...Human NutritionProfessor Chitra Wendakoon | Rheumatoid Arthritis | By Daniel Schramm | Schramm 2/24/2013 | What is Rheumatoid Arthritis? Rheumatoid Arthritis is an autoimmune disease that we do not get from a virus or human contact. The disease is our own body’s immune system turned against its self. Your immune system is an assembly of cells and organs intended to safeguard your body from external intruders. Your structure comprises the spleen, lymph nodes, tonsils, bone marrow and white blood cells. All these work collectively to fight off germs and infections that can harm you or make you sick. When your immune system is not working properly, it sees your own body as an enemy which it attacks, therefore generating a potential illness with an auto immune disease such as Rheumatoid Arthritis (RA). There are several types of auto immune diseases that can upset the body; more notably, the heart, lungs kidneys, brain as well as the joints. Since the 1930′s researchers have been exploring the link between diet and arthritis. We continue to hear claims that special diets, foods and supplements may help to cure or alleviate symptoms of arthritis, but most claims are unproven. Many experts speculate that claims of nutritional remedies and cures with food or dietary supplements are related to the “placebo affect”. The placebo effect is the patient’s perception of improved symptoms and well-being, resulting from new therapy, regardless of evidence for actual...
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...The inflammation usually begins at the base of the spine at the pelvis and may develop into the upper spine, rib cage, and neck. The hip and knee joints may also be affected. Prolonged inflammation of these joints may cause these spinal bones to fuse together. Baraliakos and Braun (2010) study found the following: Hip involvement in AS seems to be largely based on inflammation of the subchondral bone marrow. However, in contrast to the classical changes of AS in the spine, rheumatic inflammation in the hip does not lead to formation of new bones, but results in an erosive disease, which will often destroy the joint. These changes might have already occurred in young patients, and total hip replacement is often the therapy of choice in this difficult clinical situation, which leads to dramatic improvements of function in most cases (p. 3-4). Ankylosing spondylitis most commonly affects males in their 40’s and younger. Early symptoms of ankylosing spondylitis have a gradual onset of pain and stiffness that usually begins in the lower back, hips, and buttocks around the sacroiliac joints and worsens with immobility. Pain and stiffness may develop up the spine and into the neck and rib cage. Also, in the...
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...9-604-101 REV: JUNE 20, 2006 GARY PISANO LEE FLEMING Vertex Pharmaceuticals: R&D Portfolio Management (A) EEEddduuucccaaatttiiiooonnnaaalll mmmaaattteeerrriiiaaalll sssuuuppppppllliiieeeddd bbbyyy TTThhheee CCCaaassseee CCCeeennntttrrreee CCCooopppyyyrrriiiggghhhttt eeennncccooodddeeeddd AAA777666HHHMMM---JJJUUUJJJ999KKK---PPPJJJMMMNNN999III OOOrrrdddeeerrr rrreeefffeeerrreeennnccceee FFF222555222999888333 I’ve never made a bad decision. I’ve just had bad data. — Joshua Boger, CEO and Founder of Vertex Pharmaceuticals Like many New Englanders on this bright October morning in 2003, Josh Boger, CEO of Vertex Pharmaceuticals, had been up until 2:00 a.m. the previous evening watching the Boston Red Sox playoff game. The game, predictably, ended in a heartbreaking loss for the Red Sox, but Boger’s lingering disappointment (and regret over staying up so late) quickly faded as he strode down the halls of the Cambridge, Massachusetts company he had founded 15 years earlier. Vertex had four promising drugs in various stages of clinical development, and Boger was excited by the possibilities: “The portfolio is playing out exactly as we hoped. We’ve got a stream of revenues from our partnered project that will help fund our development costs. There are multiple paths for us to become profitable. We’re in a position to choose.” While the company had revenue from various corporate partnerships and roughly $600...
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...Detail-Document #241001 −This Detail-Document accompanies the related article published in− PHARMACIST’S LETTER / PRESCRIBER’S LETTER October 2008 ~ Volume 24 ~ Number 241001 Stability of Refrigerated and Frozen Drugs —Chart modified November 2008— (Based on U.S. product labeling and relevant studies) Failure to follow storage recommendations of pharmaceutical products can result in subpotent products and potentially, therapeutic failure.1-3 In addition, hundreds of thousand of medications are discarded each year because of improper storage conditions resulting in millions of dollars wasted.1,2 This can occur for a variety of reasons including improper shipping, failure to refrigerate or freeze a product upon receipt or after use, and in the event of a power failure. It is important to recognize when pharmaceutical products have not been stored according to the manufacturer’s specifications and take appropriate action. Depending on the product, lot number and expiration date, time of exposure to temperatures outside of the recommended range and actual temperature of exposure, some medications may be deemed suitable for administration while others should be discarded. The following chart provides general guidelines for the room temperature stability of common medications and vaccines which are stored in the refrigerator or freezer. However, if a pharmaceutical product has not been stored according to the recommended conditions, it is important to contact the manufacturer...
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...Rheumatoid Arthritis A Review of The Literature Mechanisms of Human Pathology Charles Childers Rheumatoid Arthritis Rheumatoid Arthritis (RA) is a chronic, autoimmune systemic inflammatory process that primarily attacks synovial joints as well as other tissues and organs of the body. This disorder is characterized by hyperplasia of synovial cells leading to an inflammatory response of the synovium that may ultimately cause destruction of articular cartilage. In cases of severe comprehensive damage joints can become ankylosed. RA is usually known to affect the wrist and hands bilaterally and symmetrically, but may be seen in any of the other synovial joints. The destruction can be progressive leading to joint deformations and disabilities.1 RA can also bring inflammation of the lungs, pleura, sclera of the eye, and pericardium. Nodules have been seen in the extensor tendons subcutaneously especially over the olecranon process. As has been reported,1 mechanistic paths to synovitis leading to this articular damage have shown tumor necrosis factor alpha (TNF-α) to take a significant part in joint inflammation responsible for the destruction. Therapies have developed to target TNF-α bringing a substantial impact on patient care. The exact etiology remains unclear in this autoimmune progressive disorder, but much is being looked at in search of an autoantigen or another triggering agent. According to Robinson,2 the importance of early diagnosis and...
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...Executive Summary: Pfizer-Wyeth Merger Deal Overview: On January 25, 2009, Pfizer and Wyeth entered into the merger agreement, pursuant to which, subject to the terms and conditions set forth in the merger agreement, Wyeth will become a wholly-owned subsidiary of Pfizer. Upon completion of the merger, each share of Wyeth common stock issued and outstanding will be converted into the right to receive, subject to adjustment under limited circumstances, a combination of $33.00 in cash, without interest, and 0.985 of a share of Pfizer common stock in a taxable transaction. Pfizer will not issue more than 19.9% of its outstanding common stock at the acquisition date in connection with the merger. The exchange ratio of 0.985 of a share of Pfizer common stock will be adjusted if the exchange ratio would result in Pfizer issuing in excess of 19.9% of its outstanding common stock as a result of the merger Deal Terms Breakdown: Transaction Value Transaction Consideration Purchase price per WYE share $50.19 Existing Cash Used $22,213 32.7% Cash per WYE share $33.00 New Debt $22,500 33.1% PFE stock value per WYE share $17.19 Total Cash $44,713 65.8% PFE shares per WYE share 0.985 Stock Consideration $23,289 34.2% Premium to 1/23/09 WYE price 29.3% Total Consideration $67,303 100.0% Total WYE shares (MM,diluted) 1,341 Total Equity...
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...ABfocus on THERAPEuTIc AnTIBoDIEs REVIEWS Therapeutic antibodies for autoimmunity and inflammation Andrew C. Chan* and Paul J. Carter‡ Abstract | The development of therapeutic antibodies has evolved over the past decade into a mainstay of therapeutic options for patients with autoimmune and inflammatory diseases. Substantial advances in understanding the biology of human diseases have been made and tremendous benefit to patients has been gained with the first generation of therapeutic antibodies. The lessons learnt from these antibodies have provided the foundation for the discovery and development of future therapeutic antibodies. Here we review how key insights obtained from the development of therapeutic antibodies complemented by newer antibody engineering technologies are delivering a second generation of therapeutic antibodies with promise for greater clinical efficacy and safety. Effector functions Fc-mediated antibody properties that are involved in target cell destruction: antibody-dependent cell-mediated cytotoxicity (ADCC), antibodydependent cellular phagocytosis (ADCP) and complement-dependent cytotoxicity (CDC). Half-life The time taken for the plasma concentration of a drug to fall to half of its original value. Initial half-life and terminal half-life refer to the first (distribution) and second (elimination) phase for bi-exponential pharmacokinetics, respectively. *Department of Immunology, Genentech, Inc.,1 DNA Way, South San Francisco, California...
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...Journal of Marketing Communications Vol. 15, Nos. 2 – 3, April– July 2009, 139–155 Building strong brands in a modern marketing communications environment Kevin Lane Keller* E.B. Osborn Professor of Marketing, Tuck School of Business, Dartmouth College, 100 Tuck Hall, Hanover, NH 03755, USA To help marketers to build and manage their brands in a dramatically changing marketing communications environment, the customer-based brand equity model that emphasizes the importance of understanding consumer brand knowledge structures is put forth. Specifically, the brand resonance pyramid is reviewed as a means to track how marketing communications can create intense, active loyalty relationships and affect brand equity. According to this model, integrating marketing communications involves mixing and matching different communication options to establish the desired awareness and image in the minds of consumers. The versatility of on-line, interactive marketing communications to marketers in brand building is also addressed. Keywords: customer-based brand equity; brand resonance; brand building; integrated marketing communications; interactive marketing communications Introduction The marketing communications environment has changed enormously from what it was 50, 30 or perhaps even as few as 10 years ago. Technology and the Internet are fundamentally changing the way the world interacts and communicates. At the same time, branding has become a key marketing priority for most companies...
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...Geriatrics Geriatrics Jennifer P. Dugan, Pharm.D., BCPS Clinical Assistant Professor University of Colorado Colorado, Denver Updates in Therapeutics: The Pharmacotherapy Preparatory Review and Recertification Course 31 Geriatrics Learning Objectives: The following case pertains to questions 2 and 3. J.T. is an 82-year-old community-dwelling woman with a history of stage III Parkinson disease, hypertension, and urinary incontinence (UI). She is receiving carbidopa/levodopa, pramipexole, selegiline, tolterodine, diazepam, metoprolol, and hydrochlorothiazide. When she comes to your pharmacy to get her prescriptions, she walks slowly with a cane, and she is stooped over. 1. Identify age-related pharmacokinetic and pharmacodynamic changes in older people. 2. Evaluate the pharmacotherapy regimens of older people to support the maintenance of optimal physical and mental function. 3. Identify inappropriate medication prescribing in older people. 4. Recommend appropriate pharmacotherapy for patients with dementia. 5. Evaluate the risks and benefits of the use of antipsychotics (APs) (including atypical APs) in older patients with dementia. 6. Recommend appropriate interventions for patients suffering from behavioral symptoms related to dementia. 7. Identify the types of urinary incontinence and recommend appropriate treatments. 8. Given a patient’s American Urology Association Symptom Index for benign prostatic hyperplasia, recommend...
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...INDIAN MARKET Due to poor sanitation conditions, infectious (acute) diseases are predominant in India. However, the incidence of chronic ailments, characterised by prolonged exposure, has been increasing with the emergence of lifestyle diseases in India, due to changing work pattern of the working population, higher stress levels, and unhealthy eating habits. Key issues answered through this analysis: What are acute and chronic ailments? What is the proportion of drugs for each segment in the total domestic formulations market? How have various therapeutic categories in the domestic formulation market performed over the last three years? Publish Date: 15-Jul-2013 | | Majority of ailments in India are more acute than chronic in nature Types of ailments Source: CRISIL Research Ailments can be classified into acute and chronic. Acute ailments are characterised by sudden, severe exposure (usually a single, large exposure) and rapid onset of the disease. The patient shows intense symptoms for a brief duration (not longer than 30 days). Infectious diseases such as common cold, fever, etc are some examples of acute ailments. However, some acute ailments may turn chronic if left unaddressed. Chronic ailments are characterised by prolonged or repeated exposures over many days, months or years. Chronic diseases can only be alleviated through treatments, but not fully cured. Unlike acute ailments, they do not usually resolve on their own accord. Examples of...
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...High-Technology Acquisitions Final Project -Acquisition Proposal: To Acquire: May 2012 Table of Content Executive Summary I A. Purpose I B. Background I C. The Rational for the Acquisition I D. Standalone, Synergy and Premium Valuations II E. Integration Plan II Part 1 - The Rational of the Acquisition 1 1. Pfizer's Strategy 1 1.1. Pfizer Growth Strategy 2 2. Pfizer's Road Map 4 2.1. Pfizer's Acquisitions Rational 4 3. The strategy behind the acquisition 5 3.1. Acquisition Motives 5 3.2. M&A vs. Alliance 5 4. Target Identification 7 4.1. Protalix - an R&D Acquisition 9 5. Synergy Analysis 10 6. Standalone, Synergy and Premium Valuations 12 6.1. Market Value 12 6.2. Trading and Transaction Multiples Valuations 12 6.3. Discounted Cash Flow (DCF) Valuation 14 6.3.1. DCF Methodology and Assumptions 14 6.3.2. Summary of the Standalone and the Synergy DCF Valuation 15 6.4. Premium 16 6.5. Walk-away Price, Net Value Creation and Financial Feasibility 17 Part 2 - The Integration Plan 18 Bibliography 21 APPENDIXES 22 Appendix 1 - Pfizer's Executive Leadership Team 23 Appendix 2 - Pfizer's Organizational Structure Scheme 24 Appendix 3 - Five Forces Analysis for the Pharmaceutical Industry 25 Appendix 4 - Pfizer's PEST Analysis 27 Appendix 5 - Level of Competition Between the Acquirers & the Uniqueness of the Acquired Company 31 Appendix 6 - Acquisition Motives 33 Appendix 7 - Protalix...
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...President. Christine L. Boudreaux is Director of Adviser Communications, and Benjamin J. Robins is General Counsel. Yvonne N. Kanner is Executive Vice President and COO, and Shehzad Sippy is a Research Analyst. Adam L. Bartkoski is Director of Adviser Operations and Development, and Ana M. Avila is an Intern. © Copyright Fiduciary Network, LLC, 2007 This material is for your private information, and we are not soliciting any action based upon it. Opinions expressed are our current views only, at the time of writing. The material enclosed is based upon information that we consider reliable, but we do not represent that it is accurate or complete, and it should not be relied upon as such. Acknowledgements We had three goals in writing this study. First, we wanted to provide people who work for pharmaceutical companies with a “30,000 foot” perspective on how and why their industry is...
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...This report is to be submitted as "2008 Korea Pharmaceutical Industry Directory" as part of the "Actual analysis of Korean pharmaceutical Industry", Korea Health Industry Development Institute(KHIDI)'s own project. December 2008 ￭ ￭ ￭ • ⅰ Chapter 1. Outline of The Project 1. Objectives and Background of Investigation ◦The existing directory book has indicated limitations in promoting Korean pharmaceutical industry internationally or domestically, failing to offer practical help. ◦For this reason, this investigation is to have a thorough grasp of ranges of business and current status of investments and technology by pharmaceutical and companies to utilize and in to strengthen their industrial by competitiveness promoting them overseas collecting and offering basic data needed for promoting transfer of technology with home and abroad institutions. ◦Also, necessity for systematic and detailed data of industrial current status that can be utilized by companies who are making commitment for the development of pharmaceutical industry. 2. Targets and Contents of Directory Book 1) Targets for directory book •Korean Pharmaceutical companies: 81 companies. 2) Contents of directory book •Investigation items 3. Method and Way for Utilization 1) Method □ Ways to select investigation targets and to promote them were developed through consultation from consultation committees and domestic pharmaceutical companies (including unlisted ones) ◦Investigated...
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...publisher. No patent liability is assumed with respect to the use of the information contained herein. Although every precaution has been taken in the preparation of this book, the publisher and author assume no responsibility for errors or omissions. Nor is any liability assumed for damages resulting from the use of the information contained herein. ISBN-13:978-0-7897-2706-9 ISBN-10: 0-7897-3706-x Library of Congress Cataloging-in-Publication Data Rinehart, Wilda. NCLEX-PN exam cram / Wilda Rinehart, Diann Sloan, Clara Hurd. -- 2nd ed. p. cm. ISBN 978-0-7897-3706-9 (pbk. w/cd) 1. Practical nursing--Examinations, questions, etc. 2. Nursing--Examinations, questions, etc. 3. National Council Licensure Examination for Practical/Vocational Nurses--Study guides. I. Sloan, Diann. II. Hurd, Clara. III. Title. RT62.R55 2008 610.73'076--dc22 2008000133 Printed in the United States of America First Printing: February 2008 Trademarks All terms mentioned in this book that are known to be trademarks or service marks have been appropriately capitalized. Pearson Education cannot attest to the accuracy of this information. Use of a term in this book should not be regarded as affecting the validity of any trademark or service mark. Warning and Disclaimer Every effort has been made to make this book as complete and as accurate as possible, but no warranty or fitness is implied. The information provided is on an “as is” basis. The...
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