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Name kava ; products in UK, the Committee on the Safety of Medicines CSM ; advised the Medicines Control Agency MCA ; to revoke licenses for all products containing the herbal ingredient. The banning order followed the CSM conclusion, based on available reports, that the risk-benefit ratio for products containing kava is not acceptable. The MCA is currently aware of 68 cases worldwide of liver problems suspected to be associated with kava. There have been three cases of liver toxicity in the UK suspected to be due to consumption of kava. Australia3. In August 2002 Australia's medicines safety regulator, the Therapeutic Goods Administration TGA ; initiated a voluntary recall of all complementary medicines containing the herb kava. The action follows the death of a woman in Australia who used a medicine containing kava. The woman had been taking several complementary medicines, one of which contained kava. She presented with liver failure within 4 months of taking this product. The TGA will undertake a further evaluation of the use of kava to determine other regulatory measures, in addition to the voluntary recall. Canada4. On 21 August 2002 Health Canada issued a warning on kava requiring a stop-sale of all kava-containing products and a recall of these products from the Canadian market. This measure comes in the wake of reports associating the use of kava with serious liver function received by Health Canada and several foreign regulatory agencies. Consumers have been advised to check the label of any herbal or food products and to discontinue the use of such products if found to contain kava. Health Canada will be establishing an Expert Advisory Panel to determine under what conditions kava might be allowed to return to the market, for example, prednisolone.
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Prevalncia de prescrio de medicamentos para pacientes idosos e no-idosos internados em um hospital escola CONTEXTO: As alteraes farmacocinticas e farmacodinmicas associadas ao envelhecimento tm sido amplamente documentadas, bem como o freqente uso simultneo de vrios medicamentos como conseqncia da elevada prevalncia de doenas crnicodegenerativas entre os idosos. Conseqentemente, o risco de reaes adversas a medicamentos e de interaes medicamentosas aumenta em idosos. Entretanto, poucos estudos tm comparado os padres de prescrio para diferentes grupos etrios de pacientes hospitalizados ou avaliaram os efeitos da idade na prescrio de medicamentos. OBJETIVO: Comparar a prevalncia de prescrio de medicamentos para pacientes idosos e no-idosos em um hospital geral universitrio a fim de avaliar se existem diferenas relacionadas idade quanto ao nmero de medicamentos prescritos, quanto escolha dos medicamentos e quanto s doses prescritas, bem como a adequao da prescrio para os pacientes idosos. TIPO DE ESTUDO: Estudo observacional, do tipo transversal. LOCAL: Hospital-escola, de complexidade terciria, com 400 leitos. AMOSTRA: Todos os pacientes internados em um dia do ms de junho de 1995, excluindo os internados na Unidade de Terapia Intensiva e dos Departamentos de Psiquiatria, Pediatria, Ginecologia e Obstetrcia. PROCEDIMENTO: Todos os medicamentos prescritos para os pacientes adultos internados nas enfermarias includas no estudo foram registrados a partir da folha de prescri and desyrel.
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CORE ABSTRACTS 124. A model-based comparison of cost effectiveness of imiquimod versus podophyllotoxin for the treatment of external anogenital warts in France Fren ; Lafuma A. Monsonego J. Moyal-Barracco M. Pribil C. [A. Lafuma, Cemka Eval, 43, boulevard Mar chal Joffre, 92340 e Bourg la-Reine, France] - ANN. DERMATOL. VENEREOL. 2003, 130 8-9 I 731-736 ; Objectives. For the National health scheme, to compare the costs and the efficacy of treatment of external anogenital warts with imiquimod and podophyllotoxin and laser therapy in the case of failure or relapse. Patients and methods. A model simulating the two successive treatments was built. In the first phase, the two topical treatments applied by the patients: podophyllotoxin for 4 weeks and imiquimod for 16 weeks were compared. In the case of failure or relapse, laser therapy that is widely used in France in this indication and, was applied. The efficacy of the topical treatments was assessed after reanalysis of the results of two controlled clinical trials versus placebo. These two trials were retained because they were comparable in method and had been recently published at the same time. A review of the literature assessed the results of laser therapy. A survey was conducted to collect the medical resources consumed by the different treatments. Results. Imiquimod provided a clearance rate of 49.5 p. 100, i.e., the disappearance of the lesions at 16 weeks, greater than that of podophyllotoxin 28.3 p. 100 ; at 4 weeks. The relapse rate was lowest with imiquimod 13.3 p. 100 ; than with podophyllotoxin 30.9 p. 100 ; . The remission rate without relapse 3 months after the end of treatment was, including the laser, of 62 p. 100 following imiquimod and of 47 p. 100 following podophyllotoxin. The costs per patient cured was of 668 euros for imiquimod and of 689 euros for podophyllotoxin. Conclusion. Imiquimod, because of its greater initial efficacy, is at least as cost-effective as podophyllotoxin the treatment of external genital warts. 125. The interest of radiological follow-up for stage III melanoma Fren ; Kerob D. Baccard M. Dupuy A. et al. [D. Kerob, Service de Dermatologie 2, H pital Saint-Louis, 1, avenue o Claude Vellefaux, 75010 Paris, France] - ANN. DERMATOL. VENEREOL. 2003, 130 8-9 I 739-741 ; Introduction. The modalities of follow-up frequency of consultations and interest of repeated radiological examinations ; of patients presenting with glandular metastases of melanoma stage III of the AJCC classification ; have not reached a consensus. Patients and methods. Since 1995, we have proposed clinical follow-up every two months and radiological controls with a thoracic-abdominal-pelvic scan every 4 months, to patients at high risk of relapse for the early screening of an infra-clinical relapse. Results. The median follow-up was of 16 month's range: 1 to 82 months ; . Eight patients out of 24 33 100 ; followed-up in this manner, had asymptomatic metastases discovered by the radiological examinations. Among these 8 patients, three presented with a an operable, single, metastatic localization and two patients underwent surgery. One patient relapsed 3 months later, the other was still alive without relapse 24 months later. Discussion. Surgery remains the treatment of choice for all stages of melanoma. In the absence of clearly effective treatment of metastatic melanoma, the early discovery of an infra-clinical metastatic relapse presents two major advantages. The first is the discovery of a single, operable metastasis, as was the case in two of the patients out of 24. The second is to be able to suspend an eventual adjuvant therapy with interferon alpha, as soon as a relapse has been discovered.
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2. Hulshoff A and Perrin J H 1977 J. Med. Chem. 20 430 3. Glasser H and Krieglstein J 1970 Naunyn-Schmiedebergs Arch. Pharmakol. 265 331 4. Thimmaiah K N, Horton J K, Seshadri R, Israel M, Houghton J A, Harwood F C and Houghton P J 1992 J. Med. Chem. 35 3358 5. Thimmaiah K N, Horton J K, Qian X D, Beck W T, Houghton J A and Houghton P J 1990 Cancer Commun. 2 249 6. Horton J K, Thimmaiah K N, Harwood F C, Kuttesh J D and Houghton P J 1993 Mol. Pharmacol. 44 552 7. Thimmaiah K N, Jayashree B S, Germain G S, Houghton P J and Horton J K 1998 Oncol. Res. 10 29 8. Eregowda G B, Kalpana H N, Hegde R and Thimmaiah K N Indian J. Chem. B in press ; . 9. Eregowda G B, Krishnegowda G, Kalpana H N, Channu B C, Dass C, Horton J K, Houghton P J and Thimmaiah K N 1999 Asian J. Chem. 11 878 10. Zamora J M, Pearce H L and Beck W T 1988 Mol. Pharmacol. 33 454 11. Bird A E and Marshall A C 1967 Biochem. Pharmacol. 16 2275 12. Hansch C 1968 J. Med. Chem. 11 920 13. Hansch C and Fujita T 1964 J. Am. Chem. Soc. 86 1616 14. Hansch C, Kiehs K and Lawrence G L 1965 J. Am. Chem. Soc. 87 5770 15. Scholtan W, Schlossmann K and Rosenkranz H 1968 Arzneimitted-Forsch. 18 767 16. Kauzmann W 1959 Adv. Protein Chem. 14 1 17. Girard A 1962 US Patent 3 048, 586; Chem. Abstr. 58 147lg 18. Franz J W, Jahnchen E and Krieglstein J 1969 Naunyn-Schmiedebergs Arch. Pharmakol. 264 462, because .
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