I. Evaluation of the Adult Trauma Patient - Any of these constitute a "trauma patient" A. PHYSIOLOGIC CRITERIA 1. Significant signs of shock accompanied by: a. Pulse 120 or blood pressure 90 geriatric patients may be in shock with a BP 90 ; Airway or Breathing Difficulties a. Respiratory rate of 10 or Intubated patient 3. Neurologic Considerations a. Evidence of Head Injury b. Glascow coma scale 13 or equal to c. Alteration in LOC during examination or thereafter; LOC than 5 min. d. Failure to localize pain. e. Suspected spinal cord injury paralysis due to an acute injury; sensory loss ; B. ANATOMIC CRITERIA 1. Penetrating trauma to the head, chest or abdomen, neck and extremities proximal to knee or elbow ; Injuries to the extremities where the following physical findings are present: 2. a. Amputations proximal to the wrist or ankle b. Visible crush injury c. Fractures of two or more proximal long bones d. Evidence of neurovascular compromise 3. Tension pneumothorax that is relieved an unrelieved tension pneumothorax would fit the definition of an unstable ABC ; 4. Injuries to the head, neck, or torso where the following physical findings are present: a. Visible crush injury b. Abdominal tenderness, distention, or seat belt sign c. Pelvic fracture d. Flail chest 5. Signs or symptoms of spinal cord injury. 6. Burn injury 10% TBSA and potential for other associated traumatic injuries C. OTHER CRITERIA CONSIDERATIONS THAT ALONE DO NOT CONSTITUTE A TRAUMA PATIENT 1. Significant Mechanisms of Injury Should Prompt a High Index of Suspicion 2. Age 60 Should Prompt a High Index of Suspicion Transportation of the Adult Trauma Patient A. Ground Transportation Time Guidelines 1. 30 minutes or less from a Trauma Center TRAUMA CENTER excluding uncontrolled airway or traumatic CPR ; 2. Greater than 30 minutes to a trauma center nearest appropriate facility.

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Prograf therapy Table 3. Distribution of Responses to Baseline AWA Items, Patient Sample 2 N 2000, for example, prograf 4. NURSES: Avg. No. of days Licensed Nurse Spends at 1.75 2 whole days spent at 1 assigned school ; assigned School per Week Total No. of LPNs in School System 0 Total No. of RNs in School System 0 Total No. of Licensed Nurses Providing 8 Delegation Total No. of Licensed Nurses Assigned to a 0 Specific Classroom Total No. of Licensed Nurses Assigned to a 0 Specific Student Total No. of Certified Registered Nurse 0 Practitioners Total No. of Health Career Teachers who are 1 also Licensed Nurses Total No. of Volunteers who are also Licensed 0 Nurses Total No. of Substitute Licensed Nurses 0 Total No. of Unlicensed Personnel who can 13 Receive Delegation from Licensed Nurse TOTAL NUMBER OF STUDENTS WITH ORDERS FOR THE FOLLOWING MEDICATIONS: Injectable Insulin 7 Glucagon 5 SoluCortef 0 Blood Products 0 Epi-Pen or Injectable Epinephrine 7 Rectal Medications 0 Inhaler Medications 47 Inhalers 41 ADD Medications 13 Antibiotics 0 Psychiatric Medications 2 Asthma Medications 0 Seizure Medications 0 Breathing Treatments 0 TOTAL NUMBER OF STUDENTS WITH ORDERS FOR THE FOLLOWING PROCEDURES: Urinary Catheterization or Assistance 1 Tracheostomy Care 0 Gastric Tube Care, Including Feeding 1 Glucose Testing 8 Ventilator Care 0 TOTAL NUMBER OF STUDENTS WITH THE FOLLOWING DISORDERS: ADHD 66 Asthma 112 Diabetes 9 Mental Illness 5 Hemophilia 0 Seizure Disorder 8. Table 1 Classification of evidence Class Description I Evidence provided by one or more well designed, randomized, controlled clinical trials, including overviews meta-analyses ; of such trials. II Evidence provided by well designed observational studies with concurrent controls e.g., case control or cohort studies ; . III Evidence provided by expert opinion, case series, case reports, and studies with historical controls. Table 2 Levels of recommendations Recommendation Level of evidence Standard Principle for patient management that reflects a high degree of clinical certainty usually this requires Class I evidence that directly addresses the clinical questions, or overwhelming Class II evidence when circumstances preclude randomized clinical trials ; . Guideline Recommendation for patient management that reflects moderate clinical certainty usually this requires Class II evidence or a strong consensus of Class III evidence ; . Practice Option Strategy for patient management for which the clinical utility is uncertain inconclusive or conflicting evidence or opinion and tacrolimus.

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GENERATION OF TRANSGENIC MICE THAT EXPRESS CRE RECOMBINASE SPECIFICALLY IN OSTEOCLASTS. W.S.M. Chiu, R.A. Davey, A.J. Notini, J.F. McManus, J.D. Zajac. Department of Medicine, The University of Melbourne, Austin and Repatriation Centre, Studley Road, Heidelberg, Victoria 3084, Australia. The Cre-lox system is a powerful technique, which allows tissue specific deletion of a target gene. The purpose of this study is to generate a transgenic mouse line that expresses Cre recombinase specifically in osteoclasts. We propose to utilise two promoters, tartrate-resistant acid phosphatase TRAP ; and cathepsin K CK ; , to generate two osteoclast specific Cre transgenic mouse lines. To test whether the TRAP and CK promoters are suitable to drive Cre expression specifically in osteoclasts, tissues were collected from 4 male and 4 female F1 CBA x C57Bl 6 mice and total RNA extracted. The mRNA levels of TRAP and CK were determined by Northern blot analysis. TRAP mRNA levels did not differ between males and females. TRAP mRNA is expressed in a number of tissues, however is significantly higher in bone compared with brain 14 fold ; , colon 4 fold ; , heart 25 fold ; , kidney 5 fold ; , liver 4 fold ; , lung 13 fold ; , muscle 15 fold ; and stomach 11 fold ; P 0.05 ; . Preliminary results demonstrate CK mRNA is expressed highly in bone and at lower levels in lung and ovary. In conclusion, TRAP ranging from 4 fold to 25 fold ; and CK are expressed at much higher levels in bone than other tissues. We are currently using these promoters to generate two Cre constructs. The resulting transgenic mice with the highest level of tissue specificity of Cre expression will be mated with lox mice to delete target genes of interest specifically in osteoclasts and pentoxifylline. PEGASYS . 12 quinapril hcl . 9 pemoline . 10 quinapril hctz . 9 penicillin v potassium. 5 quinerva . 7 PENTASA. 12 quinidine sulfate. 9 PENTOPAK . 10 RABAVERT . 12 pergolide mesylate . 7 RANEXA. 9 permethrin. 7 RANICLOR . 5 perphenazine . 7 ranitidine hcl. 11 phenazopyridine hcl . 11 RAPAMUNE. 12 PHENYTEK. 6 RECOMBIVAX HB . 12 phenytoin sodium . 6 REGRANEX . 10 pilocarpine hcl . 12 RELENZA DISKHALER. 8 piroxicam . 7 REMICADE. 12 PLAN B. 11 REQUIP . 7 plaretase. 11 RESCRIPTOR . 8 PLAVIX. 8 RESTASIS . 13 PLENAXIS . 11 RETROVIR. 8 podofilox. 10 REVEX . 13 polyethylene glycol 3350. 11 REV-EYES . 13 POLY-GAM SD . 12 REYATAZ. 8 polymixin b sulfate trimeth . 5 ribavirin . 8 potassium chloride . 13 RIDAURA . 12 potassium chloride sa . 13 rifampin. 7 PRANDIN . 8 RILUTEK. 10 pravastatin . 9 RISPERDAL. 7 PRECOSE . 8 RITUXAN . 12, 14 prednisolone acetate. 13 ROFERON-A. 12 prednisolone sodium phosphate. 13 ROMYCIN . 13 prednisone . 7 SANDOSTATIN LAR DEPOT. 11 PREMARIN . 11 SANTYL. 10 PREMPHASE . 11 selegiline hcl . 7 PREMPRO . 11 selenium sulfide. 10 primidone . 6 SENSIPAR. 12 procainamide hcl. 9 SEREVENT DISKUS . 9 prochlorperazine . 7 SEROQUEL. 7 PROCRIT. 8 sertraline . 6 PROGRAF . 12 simvastatin . 9 PROLEUKIN . 7 SINGULAIR . 13 propafenone hcl. 9 sodium fluoride . 13 propoxyphene acetaminophen . 5 sodium polystyrene sulfon. 13 propranolol hcl . 9 SOLARAZE. 10 propranolol hctz. 9 solia . 12 propylthiouracil . 12 SOMAVERT. 12 PROSCAR . 9 SONATA . 13 PROSTIGMIN . 8 sotalol hcl . 10 PROTONIX . 11, 14 SPIRIVA HANDIHALER . 9 PROVIGIL. 10 spironolactone. 10 PULMOZYME . 9 sps. 13 pyrazinamide . 7 STALEVO . 7 pyridostigmine bromide . 8 STARLIX. 8 H1099 EL644 25606A26606 Page 20 Sunshine.
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As you come to realize how many things affect health, you may think the health worker has an impossibly large job. And true, you will never get much done if you try to deliver health care by yourself. Only when the people themselves become actively responsible for their own and their community's health, can important changes take place. Your community's well-being depends on the involvement not of one person, but of nearly everyone. For this to happen, responsibility and knowledge must be shared. This is why your first job as a health worker is to teach--to teach children, parents, farmers, schoolteachers, other health workers--everyone you can. The art of teaching is the most important skill a person can learn. To teach is to help others grow, and to grow with them. A good teacher is not someone who puts ideas into other people's heads; he or she is someone who helps others build on their own ideas, to make new discoveries for themselves. Teaching and learning should not be limited to the schoolhouse or health post. They should take place in the home and in the fields and on the road. As a health worker one of your best chances to teach will probably be when you treat the sick. But you should look for every opportunity to exchange ideas, to share, to show, and to help your people think and work together. On the next few pages are some ideas that may help you do this. They are only suggestions. You will have many other ideas yourself. Fulton Health District 3-2 ; Fulton Grady Health System - Hughes Spalding Children's Hospital Metropolitan Hospital Children's Healthcare of Atlanta-Scottish Rite Emory Crawford W. Long Hospital Atlanta Medical Center Grady Health System Kindred Hospital North Fulton Regional Hospital Northside Hospital Piedmont Hospital Saint Josephs Hospital Atlanta South Fulton Medical Center Select Specialty Hospitals, for example, prograf medicine.
Competition in research, involving the development and the improvement of new and existing products and processes, is particularly significant and results from time to time in product and process obsolescence. The development of new and improved products is important to the Company's success in all areas of its business; Difficulties inherent in product development, including the potential inability to successfully continue technological innovation, complete clinical trials, obtain regulatory approvals in the United States and abroad, gain and maintain market approval of products and the possibility of encountering infringement claims by competitors with respect to patent or other intellectual property rights which can preclude or delay commercialization of a product; Significant litigation adverse to the Company including product liability claims, patent infringement claims, and antitrust claims; Product efficacy or safety concerns resulting in product recalls, regulatory action on the part of the FDA or foreign counterparts ; or declining sales; The impact of business combinations, including acquisitions and divestitures, both internally for the Company and externally in the pharmaceutical and health care industries; and Issuance of new or revised accounting standards by the American Institute of Certified Public Accountants, the Financial Accounting Standards Board or the Securities and Exchange Commission. The foregoing list sets forth many, but not all, of the factors that could impact upon the Company's ability to achieve results described in any forward-looking statements. Investors should understand that it is not possible to predict or identify all such factors and should not consider this list to be a complete statement of all potential risks and uncertainties. The Company has identified the factors on this list as permitted by the Private Securities Litigation Reform Act of 1995 and tacrolimus.

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The study protocol was approved by the local ethics committee and all 30 healthy postmenopausal volunteers age 49-61 years, bodyweight 50-78kg ; signed informed consent before participating in the study.
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