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From a presently undetermined date until 1958, researchers from the School of Aviation Medicine, Randolph AFB, TX studied temporomandibular joint physiology. This project was a subtask of a larger study investigating new methods of dental diagnosis, which began in March 1952. This larger investigation focused on the need to improve the dental health of Air Force personnel and in particular the methods of dental diagnosis i.e., more sophisticated and effective roentgenography, tomography, and panography ; , which were considered outmoded. The purpose of the subtask was to develop satisfactory methods of temporomandibular joint xray and develop a radiographic procedure that would permit serial radiographs to be made while the patient was in a postural upright position. To date, no information is available on the number of participants. The technique developed during this subtask incorporated a cephalometer that enabled accurate serial radiographs as treatment progressed. The cephalometric instrument was forecasted for use in other studies of the temporomandibular joint. Synopsis The Independent Advisory Group for Sexual Health and HIV are calling for sexual health to be moved up the agenda to address high rates of sexually transmitted infections, high levels of teenage pregnancy and to reduce nationwide variations in abortion provision. In its first annual report the Group has made 29 recommendations to the government, covering the broad areas of prioritising sexual health within public health, improving prevention and education, delivering better co-ordinated and faster services and doing more research. During its first year the Group had taken a hard look at the way sexual health is approached in this country. Its report outlined what the government could do to tackle rapidly emerging problems, but also set out the role that general practices, primary care trusts, healthcare organisations and individuals could play. Recommendations included increasing availability of free condoms through the NHS and removing VAT on all over the counter contraceptives, the NHS to fund at least 90 per cent of abortions, cutting waiting times to 48 hours or less for appointments at genitourinary medicine clinics, the routine offer of an HIV test whilst there and tailored sexual health services for ethnic minority groups. The annual report also set out the scale of the sexual health problem in the UK. It stated diagnoses of sexually transmitted infections including HIV are still rising. Despite recent reductions the UK still has the highest teenage pregnancy rate in Western Europe, and there are significant variations in abortion services both in terms of waiting times and NHS funding. The Government will formally respond to the recommendations made in the report later in the year Title Source GP practices encouraged to directly commission care Department of Health Link and aceon.

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Analysis of randomized double-blind studies. JAMA 1996; 275: 15071513. Konstam MA, Kronenberg MW, Rousseau MF, et al. Effects of the angiotensin converting enzyme inhibitor enalapril on the long-term progression of left ventricular dilatation in patients with asymptomatic systolic dysfunction. SOLVD Studies of Left Ventricular Dysfunction ; Investigators. Circulation 1993; 88: 2277283. Schneider CA, Voth E, Moka D, et al. Improvement of myocardial blood flow to ischemic regions by angiotensin-converting enzyme inhibition with quinaprilat IV: a study using [15O] water dobutamine stress positron emission tomography. J Coll Cardiol 1999; 34: 10051011. Prasad A, Husain S, Quyyumi AA. Effect of enalaprilat on nitric oxide activity in coronary artery disease. J Cardiol 1999; 84: 1 Ridker PM, Gaboury CL, Conlin PR, et al. Stimulation of plasminogen activator inhibitor in vivo by infusion of angiotensin II: evidence of a potential interaction between the renin-angiotensin system and fibrinolytic function. Circulation 1993; 87: 1969 Jafar TH, Schmid CH, Landa M, et al. Angiotensin-converting enzyme inhibitors and progression of nondiabetic renal disease: a meta-analysis of patient-level data. Ann Intern Med 2001; 135: 73 Hokimoto S, Yasue H, Fujimoto K, et al. Expression of angiotensin-converting enzyme in remaining viable myocytes of human ventricles after myocardial infarction. Circulation 1996; 94: 15131518. Shotan A, Widerhorn J, Hurst A, Elkayam U. Risks of angiotensinconverting enzyme inhibition during pregnancy: experimental and clinical evidence, potential mechanisms, and recommendations for use. J Med 1994; 96: 451 Rose BD. Clinical Physiology of Acid-Base and Electrolyte Disorders, 4th ed. New York: McGraw Hill, 1994. Choudhri AH, Cleland JG, Rowlands PL. Unsuspected renal artery stenosis in peripheral vascular disease. BMJ 1990; 301: 11971198. Reardon LC, Macpherson DS. Hyperkalemia in outpatients using angiotensin-converting enzyme inhibitors. Arch Intern Med 1998; 158: 26 Textor SC, Bravo EL, Fouad FM, Tarazi RC. Hyperkalemia in azotemic patients during angiotensinconverting enzyme inhibition and aldosterone reduction with captopril. J Med 1982; 73: 719 Burnier M, Brunner HR. Angioten. Some people conclude that they are happier taking medication after all and risedronate.
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The big-cap drug companies' fixation on blockbusters, which took hold following the mega-mergers of 2000, has certainly given the specialty pharmaceuticals industry a lot of room to maneuver. In 2000, when Pfizer Inc. moved to acquire Warner-Lambert Co. in a $91.5 billion hostile takeover, edging out a lesser bid by drug rival American Home Products Corp., the landscape began to change. That same year, Glaxo Wellcome Plc merged with SmithKline Beecham Plc in a $78 billion deal. Pfizer's market capitalization today stands at $244.9 billion; Glaxo SmithKline's is $146.4 billion. Merck & Co. Inc. is valued at $126.8 billion. Eli Lilly and Company and Bristol-Myers Squibb Co. are valued at $85.43 billion and $62.42 billion, respectively. And more mega-mergers are expected; weeks ago, Bristol became the subject of takeover rumors among investors. As the big-cap pharmaceuticals business gets bigger, opportunities abound for companies that want to concentrate on niche drugs. "For Merck, a $100 million product represents less than 1% of sales. Yet, it is expensive to maintain drugs, " says Paul Donofrio, an investment banker focusing on specialty pharmaceuticals for Banc of America. Applied Biosystems with its joint-venture partner MSD Sciex announced the introduction of a line of LC systems at PittCon 2006. With the introduction of TempoTM LC systems, Applied Biosystems MDS Sciex now offers complete application-based solutions for proteomics, biomarker, and drug discovery studies. These total systems provide single-vendor LC MS solutions that include sales, installation, service, and support. The new product line includes four separate systems: TempoTM nano LC system for 1-dimensional nano HPLC TempoTM nano MDLC for multi-dimensional HPLC TempoTM ht LC system for high-throughput microflow applications TempoTM LC MALDI Spotting System for MALDI MS The TempoTM LC systems are custom manufactured by Eksigent Technologies, LLC Dublin, CA ; . 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Conference in Portland Oregon, Let me close with a concrete prophysicians in the U.S. and and the next DAN! Conference is posal and a challenge: some overseas. Most scheduled for the Washington, DC area I urge that the Federal Government important, there are April 16-18, 2004. We also have held undertake the evaluation of autistic chilthousands of children, a series of mini-DAN! conferences for dren who have been treated by the docmany, as noted above, the the training of physicians and other tors in our Defeat Autism Now! DAN! ; sons and daughters of healthcare practitioners, and are develmovement, as compared to children DAN! physicians, who are oping a curriculum for teaching nurses treated by physicians who adhere to the no longer diagnosed as how to implement the DAN! apconventional, much less effective treatautistic and who have proaches to diagnosis and successful ment modalities. been mainstreamed in treatment of autism. See I propose that the NIH fund imtheir school systems. The AutismResearchInstitute or mediately, on a high-priority basis, a DAN! program is having DefeatAutismNow . ; There low-cost telephone or mail questionnaire excellent success! are at present several hundred DAN! survey of 1, 000 parents of autistic chilphysicians in the U.S. and some overdren, divided into two groups: seas. Most important, there are thousands of children, Group A. Parents whose autistic children have many, as noted above, the sons and daughters of DAN! been patients, for one year or longer, of 25 DAN! physicians, who are no longer diagnosed as autistic and doctors selected by the Autism Research Institute. who have been mainstreamed in their school systems. Twenty patients would be selected randomly from the The DAN! program is having excellent success! pool of autistic patients treated by each of the 25 DAN! Despite the obviously good results we are achievdoctors. ing, there are a great many obstacles to overcome. One Group B. Similar to Group A, except that the major obstacle is the obstinate insistence by the Food children would be from the practices of 25 pediatriand Drug Administration that there is no effective treatcians selected by NIH or the American Academy of ment for autism, and that it is quackery to claim otherPediatrics. wise. I would like to submit as part of my testimony the The survey would ask for such information as: following letter written by myself and Jon Pangborn, 1. The child's symptoms, pre- and post-treatment. Ph.D. also the father of an adult autistic son ; to Mark 2. Any objective criteria of improvement e.g., McClelland, M.D., Commissioner of the FDA. Note that mainstreamed? IQ improvement? Speaking? Number of the FDA claims on its website that autism is hopeless words sentences? etc. ; . and untreatable, despite a great deal of scientifically3. The parents' rating of improvement 10-point documented evidence to the contrary. In our letter of scale ; . May 8, 2003 to Dr. McClelland, which has yet to re4. Which treatments were provided? ceive a satisfactory reply, I cite some of the evidence 5. Which treatment modalities have helped the child which disproves the contentions of the FDA policy statemost? ment. For example, I cite, and placed into evidence, 22 The parent responses to questions 1, 2, and 3 would published studies, based on research conducted by scibe analyzed by judges who are blind to whether the paentists in 6 countries, demonstrating that vitamin B6 tients were in Group A or Group B. This would be an usually in combination with the mineral magnesium ; excellent launching pad for a long-neglected and longbrings about highly significant improvement in autistic needed federal program of research on effective autism children and adults. Eleven of these studies have been treatments. double-blind, placebo-controlled experiments, and many The hour is late -- let's move ahead. Tell your health care professional if you are using any other prescription or nonprescription over-the-counter ; medicine that is to be used in the eye and albenza and quinapril, for example, losartan.

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1. Guo Y, Byrn SR, Zografi G. Physical characteristics and chemical degradation of amorphous q8inapril hydrochloride. J Pharm Sci. 2000; 89: 128Y143. Strickley RG, Visor GC, Lin H-H, Gu L. An unexpected pH effect on the stability of moexipril lyophilized powder. Pharm Res. 1989; 6: 971Y975 and albendazole.

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P-52 DOSE VARIABILITY ALONG A SEED STRAND DUE TO STRAND CURVATURE IN CORONARY INTRAVASCULAR BRACHYTHERAPY Martin Bues, Ph.D., Edward J Holupka, Ph.D., Anthony L Abner, M.D. 1Radiation Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, because what is quinapril.

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That junior surgical trainees are as effective, if not more so, in harvesting venous conduits for CABG, than surgical assistants. They base this conclusion on the analysis of outcomes which are largely irrelevant on how or who harvested the venous conduits. Quality of harvesting venous conduits affect at least two important outcomes which have not been analysed in their study, namely shaphenectomy site infection, and mid and long-term patency of venous grafts. It is practice in some teaching departments to let the junior-most trainee to harvest the long saphenous vein, whilst more senior surgeons harvest the arterial conduits and prepare the patient for cardio-pulmonary bypass. It is therefore conceivable that the quality of the harvested conduits and wound closure technique would not compare favourably to someone who has received formal teaching and has broad experience in completing the task. Junior trainees benefit from having surgical assistants available in the operating theatre. They can learn from these assistants who have the time and knowledge to teach. In addition, once the trainee has become competent in the procedure, he or she can dedicate their educational time to learn other advanced techniques. Needlessly performing simple, repetitive tasks, such as vein harvesting, compromises the overall learning continuum and advancement of junior trainees. Allowing proficient surgical assistants to complete straightforward tasks in the operating room facilitates the learning process of junior and senior trainees. In their paper the authors also state that cardio-thoracic surgery training is based on a form of apprenticeship. This concept needs to be changed. Never before have cardio-thoracic surgeons been as accountable as they currently are, and never before have there been so many expectations placed on them. And yet, cardio-thoracic trainees are asked to limit the time they spend at their teaching hospitals in order to comply with working time directives. The cardio-thoracic surgeons of the XXI century will have to be trained in a `48 h week' setting. Novel and innovative training strategies will have to be introduced in the teaching of the specialty. The time residents spend at their teaching units will have to be optimised for learning. We have to evolve from the concept of trainees as apprentices to the concept of trainees as learners. Surgical assistants can play an important role in this process. References. Living footnotes from the harvard health letter, volume 20 number 10, august 1995: cholesterol ldl - small, dense cholesterol particles worse for your heart - study at the lawrence berkeley laboratory american heart association cholesterol education program telnet session you can control cholesterol, and the sooner, the better - study at the cardiovascular institute of the south.

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