acceptance of individual legislative EU regulations. Inasmuch as the data concerned with the problem of determination of suitable applications of screening tests for goats milk ZENG et al. 1998 ; are almost absent in the available literature, the objective of this work was to evaluate and compare some detection limits of the most frequently used antibiotics -lactam antibiotics and cephalosporins, aminoglycosides, tetracyclines, macrolides, others ; estimated by means of three different methods, i.e. the classical disk diffusion method and the rapid methods represented by Delvotest SP and Penzym S 100. A model experiment permitted us to assess the sensitivity.
Group patients also had a factor VIII : V ratio of 30 or above at 72 h but all seven patients survived, one developing transient encephalopathy. This study suggests that, if measured less than 72 h post overdose, a factor VIII: V ratio of 30 or above and or a factor V concentration of 10% or below are not reliable early prognostic indicators in paracetamol poisoning, unless 1 accompanied by grade III IV encephalopathy.'.
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Drug Accu-Chek Compact Reagent Strips Griseofulvin Dutasteride Avodart ; Duloxetine Yentreve ; Fulvestrant Faslodex ; Condition Blood glucose monitoring Fungal infections of the skin Benign prostatic hyperplasia Moderate to severe stress incontinence in women. Treatment of oestrogenreceptor positive metastatic or locally advanced breast cancer in postmenopausal women in whom disease progresses or relapses while on or after other antioestrogen therapy. Reduction of bone damage in bone metastases in breast cancer DTC Decision Not approved Approved Not approved; evidence vs finasteride was unconvincing Deferred awaiting review of FDA concerns Approved for use by ULHT specialists. GP prescribing is only appropriate within the context of an appropriate shared care guideline. Approved for use by ULHT specialists. GP prescribing is only appropriate within the context of an appropriate shared care guideline. Approved for use by ULHT specialists. GP prescribing is only appropriate within the context of an appropriate shared care guideline. Approved Status Red Amber Red Red Amber.
Weed, Calif., brewers thought they were making a clever play on words when they had the bottle caps of their beer stamped "Try Legal Weed, " but federal regulators were not amused and ordered what they called an illegal-drug reference removed, the Associated Press reported April 23. The U.S. Alcohol and Tobacco Tax and Trade Bureau ordered Mount Shasta Brewing co., the brewers of Lemurian Lager, to remove the wording, saying it could "mislead consumers about the characteristics of the alcoholic beverage." "I've never tried marijuana in my life, "said brewer Vaune Dillmann, 61. "I don't advocate that. It's just our town's name." The town is named for lumber baron Abner Weed, and itself sports signs like "Temporarily Out of Weed" and "100 Percent Pure Weed." Dillmann recently spent , 000 to order 400, 000 of the "Try Legal Weed" bottle caps. He says he's perplexed that the federal government is banning his slogan when it has allowed Hemp Ale and Anheuser-Busch's famous marketing slogan, "This Bud's for you.
Basic patents are in effect for the following major products in the united states: cancidas, comvax haemophilus b conjugate and hepatitis b vaccine ; , cosopt, cozaar, crixivan, emend aprepitant ; , fosamax, hyzaar, invanz ertapenem sodium ; , maxalt, primaxin, propecia finasteride ; , proscar, recombivax hb, 10 table of contents singulair, timoptic-xe timolol maleate ophthalmic gel forming solution ; , trusopt, and zocor.
S1. Anabolic Agents a. Nine substances have been added to the list of examples. b. For endogenous steroids, the T E ratio, which prompts an investigation, has been changed to 4: 1 from 6: 1. A doping case can be put forward if evidence supports the case even at T E ratios less than 4: 1. ; S2. Hormones and Related Substances a. Previously prohibited in men, these substances are now prohibited in both men and women. S3. Beta-2 agonists a. All beta-2 agonists are prohibited in- and out-ofcompetition. b. Salbutamol albuterol, levalbuterol ; , salmeterol, terbutaline, and formoterol are permitted by inhalation with a completed Abbreviated Therapeutic Use Exemption TUE ; . c. A salbutamol albuterol ; concentration greater than 1, 000 ng ml is a doping violation in- or out-of-competition and with or without an Abbreviated TUE ; unless the athlete can prove the concentration is due to therapeutic use by inhalation. S4. Agents with Anti-Estrogenic Activity a. Substances that were previously prohibited in men are NOW prohibited in both men and women. S5. Diuretics and other Masking Agents a. Rinasteride Propecia, Proscar ; and other 5-alpha reductase inhibitors have been added as prohibited substances. b. The contraceptive Yasmin is prohibited as a medication due to the presence of the diuretic drospirenone. c. A TUE is not valid if an athlete's urine contains a diuretic in association with Threshold or sub-threshold levels of a Prohibited Substance. S6. Stimulants a. Stimulant rules are unchanged and all are prohibited in-competition. S7. Narcotics a. Fentanyl and its derivatives have been added to the Prohibited List. b. Eleven narcotics are specifically prohibited in-competition. c. Local anesthetics are permitted unless specifically listed.
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