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Table 2 Expression of GAD67 and Gleason scores in the prostates of cancer patients with or without metastasis All prostate samples are divided into four groups according to Gleason score and expression of GAD67. The number in parentheses in each group indicates the number of prostates from patients with metastasis. Fisher's exact analysis demonstrated a significantly higher frequency of GAD67 expression in the prostates with higher Gleason scores P 0.001 ; . Binomial logistic regression analysis revealed that expression of GAD67 was associated with a significantly higher risk of metastasis odds ratio, 46.861; 95% confidence interval, 16.01137.21 ; than a higher Gleason score odds ratio, 3.463; 95% confidence interval, 1.0511.48 ; . Gleason GAD67-positive GAD67-negative 8 4 ; 44 4 ; Gleason 66 61 ; 30.
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Establishing at least one such treatment centre in every district of the country NCD 1998 ; . Government response to drug use and HIV There is an acknowledgment by the Ministry of Health that IDUs are at a high risk of acquiring HIV and other blood born viruses, largely as a result of the widespread sharing of injecting equipment. They are also aware the risks are not just associated with injecting, that IDUs can pose a risk to others through sexual transmission. Yet, at this stage, the government and the NGO sector have a limited capacity to respond. The focus is upon supply and demand reduction and the government is fully aware that a full range of services for drug users remains severely limited. Harm reduction has been considered as a way to address the current problems but it will require substantial financial support both from international and federal bodies and a strong political will NCD 1998 ; . There are currently no plans to introduce government funded needle syringe programs NSP ; although the government has permitted a NSP to operate in Lahore by the NGO Nai Zindagi. As a result of the NSP in Lahore, other such programs have now been initiated by the same NGO in collaboration with partner NGOs in Quetta, Rawalpindi, Karachi and Peshawar. The focus of these programs is to provide street outreach services to reduce HIV transmission and to provide referral for drug treatment T. Zafar personal communication 2001 ; . There are currently no substitution therapy programs in the country. National AIDS Policy In 1987 the government established the Federal Committee on AIDS and in 1988 the National AIDS Control Programme NACP ; was launched. The NAP plays an important role in increasing awareness about HIV AIDS issues in Pakistan but many of its efforts have been thwarted as a result of inconsistent political resolve and a scarcity of financial resources MOH and UNAIDS 2000 ; . At end of 1999, NACP with various other bodies both government and non-government, expanded the National HIV AIDS Strategic Framework for 2001 to 2006. In this new framework nine priority areas are the focus including vulnerable and high-risk groups such as IDUs. One of the goals is to implement effective peer education programs and to initiate innovative comprehensive harm reduction programs for IDUs, which would also include income-generating initiatives MOH 2000 ; . There are no specific details available about these harm reduction initiatives or how they should operate. With the ongoing social, economic and political difficulties in Pakistan it is difficult to determine how much of an impact these new approaches will have upon the very large drug using community of Pakistan. Non government responses to drug use and HIV It is acknowledged that the HIV epidemic cannot be addressed by the government alone and that NGOs have special access to groups at higher risk of HIV infection. Currently there are least 72 NGOs involved in HIV AIDS related activities but very few are directly involved with working with drug users MOH and UNAIDS 2000 ; . The NGO Nai Zindagi based in Lahore, is a key agency working directly with drug users and IDUs with funds received from UNAIDS. Founded in 1990, they not only.
Clean their floors, and diaper their babies, and asking them about their habits and frustrations. Back in 2000, the typical brand marketer spent less than four hours a month with consumers. Says Stengel: "It's at least triple that now." Lafley, meanwhile, prods everybody he meets to view the brands not as scientists who focus on technical perfection ; but as consumers. So does Deb Henretta. The president of P&G's baby-care division, she opened a diaper-testing center right down the hall from her office. There dozens of young moms watch their tots get undressed, diapered, and measured every which way by P&G technicians in brightly colored smocks. One thing the lab experience has taught P&G is that parents are frustrated by how long it takes their youngsters to be toilet trained. So this August, Henretta is launching a new line, Pampers Feel 'n Learn Advanced Trainers, designed to stay wet for two minutes, alerting toddlers to try tinkling in the toilet. Expand what each brand does. Pampers' mission changed from "we want the driest diapers" to "helping moms with baby's development." Such rethinking and the spate of new products that went with it, from Easy Ups training pants to Kandoo baby wipes, have helped Pampers--P&G's biggest brand--gain share against Kimberly-Clark's Huggies for the first time in nearly a decade. The Crest brand, which had lost share to Colgate for seven years straight, is another example. Its new strategy: "A healthy, beautiful smile for life." P&G created a new category, teeth-whitening systems, with Crest Whitestrips, peroxide-coated strips that adhere to your choppers, and Crest Night Effects paint-on gel. With $300 million in annual retail sales, these products dominate the market with a 70% share. Crest SpinBrush, a toothbrush with a battery-powered rotating head, brings in $160 million in sales, making it the nation's bestselling toothbrush. And new highintensity toothpaste flavors like citrus and cinnamon, which appeal to young and ethnic consumers, have helped Crest catch up to Colgate in the U.S. toothpaste wars. Though still No. 2 globally, Crest has doubled in sales in three years, and profits are up even more. Get employees from different divisions to exchange ideas. North American oral-care boss Diane Dietz got help on Crest's new flavors from her colleagues who work on Millstone coffee and Herbal Essences shampoos. Aroma experts, they helped her develop a scratch-and-sniff feature on Crest packages. She also looks for marketing advice when she goes to the "top-15 meetings" that CMO Stengel convenes every quarter for the key people who work on P&G's 15 biggest brands. "We don't exist in silos anymore, " says Susan Arnold, P&G's beauty-care and femininecare boss, who picks up ideas when she roams the "poster shows"--internal trade shows in which each business unit displays a storyboard listing recent successes and best ideas. P&G's 7, 500 R&D people, located in 20 technical facilities in nine countries, post problems "How can you clean without rinsing?" ; on an internal website and also meet in "communities of practice" dedicated to areas of expertise. Need to know about whiteners? Come to the Bleach COP meeting on Monday! ; Lafley evaluates the scientists' and marketers' idea sharing when he conducts half-day "innovation reviews" in each business unit annually. "People get just as much credit for giving good ideas as for receiving, " he says. It works see table for products that resulted from intracompany collaboration ; . Just one example: To develop Mr. Clean AutoDry, home-care R&D boss Karl Ronn turned to scientists in P&G's Pur water purification unit and to the folks who work on Cascade and know how to dry dishes without spotting. When necessary and leflunomide, for example, .
443. Nunn P, Kibuga D, Gathua S, Brindle R, Imalingat A, Wasunna K, Lucas S, Gilks C, Omwega M, Were J, McAdam K. Cutaneous hypersensitivity reactions due to thiacetazone in HIV-1 seropositive patients treated for tuberculosis. Lancet 1991; 337: 627-30. Ipuge YAI, Rieder HL, Enarson DA. Adverse cutaneous reactions to thiacetazone for tuberculosis treatment in Tanzania. Lancet 1995; 346: 657-60. Kelly P, Buve A, Foster SD, McKenna M, Donnelly M, Sipatunyana G. Cutaneous reactions to thiacetazone in Zambia - implications for tuberculosis treatment strategies. Trans R Soc Trop Med Hyg 1994; 88: 113-5. Saiag P, Caumes E, Chosidow O, Revuz J, Roujeau JC. Drug-induced toxic epidermal necrolysis Lyell syndrome ; in patients infected with the human immunodeficiency virus. J Acad Dermatol 1992; 26: 567-74. Dukes CS, Sugarman J, Cegielski JP, Lallinger GJ, Mwakyusa DH. Severe cutaneous hypersensitivity reactions during treatment of tuberculosis in patients with HIV infection in Tanzania. Trop Geogr Med 1992; 44: 308-11. Roujeau JC. Toxidermies au cours de l'infection VIH. Presse Md 1994; 23: 111-2. Nunn P, Porter J, Winstanley P. Thiacetazone - avoid like poison or use with care? Trans R Soc Trop Med Hyg 1993; 87: 578-82. van Gorkom J, Kibuga DK. Cost-effectiveness and total costs of three alternative strategies for the prevention and management of severe skin reactions attributable to thiacetazone in the treatment of human immunodeficiency virus positive patients with tuberculosis in Kenya. Tubercle Lung Dis 1996; 77: 30-6. Sbarbaro J, Blomberg B, Chaulet P. Fixed-dose combination formulations for tuberculosis treatment. Editorial ; . Int J Tuberc Lung Dis 1999; 3 suppl ; : S286-S288. 452. International Union Against Tuberculosis and Lung Disease. Assuring bioavailability of fixed-dose combinations of anti-tuberculosis medications. A joint statement of the International Union Against Tuberculosis and Lung Disease and the World Health Organization. As approved by the Executive Committee and Council of the IUATLD, Bangkok, November 1998. Int J Tuberc Lung Dis 1999; 3 suppl ; : S282-S283. 453. Anonymous. Quality assurance: protocol for assessing the rifampicin bioavailability of combined formulations in healthy volunteers. Int J Tuberc Lung Dis 1999; 3 suppl ; : S284-S285. 454. Chaulet P. Implementation of fixed-dose combinations in tuberculosis control: outline of responsibilities. Int J Tuberc Lung Dis 1999; 3 suppl ; : S353-S357. 455. Blomberg B, Kitler ME, Milstien J, Dellepiane N, Fanning A, Norval PY, Spinaci S. Availability of quality fixed-dose combinations for the treatment of tuberculosis: what can we learn from studying the World Health Organization's vaccine model? Int J Tuberc Lung Dis 1999; 3 suppl ; : S371-S380.
845. Fife C, Meyer JS, Margishvili GM. The use of hyperbaric oxygen in the treatment of headache - Hyperbare Oxygenationstherapie - Intensivinedizin, Kopfschmerz, Schlaganfall. Interdisziplinares Symposium zur hyperbaren Oxygenationtherapie, Gottingen, pages 41-52, Archimedes Verlags GmbH 1998. 846. Meyer JS, Konno S, Margishvili GM, Terayama Y. Vasodilator response to acetazolamide tested in subtypes of vascular dementia. J. Stroke and Cerebrovascular Disease, 7 5 ; , pp. 323-329, 1998. 847. Meyer JS, Konno S, Margishvili GM, Haque Md. A. Transformed Migraine as a cause of chronic daily headache. Proceedings XII Migraine Trust International Symposium, London, England, pp. 14-15, 1998. 848. Meyer JS, Rauch GM. Editorial. Gender differences in cerebral perfusion. J. Neurol. Sciences, 162: 133, 1999. Konno S, Meyer JS, Margishvili GM, Rauch RA, Haque A. Transformed migraine is a cause of chronic daily headaches. Headache, 39: 95-100, 1999. Meyer JS, Rauch GM, Rauch RA, Haque A. Risk factors for cerebral hypoperfusion, cognitive decline and dementia. In Hemodynamics and cerebral perfusion: new evidence in the pathology of AD. International Business Communications Conference Symposium, 225 Turnpike Road, Southborough, MA 1772-1749. 1999. 851. Meyer JS, Rauch GM, Haque A, Rauch RA. Cardiovascular and other risk factors for Alzheimer's Disease and Vascular dementia abstracts ; . In Vascular Factors in Alzheimer's Disease. Alzheimer's Reports 1999 S5 1, Editorial Office, Department of Medicine, Box 157, Addenbrook's Hospital, Hills Road, Cambridge, CB2 2QQ UK. 852. Mortel KF, Meyer JS, Rauch GM, Rauch RA, Haque Md.A. Factors influencing survival among patients with Vascular dementia and Alzheimer's disease. J. Stroke and Cerebrovascular Disease. 1999; 8: 57-65. Rauch GM, Meyer JS, Haque A, Rauch RA. Aging, risk factors for cognitive decline and dementia. J. Cerebral Blood Flow and Metabolism. 1999 19: Suppl. 1 S15. 854. Meyer JS, Rauch GM, Rauch RA, Haque A. Risk factors contributing to dementias of vascular and Alzehimer's type. In 1st International Congress of Vascular Dementia Koreyn, A.D., ED. ; Monduzzi Editore, Bologna, Itraly, 1999; 67-70 and donepezil.
9 Normal concentrations of GHB in urine are less than 0.010 mg mL 28, 31, 32 ; . In acute overdose cases, concentrations of GHB in urine average about 1 mg mL 15, 33 ; and are very robustly detected by the methods developed here. In fact, dilution or use of a smaller volume of urine obtained from an individual in severe overdose would be required to obtain non-saturating results. Although ethanol is an alternative substrate for GHB-DH, it binds too weakly to yield false positives at concentrations that might occur in urine. About 1% w v ; ethanol is threshold for false positives in both solution endpoint and dipstick tests. Dipsticks should be read at 2 min, as longer time periods can result in false positives. Another potential application for a GHB test is screening of beverages. However, the high concentrations of ethanol found in typical alcoholic beverages do produce substantial color in 2 min. As GHB is not volatile and ethanol is, alcoholic beverages can be evaporated before testing to avoid false positives. The dipstick assay easily detects GHB at concentrations that are sub-psychopharmacologic in a 4-oz beverage. The color of a tested beverage can affect interpretation of a dipstick result. Of 25 unadulterated alcoholic beverages tested, only red wine produced a color that could be mistaken for the presence of GHB. However, the color was present before dipstick assay reagent was applied and could be recognized not to be due to GHB by that behavior. This type of false positive also could be recognized by a novice if two pro-dyes producing different colors were painted side-by-side on the dipstick paper. Other assays for GHB either a ; require sophisticated equipment, a skilled person and a relatively long time period to complete 34-37 ; , or b ; use chemistry that is hazardous, multi-step and very susceptible to false positives 38-40 ; . In contrast, the enzymatic assay for GHB is reliable, sensitive, inexpensive and rapid. Also, common stabilizers of physiological fluids do not compromise enzymatic assay. In experiments not shown here, sensitivity has been increased significantly, and GHB in samples of human serum and saliva have been assayed successfully. Further development and validation of these enzymatic screening tests for GHB might identify additional opportunities and should delineate limitations in forensics applications.
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Managing Officer, Toyota Motor Corporation President and CEO, Toyota Motor Marketing Europe NV SA Tadashi Arashima joined Toyota in April 1973 after graduating from Keio University's Faculty of Law in March that same year. In January 1997, he was made general manager of the Production Control Division's Control Department and, in January 1998, he was appointed general manager of the Europe & Africa Division's Marketing Department. In January 1999, he became general manager of the Europe & Africa Division. January 2000 saw him seconded to Toyota Motor Marketing Europe NV SA, before returning to Japan and taking up the position of general manager at the Europe & Africa Operations Center's Europe Division in January 2003. In June 2003, he was made a managing officer. The European market is characterized by fierce competition and is full of customers who possess a very keen eye. Mr Arashima wants to make every effort to develop this market as the third pillar in Toyota's global strategy. Bearing in mind that `the automobile business equals the people business', he hopes to be able to lend a hand in further developing and establishing `The Toyota Way' in sales and marketing. Mr Arashima was born in 1949, in Ise City, Mie Prefecture. He and his wife, Sachiko, have two sons. In his spare time, he enjoys listening to music, watching sports, playing golf, watching movies and traveling and mesalazine.
The dramatic increase over the past 10 years in the amount of available clinical research on the use of antidepressants to treat major depression in children and adolescents has substantially improved our knowledge of the safety and efficacy of these medications in the pediatric population. Many questions remain, however, that highlight the need to continue research in this patient population rather than relying on the extrapolation of data from trials involving adults. In this article, we review the current state of research into antidepressant therapy for major depression in children and adolescents. In addition, we discuss methodologic issues and clinical implications specific to the pediatric population, for example, plasmodium falciparum.
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