Aripiprazole

Chapter 1. Overview of Drug Development for Bipolar Disorder Introduction Evolution of Pharmacological Therapy for Bipolar Disorder Overview of Bipolar Disorder Drug Development Activities Practice Guidelines for the Treatment of Patients With Bipolar Disorder Revised ; Chapter 2. Company Profiles Introduction Abbott Laboratories AstraZeneca Bristol-Myers Squibb D-Pharm Ltd Eli Lilly GlaxoSmithKline Johnson & Johnson Novartis Organon Akzo Nobel ; Otsuka Pharmaceutical Pfizer Repligen Sanofi Aventis Shire Pharmaceuticals Chapter 3. Recent and Current Clinical Development for Marketed Bipolar Therapies Introduction Depakote Divalproex Sodium ; Overview Competing Products and Investigational Drugs Anticipated Filing Date s ; Market Potential Ongoing Trials Published Data Geodon Ziprasidone ; Overview Competing Products and Investigational Drugs Anticipated Filing Date s ; Market Potential Ongoing Trials Published Data Chapter 3 continued ; Lamictal Lamotrigine ; Overview Competing Products and Investigational Drugs Anticipated Filing Date s ; Market Potential Ongoing Trials Published Data Risperdal Risperidone ; Overview Competing Products and Investigational Drugs Anticipated Filing Date s ; Market Potential Ongoing Trials Published Data Seroquel Quetiapine ; Overview Competing Products and Investigational Drugs Anticipated Filing Date s ; Market Potential Ongoing Trials Published Data Symbyax Olanzapine and Fluoxetine ; Overview Competing Products and Investigational Drugs Anticipated Filing Date s ; Market Potential Ongoing Trials Published Data Zyprexa Olanzapine ; Overview Competing Products and Investigational Drugs Anticipated Filing Date s ; Market Potential Ongoing Trials Published Data Abilify Aripprazole ; Overview Competing Products and Investigational Drugs Anticipated Filing Date s ; Market Potential Ongoing Trials Published Data. The Preferred Drug List, Formulary Exclusions, Precertification, Quantity Limit and Step-Therapy Lists are subject to change. Also note that Step-Therapy, Precertification and Quantity Limit programs, are not applicable in all service areas and aceon, for example, aripiprazole quetiapine. Continue to take aripiprazole even if you feel well. Goods in Kenya, " unpublished working paper. Miguel, Edward, and Michael Kremer. 2004 ; . "Worms: Identifying Impacts on Education and Health in the Presence of Treatment Externalities, " Econometrica, 72 1 ; , 159-217. Miguel, Edward, and Michael Kremer. 2003 ; . "Networks, Social Learning, and Technology Adoption: The Case of Deworming Drugs in Kenya, " unpublished working paper. Morduch, Jonathan. 1999 ; . "The Microfinance Promise, " Journal of Economic Literature, 37 4 ; , 15691614. Mwabu, G. J. Mwanzia, W. Liambila. 1995 ; . "User Charges in Government Health Facilities in Kenya: Effect on Attendance and Revenue, " Health Policy and Planning, 10 2 ; , 164-170. Pant C.R., et al. 1996 ; "Impact of Nutrition Education and Mega-Dose Vitamin A Supplementation on the Health of Children in Nepal, " Bulletin of the World Health Organization, 74 5 ; , 533-45. Partnership for Child Development [PCD]. 1999 ; . "The Cost of Large-scale School Health Programmes which Deliver Anthelmintics in Ghana and Tanzania, " Acta Tropica, 73, 183-204. Program on International Policy Attitudes PIPA ; . 2001 ; . Americans on Foreign Aid and Hunger: A Study of U.S. Public Attitudes. Available: : pipa OnlineReports BFW toc . Pollitt, E. 1990 ; . "Infection: Schistosomiasis, " Malnutrition and Infection in the Classroom, Paris, Unesco: 151-162. Rosenstein-Rodan, P. N. 1943 ; . "Problems of Industrialization of Eastern and South-Eastern Europe, " Economic Journal, 53, 202-211. Rostow, W. W. 1960 ; . The Stages of Economic Growth, Cambridge: Cambridge University Press. Savioli L., Crompton, W.T. and M. Niera 2003 ; . "Use of Anthelminthic Drugs During Pregnancy, " American Journal of Obstetrics and Gynecology, 188: 5-6. Udry, Christopher. 1996 ; . "Gender, Agricultural Productivity, and the Theory of the Household, " Journal of Political Economy, 104 5 ; , 1010-1046. UNICEF. 1998 ; . "A Manual on School Sanitation and Hygiene, " Water, Environment, and Sanitation Technical Guidelines, Series Number 5. Tanner, M. 1998 ; . "Sustainable health development sustainable health services editorial ; ", Tropical Medicine and International Health, 3 10 ; , 765-766. Utzinger, J., R. Berquist, Xiao Shu-Hua, B.H. Singer, and M. Tanner. 2003 ; . "Sustainable Schistosomiasis Control the Way Forward", Lancet, 362, Dec. 6, 2003, 1932-34. Warren, K.S., et al. 1993 ; . "Helminth infections." In Disease Control Priorities in Developing Countries ed. Jamison, D.T., Mosley, W.H., Measham, A.R. and Bobadilla, J.L. ; , 131-60. Oxford and perindopril.

In a 26-week olanzapine-controlled study, the incidence of extrapyramidal symptoms eps' ; was 1 8% for aripiprazole and 1 7% for olanzapine-treated patients and risedronate.

Aripiprazole intermediates We identified fifteen studies that we could include. All were described as randomised and all but three as being double-blind. Kern 2001, Riera 2004 and Stock 2005 were open-label studies. One of the double-blind studies Adson 2003 ; allowed the option of open-label administration of aripiprazole during weeks three to six of the study for people who had not responded to treatment. 4.1 Length of trials Schizophrenia is a lifelong illness that affects young people. Ten studies reported data on shortterm follow-up up to 12 weeks ; , three on medium-term follow-up 13 to 26 weeks ; and two studies reported data on long-term follow-up over 26 weeks, Kujawa 2002, Stock 2005 ; . Two studies involved the administration of intramuscular aripiprazole and had extremely short follow-up periods Daniel 2004, Oren 2005 ; . Some of the ongoing studies may involve medium or long-term follow-up. 4.2 Participants Eight of the fifteen included studies involved participants without clearly operationalised diagnoses Carson 2002 b, Daniel 2004, Kern 2001, Kujawa 2002, Marcus 2005, McQuade 2003, Riera 2004, Stock 2005 ; . All but six trials included people with a sole diagnosis of schizophrenia. The remaining six studies included patients with schizophrenia or schizoaffective disorder Carson 2000 a, Daniel 2004, Kern 2001, Oren 2005, Potkin 2003, Riera 2004 ; . The majority of participants in most studies were male, and had a mean age in their late thirties to early forties. In nine trials we could not elicit definitive exclusion criteria from available reports Carson 2002 b, Daniel 2004, Kern 2001, Kujawa 2002, Marcus 2005, McQuade 2003, Oren 2005, Riera 2004, Stock 2005 ; . Adson 2003 and Potkin 2003 required people taking part in the trial to have had a history of response to other antipsychotics excluding clozapine, whereas another study excluded participants if they had previously been resistant to clozapine therapy Kane 2003 ; . In the same vein, Daniel 2000 excluded people with a history of resistance to anti-psychotic medication. One study Riera 2004 ; included participants who were due to be prescribed antipsychotics for the first time, or for whom a change of medication was deemed appropriate. Most people in these studies were moderately to severely ill and many were acutely ill. 4.3 Setting Eight of the fifteen studies were described as occurring in hospital or inpatient settings Adson 2003, Carson 2000 a, Csernansky 2003, Daniel 2000, Daniel 2004, Marcus 2005, Oren 2005, Potkin 2003 ; . Two trials took place in out-patient or mixed settings Carson 2002 b, Riera 2004 ; and we could find no explicit information on the settings of the remaining studies. 4.4 Study size Riera 2004 with 1599 participants and Kujawa 2002 with 1294 people were by far the largest studies. Csernansky 2003 randomised only 103. All the remaining studies included between 200 and 500 participants. 4.5 Interventions The trialists administered aripiprazole in a wide range of doses from 1mg per day to 30 mg per day. Comparators were placebo, conventional antipsychotics, haloperidol 6.5-20 mg day ; and perphenazine 8-64 mg day and the newer generation antipsychotics olanzapine 10-20 mg day ; and risperidone 6 mg day . Most drugs were given orally, however in two studies medication was given intramuscularly Daniel 2004, Oren 2005 ; . In one open label, naturalistic study, patients were randomised to a safety control group which included antipsychotic medications both typical and atypical ; chosen by the investigator Riera 2004 ; . The medications used in the safety control group were known to include zisprasidone, olanzapine, risperidone, quetiapine, clozapine at varying. Medical Letter. 1999; 41: 1112 and salmeterol. The plan does not cover the following: 1. Prescription Drug Products in amounts exceeding the supply limit referenced in Section 2. Drugs which are prescribed, dispensed or intended for use while You are an inpatient in a hospital or other facility. 3. Experimental, Investigational, Educational or Unproven Services, technologies which include medical, surgical, diagnostic, psychiatric, substance abuse, or other health care, supplies, treatments, procedures, drug therapies or devices. 4. Prescription Drug Products furnished to a Plan Participant by any local, state or federal government entity; except as otherwise provided by law, any Prescription Drug Product to the extent payment or benefits are provided or available from any local, state or federal government entity for example, Medicare ; regardless of whether payment or benefits are received. 5. Prescription Drug Products for any condition, illness, injury, sickness or mental illness arising out of or in the course of employment for which compensation benefits are available under any Worker's Compensation Law or other similar laws, regardless of whether the Plan Participant makes a claim for, or receives such compensation or benefits. 6. Compounded drugs not containing at least one 1 ; ingredient with a valid National Drug Code NDC ; number and requiring a Doctor's Order to dispense. In addition, the Compounded Medication must have FDA approval. 7. Drugs available over-the-counter or for which the active ingredients do not require a Prescription by federal or state law. 8. Injectable drugs administered by a Health Professional in an inpatient or outpatient setting. 9. Durable or disposable medical equipment or supplies, other than the specified diabetic and ostomy supplies. 10. Replacement Prescription Drug Products resulting from lost, stolen or spilled Prescription Orders or Refills. 11. Legend general vitamins except Legend prenatal vitamins, Legend vitamins with fluoride, and Legend single entity vitamins. 12. Prescription Drug Products that are not medically necessary. 13. Charges to administer or inject any drug. 14. Prescription Drug Products that are administered or entirely used up at the time and place ordered, such as in a clinic or doctor's office. 15. P rescription Drug Products for which there is normally no charge in professional practice. 16. Contraceptive devices, therapeutic devices, artificial appliances, or similar devices, regardless of intended use, for instance, aripip5azole ocd.

Aripiprazole for bipolar depression The name of the registered optical dispenser who participated in a meeting concerning the proposed optometry practice act in south australia, convened by south australia health-department staff and held on 8 june, is tracey hull, not tracey hallam, as reported in the july issue of insight and fluticasone! ARB and a statin are also often prescribed shortly after MI, as are other drugs to reduce clotting and minimize blockages. Further drug therapy is based on the type of MI and other factors. 1. Bristol Myers Squibb Otsuka Pharmaceuticals. Abilify. Summary of Product Characteristics 2004; 1-9. 2. Mueser KT, McGurk SR. Schizophrenia. Lancet 2004; 363: 2072. Anon. Prodigy guidance - Schizophrenia. Prodigy Guidance 2004. 4. Turner T. ABC of mental health: Schizophrenia. BMJ 1997; 315: 108-11. Gelder M. Psychiatry in medicine. In Weatherall D, Ledingham JGG, Warrell D, eds. Oxford Textbook of Medicine, pp. 4203-59. Oxford: Oxford University Press, 1996. 6. Anon. Drug treatments for schizophrenia. Effective Health Care 1999; 5: 1-12. National Institute for Clinical Excellence. Guidance on the use of newer atypical ; antipsychotic drugs for the treatment of schizophrenia. Technology Appraisal Guidance Number 43. 1-26. 2002. Pigott TA, Carson WH, Saha AR et al. Aaripiprazole for the prevention of relapse in stabilised patients with chronic schizophrenia: A placebo-controlled 26-week study. J Clin Psychiatry 2003; 64: 1048-56. Kane JR, Carson WH, Saha AR et al. Efficacy and safety of aripiprqzole and haloperidol versus placebo in patients with schizophrenia and schizoaffective disorder. J Clin Psychiatry 2004; 63: 763-71. Potkin SG, Saha AR, Kujawa MJ et al. Aripiprazole, an antipsychotic with a novel mechanism of action, and risperidone vs. placebo in patients with schizophrenia and schizoaffective disorder. Arch Gen Psychiatry 2003; 60: 681-90. Kasper S, Lerman MN, McQuade RD et al. Efficacy and safety of aripipraole vs. haloperidol for long-term maintenance of treatment following acute relapse of schizophrenia. Int J Neuropsychopharmacol 2003; 6: 32537 and advil.

Treatments for schizophrenia. These drugs should also be considered as treatment options for patients on `typical' antipsychotic drugs who are experiencing unacceptable side effects and for those in relapse who have previously experienced lack of efficacy or unacceptable side effects when taking `typical' 7 antipsychotic drugs. In those with evidence of treatment-resistant schizophrenia it is recommended that clozapine be introduced at the earliest 7 opportunity. Dosage and administration The recommended starting and maintenance dose for aripiprazole is 15 mg administered once daily. The 1 maximum daily dose should not exceed 30 mg. Caution should be exercised when using aripiprazole to treat patients with severe hepatic impairment, especially when the maximum daily dose of 30 mg is used. No dose adjustment is required in patients with renal impairment. A lower starting dose should be considered in patients over 65 years of age. There are significant potential drug interactions that dictate reduction e.g. ketoconazole ; or increase e.g. carbamazepine ; in the dose of aripiprazole. See the Summary of Product Characteristics SPC ; for further 1 details. It is recommended that the responsibility for prescribing aripiprazole remains with secondary care for at least the first six months of treatment, in order to monitor effectiveness and tolerability in individual patients. Clinical efficacy There were four randomised controlled trials n 2422 ; that evaluated the efficacy of aripiprazole 15, 8-10 20 or 30 mg day ; compared with placebo 3 trials ; 11 and haloperidol 1 trial ; . In two of the trials haloperidol and risperidone were included as active 9, 10 treatments but not as comparators. The majority of study participants were male with a mean age of about 40 years. All trial participants had a diagnosis of schizophrenia according to DSM-IV criteria. In one trial, participants had chronic schizophrenia requiring continuous treatment; in the remaining trials, patients had been hospitalised for an acute relapse. All patients had a history of a positive.
Anti-psychotic medications can be helpful in controlling psychotic symptoms delusions, hallucinations ; or disorganized thinking. Anti-psychotics are occasionally used to treat severe anxiety and may help in reducing very aggressive behavior. Expected benefits of medication: Stabilization of psychotic symptoms decrease or eliminate hallucinations delusions ; Decrease aggressive behavior Decrease anxiety Name of Medication Dosage Most Common Side Effects Warnings Adult Min Max SAFETY & EFFICACY NOT ESTABLISHED IN Risperdal Most likely to Cause RISPERIDONE Dose: 0.25mg 16.0mg CHILDREN LESS THAN 18 YRS. extrapyramidal effects EPS ; agitation, anxiety headache weight gain sleepiness low blood pressure when standing up Adult Min Max Dose: 2.5mg 20.0mg SAFETY & EFFICACY NOT ESTABLISHED IN Zyprexa Most likely to cause OLANZAPINE Pediatric Min Max CHILDREN LESS THAN 18 YRS. significant weight May increase risk of high blood glucose or development of Dose: 0.12mg kg 0.29mg kg gain diabetes. dry mouth Seroquel QUETIAPINE Abilify ARIPIPRAZOLE Adult Min Max Dose: 50.0mg 800.0mg Adult Min Max Dose: 10.0mg 30.0mg constipation Very sedating Headache GI symptoms, anxiety SAFETY & EFFICACY NOT ESTABLISHED IN CHILDREN LESS THAN 18 YRS. SAFETY & EFFICACY NOT ESTABLISHED IN CHILDREN LESS THAN 18 YRS and theophylline and aripiprazole. The "ABC" Link Many studies scientifically demonstrate the link between abortion and breast cancer ABC link ; . Still, abortion advocates attempt to explain away the evidence. However, breast cancer is potentially deadly, and we simply cannot ignore the added risk abortion poses. According to Dr. Joel Brind, the leading expert on the ABC link, 13 of 1415 American studies to date--eight of which are statistically significant--show that women who have an abortion increase their risk for breast cancer. Worldwide, 27 of 33 studies demonstrate the link, 17 of which are statistically significant. Dr. Brind is a professor of biology and endocrinology at Baruch College of the City University of New York. He is also the president of the Breast Cancer Prevention Institute in Poughkeepsie, New York. His noteworthy article, "Induced Abortion as an Independent Risk Factor for Breast Cancer: A Comprehensive Review and Meta-Analysis, " written in collaboration with colleagues at the Penn State College of Medicine, appeared in the October 1996 issue of the Journal of Epidemiology and Community Health by the British Medical Association.16 In this study, he found a significant 30 percent increased risk for breast cancer for women who had one or more induced abortions.17 "There is a clear relationship documented in medical journals showing that women who abort their first pregnancy are at a much higher risk of developing breast cancer than women who carry their pregnancy to term, " stated Dr. Brind.18 In fact, the two latest American studies illustrate this, thus exhibiting consistency with past studies' findings. From Dr. Pamela Marcus' study, Dr. Brind calculated an approximate 20 percent increased risk for breast cancer.19 Dr. DeAnn Lazovich's study demonstrated a nonsignificant increased risk of 10 percent. The authors state that "the low prevalence of induced abortion argues for a cautious interpretation"20 of the results. But Dr. Brind notes that, in light of the study's consistency with past findings, such "caution" is not warranted. Even an expert hired by pro-abortion Planned Parenthood admitted the ABC link in court testimony. When asked whether a 15-year-old is more likely to contract breast cancer if she has an abortion than if she gives birth, Lynn Rosenberg, Sc.D., replied, "Probably, yes."21 The Emotional Fallout Although the physical risks of abortion are daunting, the emotional effects are every bit as painful and enduring. Discovering post-abortion syndrome PAS ; has changed the thinking of many abortion advocates. The American Journal of Psychiatry reported that of 500 post-abortive women studied, 43 percent showed immediate negative responses. That number grew to 50 percent in a later review. Additionally, up to 10 percent of the women surveyed were classified as having developed "serious psychiatric complications."22 Nancyjo Mann, founder of Women Exploited by Abortion WEBA ; , described her saline abortion as emotionally destructive. Seven months later, at the age of 22, Nancyjo had a total hysterectomy due to abortion complications.23 Her life plummeted into drugs, depression, promiscuity and prostitution. Shortly after her transformation in 1981, she founded WEBA. Many more women suffer in silence, afraid to tell anyone about their pain because of abortion's social stigma. And women are not the only ones who suffer. The Other Victims Rarely addressed segments of post-abortive sufferers are men and children. Until recently, the large number of men suffering from abortion has been dismissed. "Men everywhere report that abortion is a horrendous and heartbreaking experience, whether they oppose or support the decision to abort, " said Wayne Brauning, the founder of MARC Men's Abortion ReCovery ; Ministries. "They are angry . feel guilty and powerless . They have problems relating to women and children. One man had been an alcoholic and committed various crimes for which he served time, but he said the worst thing he had ever done was to encourage his girlfriend to have an abortion."24 The children of women who have had abortions also suffer. Instead of ridding the nation of child abuse by eliminating "unwanted" children, reports of child abuse have skyrocketed since the courts began to permit abortion in America. This pattern of increased abuse has also appeared in Canada, Britain and Japan.25 Former Surgeon General C. Everett Koop writes, "In 1972, there were 60, 000 [reported] child-abuse incidents Just four years later, the number . passed the half-million mark. Child abuse is the fifth most frequent cause of death among children."26 According to the U.S. Department of Health and Human Services, just under 1 million children were victims of substantiated or indicated child abuse and neglect in 1997.27 Dr. Philip Ney, a professor of psychiatry, has concluded that abortion is linked to child abuse.28 He found that "maternal bonding instincts are weakened by the deliberate denial of maternal attraction which must take place in an abortion."29 After all, if it is all right to abuse one's offspring before birth, why not after birth as well? The psychological impact of abortion on siblings is also significant. Dr. Edward Sheridan has provided therapy for abortion-traumatized siblings for over 30 years. "If no explanation is given [for the abortion], this confusion may lead the child to somehow feel personally responsible for the loss, " he says. "On the other hand, if the child becomes aware that the mother actively chose to `get rid' of the sibling, he often begins to fear her."30.
Mechanism of action: the mechanism of action of aripiprazole is fundamentally different from currently available antipsychotics and albenza.

This is a class of medications that disrupts the autonomic nervous system. I never said or implied that drugs do not carry side effect.

Presentations at national meetings have suggested that quetiapine mueller et al, 2002 ; , ziprasidone loebel et al, 2002 ; and aripiprazole cornblatt et al, 2002 ; may also benefit cognition.

Department of Microbiology, Georgetown University, School of Medicine, Washington, DC, USA. dablashi abionline and quinapril.
The author suggests to enroll 10 subjects initially in open label fashion to take aripiprazole plus their current fda approved antidepressant to see if further elimination of depressive symptoms occurs and to show this pharmacological approach as a tolerable combination of medications. 3. On or about March 23, 2002, Respondentfilled out an intake form for inmate C. C. The Respondentwas screening inmate C. C., or performing an initial assessmentof his general mental and physical health as he came into the Facility. Inmate C.C. had a gunshot. Work in this area in our laboratory is supported by grants from the National Institutes of Health Grant AI20148 ; and the U.S. Department of Agriculture Grant 97-35201-4578 ; to A.D.O.

Often found in the East China Sea and Bohai Sea. More than 20 were toxic. Fortunately, the toxic red tides did not affect human beings and the aquatic breeding industry thanks to rapid emergency measures taken by marine authorities, said Li. China has installed a basic marine environment and disaster observation network and an early warning system, covering both offshore areas and distant waters, with the co-operation of several departments. Global warming thawing Qinghai Plateau Xinhua Net, 2005-01-11 ; Affected by global warming, the frozen earth on the Qinghai Plateau has been thawing, according to scientists with the northwest China's Qinghai Province. Scientists with the Qinghai Climate Data Center have analyzed the data from the frozen area of the plateau in the past decades by using geological information system technology. The scientists found that in the frozen region, the earth's temperature has been noticeably rising. Also, the duration of the year during which the ground is frozen is becoming increasingly shorter and the thickness of the frozen layer has decreased. According to statistics, the layer of frozen earth is now 50 meters more shallow than it was decades ago, said Qin Ningsheng, director of the center. Qin said that Xining, the capital city of the province, and Gangcha County, are the two places that have witnessed the worst thaw due to the "hot island" effect brought about by urbanization, and the falling water level in the Qinghai Lake. Because the layer of frozen earth plays a great role in maintaining the ecology of the plateau, Qin called for the government to pay attention to the changes and take measures to protect the current ecological system. Polar explorers climb peak of Antarctica China Daily, 2005-01-11 ; Chinese polar explorers have completed half of their Kunlun Dome A Inland Icecap programme, the primary mission of China's 21st Antarctic expedition, by climbing to the north peak of Dome A. Zhang Zhanhai, the leader of the expedition said that he had received a telephone report from Li Yuansheng, the leader of the mission team, that his team successfully mounted the north peak at 11: 30 Beijing time on Sunday. Preliminary measurement by global positioning system shows that the north peak of Dome A is 4, 091 metres above sea level. According to telemetering data of the satellite, the South Pole's inland icecap has two peaks, more than 10 kilometres away from each other. Only by a joint measurement from the satellite and the ground can the explorers decide which one is higher. After a more exact survey of the north peak, the mission team will set out to look for the south peak. Gai Junxian, the mission team's technician, left the team on Saturday because of a strong altitude reaction. He is now receiving treatment at a research station of the United States and is in a stable condition.
Prolonic - a drug-delivery technology specifically designed to release an active agent in the colon, for example, aripiprazole india. Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal products should be disposed of in accordance with local requirements.
Trained nurse on-site ; are included in the number of patients on satellite dialysis. This makes comparison across countries problematic. Nevertheless data from national registries suggest there has been a major growth in RSUs in other countries.14, 15 Although the model of an RSU requires flexibility with respect to the size of the population served, several questions are raised by the findings of this survey. The optimal size for an RSU is far from clear, as shown by the considerable variation in those currently operating, which in part reflects the geographical distribution of the catchment population of the MRU. As a significant proportion of patients dialysing in these units are elderly and or diabetic, with co-existing comorbidity, the safety of RSUs sited far from an acute medical facility needs to be investigated as most RSUs do not have permanent medical cover. It is also important to evaluate patients' views of dialysis away from the main unit, and the impact of care in an RSU on the quality of life QoL ; of patients. As RSUs are becoming a significant part of the provision of RRT in the UK, their costeffectiveness and how this varies by type of RSU need to be evaluated. As demand for RRT continues to grow, more RSUs are likely to open, with the main units treating largely the most difficult HD patients. However, eventually it is probable that some RSUs, particularly those on an acute hospital site and with a large local catchment population, will evolve into medically staffed autonomous renal units which can provide not only a chronic HD service for all HD patients in their catchment area, but also a full nephrology service. This would be closer to the model of services in other developed countries. It was also possible to extend the use of the survey data in a judicious way that allowed the illustration of how relative performance can be assessed. From an economics perspective, it is considered important to understand relative efficiency of units. This helps managers to examine overall and individual performances and compare a unit with appropriate `peers'. However, to assess such performances requires linking data on inputs e.g. medical nursing time ; and outputs of RSU care e.g. patients treated, including some measure of the quality of care ; and typically such data are not readily available. Indeed this is a general problem for the NHS. The survey data presented a unique opportunity to apply data envelopment analysis DEA ; to a renal service in the UK for the first time. Norwegian institute of public health, division of forensic toxicology and drug abuse, oslo, norway. Alastair benbow head of european psychiatry for glaxosmithkline 10 2002 — - we take the safety of our medicines extremely seriously. There were 3136 reports of Pseudomonas spp bacteraemia made in 2004 table 1 ; of which the majority 2430; 77% ; were due to P. aeruginosa, a 58% increase since 2000 when 1535 reports were submied 1.

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