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Henderson R, Kurlan R, Kersun JM. Preliminary examination of the comorbidity of anxiety and depression in Parkinson's disease. J Neuropsychiatry Clin Neurosci 1992; 4: 257-64. Menza MA, Robertson-Hoffman DE, Bonapace AS. Parkinson's disease and anxiety: comorbidity with depression. Biol Psych 1993; 34: 465-70. Zesiewicz TA, Gold M, Chari G, Hauser RA. Current issues in depression in Parkinson's disease. J Geriatr Psychiatry 1999; 7: 110-8. Cummings JL, Masterman DL. Depression in patients with Parkinson's disease. Int J Geriatr Psychiatry 1999; 14: 711-8. Dooneef G, Mirabello E, Bell K, Marder K, Stern Y, Mayeux R. An estimate of the incidence of depression in idiopathic Parkinson's disease. Arch Neurol 1992; 49: 305-7. Kostic VS, Filipovic SR, Lecic D, Mancilovic D, Sokic D, Sternic N. Effect of age at onset on frequency of depression in Parkinson's disease. J Neurol Neurosurg Psychiatry 1994; 57: 1265-7. Taylor A, Saint-Cyr JA, Lang AE, Kenny FT. Parkinson's disease and depression: a critical re-evaluation. Brain 1986; 109: 279-92. Mindham RH. Psychiatric symptoms in parkinsonism. J Neurol Neurosurg Psychiatry 1970; 33: 188-91. Marder K, Tang MX, Cote L, Stern Y, Mayeuf R. The frequency and associated risk factors for dementia in patients with Parkinson's disease. Arch Neurol 1995; 52: 695-701. Bejjami BP, Damie P, Anulf I, Thivard L, Bonnet AM, Dormont D. Transient acute depression induced by high frequency deep-brain stimulation. N Engl J Med 1999; 340: 1476-9. Caley CF, Friedman JH. Does fluoxetine exacerbate Parkinson's disease? J Clin Psychiatry 1992; 53: 278-82. Toyama SC, Iacono RP. Is it safe to combine a selective serotonin reuptake inhibitor with selegiline. Ann Pharmacother 1994; 28: 405-6.
This estimate assumes that BKKBN procurements are proportional to the number of users. A more accurate estimate would adjust for different procurements per user, by province.
MANAGEMENT'S REPORT The Company's management is responsible for preparing the accompanying Consolidated Financial Statements in conformity with U.S. generally accepted accounting principles "GAAP" ; . In preparing these Consolidated Financial Statements, management selects accounting policies and uses its judgment and best estimates, as appropriate in the circumstances. Management has determined such amounts on a reasonable basis in order to ensure that the financial statements are presented fairly, in all material respects. The Company maintains a system of internal accounting controls designed to provide reasonable assurance, at a reasonable cost, that assets are safeguarded and that transactions are executed and recorded in accordance with the Company's policies. This system is supported by policies and procedures for key business activities, by the hiring of qualified staff and by a continuous planning and monitoring program. Deloitte & Touche LLP has been engaged by the Company's shareholders to audit the Consolidated Financial Statements. During the course of their audit, Deloitte & Touche LLP considered the Company's system of internal controls to the extent necessary to render their opinion on the Consolidated Financial Statements; however, they were not engaged to, nor do they, express any opinion regarding the effectiveness of the Company's system of internal controls over financial reporting. The Board of Directors is responsible for ensuring that management fulfills its responsibility for financial reporting and is ultimately responsible for reviewing and approving the financial statements. The Board carries out the responsibility principally through its Audit Committee. The members of the Audit Committee are outside directors. The Committee considers, for review by the Board of Directors and approval by the shareholders, the engagement or reappointment of the external auditors. Deloitte & Touche LLP has full and free access to the Audit Committee. Management acknowledges its responsibility to provide financial information that is representative of the Company's operations, is consistent and reliable, and is relevant for the informed evaluation of the Company's activities.
Hopkins University, USA. The plasma samples of the pregnant women enrolled in the study and cord blood samples were processed for determining HIV-1 viral load. During the year, 227 samples in addition to 34 from pregnant women enrolled in 2002 ; were processed for viral load estimation. Analysis of Generic Antiretroviral Formulations Manufactured in India India is a major producer of generic HIV antiretroviral drugs. These are widely used in developing countries since they are less expensive than those produced elsewhere. However, data describing the integrity of these drugs are not available. Therefore, the content of efavirenz 600 mg ; , nevirapine 200mg ; , zidovudine 300mg ; , stavudine 30 mg ; , lamivudine 150 mg ; , didanosine 250 mg ; and a combination pill containing nevirapine, stavudine and lamivudine in the same dosages obtained from three Indian sources Aurobindo Pharma, Ranbaxy and Cipla ; was analyzed by TRC, Chennai and compared with proprietary medications manufactured in USA. Six tablets capsules of each antiretroviral drug were processed and analyzed in duplicate. The concentration of the drugs was calculated from a set of calibration standards of known concentration. The drugs compared well with the proprietary formulations and the variability ranged from 0.01 to 8.3%. All the formulations were within 5% range of the stated contents as compared to the proprietary drugs except for stavudine and lamivudine which were slightly higher, but withing 10% range. Immunological Studies Activated CD3 + T lymphocytes in HIV Infection The activation of T lymphocytes harbouring latent virus triggers the multiplication of HIV at the later stage of disease progression. During the year CD3 + HLA-DR + T lymphocytes were estimated in 746 HIV infected individuals and 67 healthy controls. The data shows that activated T lymphocytes circulate at all stages.
S Sader, F Dawood, M Chen, N Khaper, M Sun, PP Liu Heart And Stroke Richard Lewar Centre Of Excellence, Faculty Of Medicine, University of Toronto, Toronto, Ontario Gelsolin GSN ; is a Ca2 + - and polyphosphoinositide 4, 5-biphosphate PIP2 ; -regulated actin filament severing and capping protein that is implicated in actin remodelling. Recently, it has been demonstrated that GSN mRNA and GSN protein were upregulated in failing human heart as well as in two different mouse models of heart failure. This project aims to delineate the role of GSN in the cardiac remodelling process following hemodynamic stress of aortic banding. GSN homozygous knockout and wild type controls of C57BL6 Balbc background at 8 weeks of age were anesthetized and subjected to aortic banding to generate systolic gradient of 75 mmHg across the aorta. After 8 weeks of surgery, the animals underwent retrograde Millar conductance catheter cannulation to derive ventricular pressure-volume relationships. The mice were divided into four groups: sham wild type and sham knockout and aortic banded AB ; wild type and AB knockout. Our results showed better survival rate in the knockout aortic-banded group compared to the wild type group. The heart weight body weight HW BW ; ratio, indicative of hypertrophy, was significantly increased in the AB wild type group. In addition, the analyzed data from the hemodaynamic experiments demonstrated a significant improvement of the heart function in the knockout aortic-banded group when compared to the wild type group. The data is presented as mean SEM in the table below.
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Use of rules A total of 32 statements i.e. not more than 1.6 per participant ; were coded as rules. According to our judgment, 18 of these 32 statements were derived from or were compatible with the guidelines including those rules that were not entirely correct in detail, e.g. regarding the cut-off limits for LDL and HDL ; and twelve of these 18 were a more or less directly referring to secondary prevention or diabetes e.g "He has angina pectoris and should be below 5 in cholesterol" ; . Examples of other contents for the statements coded as rules were age limit for cholesterol treatment, importance of looking for secondary hypercholesterolaemia, the role of LDL HDL ratio, priority of smoking vs. pharmacological treatment, the desired blood pressure value for diabetics blood pressure and the cut-off value for ten-year risk for primary prevention. For two of the patient cases case GM with diabetes mellitus, and case AR with a history of angina pectoris ; , the guidelines allow a simple decision rule to be applied. Of the 32 instances of reference to a rule, 24 were in connection with these two patient cases. Risk estimation For the four primary prevention cases, IS, TW, SH and PU, a number of statements referring to numerical risk estimate guidelines say 20% within the next ten years ; could have been expected. Only two participants referred to numerical risk estimates.
For patients requiring cardiac support: an implantable pneumatic MCSD HeartMate IP ; that is powered by an external electrically driven air pump, and an electric MCSD HeartMate VE ; that is driven by an implanted electric motor and powered by a lightweight battery pack worn by the patient. In 1994, the FDA granted approval for the commercial sale of the HeartMate IP for use as a bridge to transplant. The HeartMate VE was granted the same approval by the FDA in September 1998. With these approvals, both systems became available for sale to cardiac centers throughout the United States. In August 1998, the HeartMate IP received Canadian approval, permitting the sale of both the air-driven and electric versions throughout Canada. The HeartMate IP received the European Conformity Mark in April 1994, and the HeartMate VE received the same marking in August 1995. In late 1995, the FDA approved the protocol for conducting clinical trials of the HeartMate VE MCSD as an alternative to medical therapy in the REMATCH trial; and in May 1998, the first patient was implanted with it as part of this trial. The HeartMate VE MCSD is being used in Europe as both a bridge to transplant and as an alternative to medical therapy. As of July 2006, over 4100 patients worldwide have been supported with the HeartMate MCSD. The use of the HeartMate as a destination therapy was approved by the FDA in November 2002. The overall costs for use of the HeartMate as a destination therapy are estimated to be similar to the costs for a heart transplant, or about $160 000. The HeartMate will probably be used much like dialysis treatment to support patients with kidney failure, supplementing the heart as needed on a long-term basis Fig. 5 and decadron.
The ten patients related samples provide evidence that in routine use the LC MS method can achieve reliable confirmation of the drugs that have been taken by a particular patient. The use of multiple reaction monitoring experiments as performed on a triple quadrupole type mass spectrometer could help to provide complementary evidence in the cases where additional confirmation is required, and could form a secondary more detailed screening process. The future of LC MS primary drug screening is clearly feasible and does offer some clear advantages over UV based screening protocols, and it is expected that the number of drugs that could be detected could be significantly increased and extended to other drug classes. It is also expected that the fragmentation data acquired could be used with a library search engine once a library of MS MS fragments has been generated using atmospheric pressure ionization, which is currently in progress.
A household survey of maternal and child health in the Mt. Frere district, Eastern Cape, is currently underway as part of the ISDS initiative to strengthen the decision-making capacity of the district health management team DHMT ; . In view of the dearth of existing reliable data, and the recognised priority of MCH in this region, the need for such a community-based "baseline" survey is apparent. To encourage ownership of the survey results, and their use in subsequent planning and evaluation of the health services, a team of local health service personnel, including some members of the DHMT, have been trained in research protocol development, and are presently carrying out the fieldwork for the above survey. One of the purposes of the research is to try to find out where pregnant women from the area deliver their babies and what problems they encounter, as well as to gather information on the estimated frequency and cause of child and maternal deaths. At present, there is little useful data about maternal and child health to allow for proper planning. The format of the training has been participatory, in that each module of theory presented was followed by a group session to develop a component of a protocol around a priority health problem identified by the group. The manual used is referenced below, and is also the basis for the HST publication on Health Systems Research HSR ; . The principles of HSR were then applied by the participants in critiquing a research protocol and questionnaire for the household survey, which helped to refine the instrument in preparation for the pretesting. A detailed workplan and budget were developed in plenary and presented to the research supervisors for approval. The pretesting was carried out during the course of a second session in Mt. Frere. After a summary of the protocol and a review of the Xhosa translation of the questionnaire, the team of 14 interviewers was divided into pairs to visit 3 households each. The report back on this exercise was helpful in indicating some alterations to be made to the questionnaire, and in developing a more realistic workplan based on the time taken to complete each questionnaire. The sampling methodology, a simple random sample drawn from sampling frames compiled by the village health workers VHWs ; , was also clarified so that the interviewers are clear on the procedure to follow in the field when, for example, there is no one at home. A total of 600 households, clustered around four permanent clinics will be surveyed. Withtin this sample, households will be stratified according to whether they are less or more than an hour's travel from the clinic. Once the survey is complete, further training will cover data entry and analysis using Epi Info; use of qualitative methods and dexamethasone.
Patients complain of muscle pain that may be diffuse or limited to a specific area. There is often a sensory disturbance, such as numbness distal to the site of pain. Onset may be secondary to injury or related to working environment issues, such as poor posture and muscle overuse. Sleep disturbance is reported, either because of difficulty finding a comfortable position or waking during sleep.
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R32 At the time of issue of this guideline, angiotensin-II receptor antagonists see Table 8 ; are not licensed in the UK for heart failure and studies are ongoing. However, angiotensin-II receptor antagonists may provide an alternative to ACE inhibitors for patients intolerant of ACE inhibitors for example, because of cough ; . The triple combination of ACE inhibitor, beta-blocker and angiotensin-II receptor antagonist should be avoided, pending the results of further trials. A and divalproex.
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Report INCSR ; as stable at 4, 150 metric tons annually since 1996. There are no current accepted interagency estimates of the amount of marijuana destined for the United States from Colombia. The Royal Canadian Mounted Police RCMP ; estimates annual production of marijuana in Canada at 800 metric tons. Seizure and law enforcement reporting suggests that multimetric-ton quantities reach U.S. markets yearly. According to the INCSR, the last estimate of marijuana production in Jamaica was in 1997; approximately 214 metric tons were produced in that year. There are no accepted interagency estimates of how much marijuana from Jamaica is destined for the United States. Current law enforcement information indicates, however, that marijuana from Jamaica is being smuggled in the Caribbean, often through the Bahamas, with increasing frequency and tolterodine.
Danut Satkien, Ausra Kavolinien, Irena Petrauskien, Raimonda Sirvyt Clinic of Cardiology, Kaunas University of Medicine, Lithuania Key words: angiotensin-converting enzyme inhibitor, angioedema, pathophysiologic mechanisms, management. Summary. Angioneurotic edema is a rare 0.10.2% ; but potentially life-threatening side effect of angiotensinconverting enzyme inhibitors. It can result in serious respiratory distress, airway obstruction and death. Angiotensin-converting enzyme inhibitors associated angioedema is clinically poorly recognized and frequently underestimated condition. A case history of patient with angioneurotic edema due to treatment with ramipril is presented. A 51-yearold man has been sequentially treated for two years with atenolol, indapamide, enalapril, and fosinopril due to primary arterial hypertension. When the treatment was switched to ramipril 5 mg twice a day the fourth dose of the drug was followed by swelling of lips, tongue, and pharynx without symptoms of airway obstruction. Ramipril was discontinued, prednisolone 120 mg and loratidine 10 mg were given. Symptoms of angioedema gradually disappeared. Mechanisms of angioedema are not fully clear. Pharmacological action of angiotensin-converting enzyme inhibitors on bradykinin and substance P, immunological mechanisms and disarrangements in complement system are discussed. Treatment includes immediate withdrawal of angiotensin-converting enzyme inhibitors and acute therapy with epinephrine 0.30.5 ml subcutaneous, 50 mg diphenhydramine s c or 4050 mg methylprednisolone. Future treatment with angiotensin-converting enzyme inhibitors is contraindicated.
2-9 RESIDUAL LIFETIME RISK OF DEVELOPING HYPERTENSION IN MIDDLE-AGE WOMEN AND MEN. The long-term risk of developing hypertension is best described by the lifetime risk -- the probability that an individual will develop hypertension over the course of his or her remaining lifetime. It is possible that the lifetime risk may have increased in recent years because of the increased longevity of the population and the national increase in obesity. This study estimated the residual lifetime risk of developing hypertension among the Framingham Heart Study participants. Conclusion: Development of hypertension 140 90 ; is almost universal and gliclazide.
Liability shall be established where a person: i ; has operational control of the relevant activity; ii ; has breached a legal duty of care through intentional, reckless or negligent conduct, including acts or omissions; iii ; such breach has resulted in actual damage to biodiversity; and iv ; causation is established in accordance with section xx of these rules, for example, oxymetazoline.
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Through ODS cartridges Sep-Pak C18, Waters Associates, Milford, Massachusetts ; , moistened with methanol 3 ml ; and washed with 1% trifluoroacetic acid TFA ; 10 ml ; in water solution. Cartridges were coated with 1% polypeptide solution Polypep, Sigma Chemical Company, St. Louis, Missouri ; to minimize nonspecific absorption and washed again in a mixture of methanol water TFA 80 19 1%, vol vol vol ; . The sample was applied and the gel washed with a mixture of 5 ml 1% TFA 1% NaCl 1: ratio, vol vol ; . The absorbed ANF was eluted with 2 ml methanol and evaporated to dryness Hetovac and Hetotrap CT60, Heto Lab Equipment, A S, Birkerod, Denmark ; . The extraction procedure was performed at 4 C using the cartridges once. Extraction efficiency recovery rate 85.55.6%, meanSD, n 75 ; was estimated through labeled ANF approximately 800 cpm, Amersham, Buckinghamshire, England ; . The dried residue was frozen at -70 C and reconstituted with 500 fil assay buffer sodium phosphate 50 mM, 2% bovine albumin, 0.1% Triton-X, EDTA 10 mM, pH 7.4 ; . Samples were incubated overnight for approximately 15 hours ; at 4 C with 100 p\ antihuman ANF- l-28 ; rabbit antiserum Peninsula Labs., Inc., Belmont, California ; for detection of the carboxyl end of ANF, and therefore, also the amino terminaldepleted synthetic hormone used in this study. Labeled ANF in 100 n\ assay buffer was then added approximately 18, 000 cpm ; , and the incubation was prolonged overnight at 4 C. Bound and free ANF were separated by the addition of 100 p.1 normal rabbit serum solution and 100 y\ goat antirabbit immunoglobulin antiserum and centrifuged 4, 000 rpm for 20 minutes ; after 2 hours of incubation at room temperature. Precipitate and supernatant were counted in a gamma counter LKB 1275, Turku, Finland ; . Synthetic human ANF- l-28 ; Peninsula Labs., Inc. ; was employed for the standard curves. The assay had a mid range of 20 pg tube, and the lowest detectable dose of ANF was 6 pg ml. The intra-assay and interassay variation coefficients were 12.5% and 15.0%, respectively. Final ANF values were corrected for the respective extraction rates. No nonspecific interferences from compounds used in the steps before radioimmunoassay were found. Forearm blood flow studies. A polyethylene catheter 21 gauge, Abbot, Sligo, Ireland ; was inserted into the left brachial artery, while the patient was under light local anesthesia xylocaine, 2% ; , and connected through stopcocks to a pressure transducer MS20, Electromedics, Englewood, Colorado ; for systemic mean blood pressure VS pulse pressure + diastolic pressure ; monitoring by VSM1, Physio Control, Redmond, Washington ; and to an infusion pump series 944A, Harvard Apparatus, South Natick, Massachusetts ; for intra-arterial infusions, using separate ports for each substance. Systolic and diastolic blood pressure and heart rate were monitored continuously and recorded on line and dibenzyline.
1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington DC, American Psychiatric Association, 2000. 2. Fava M, Davidson KG. Definition and epidemiology of treatment-resistant depression. Psychiatr Clin North 1996; 19: 179200. Nierenberg AA, Amsterdam JD. Treatment-resistant depression: definition and treatment approaches. J Clin Psychiatry 1990; 51 suppl ; : 3950. 4. Narrow WE, Rae DS, Robins LN, Regier DA. Revised prevalence estimates of mental disorders in the United States: using a clinical significance criterion to reconcile 2 surveys' estimates. Arch Gen Psychiatry 2002; 59: 115123. Tiemens BG, Ormel J, Simon GE. Occurrence, recognition, and outcome of psychological disorders in primary care. J Psychiatry 1996; 153: 636644. Katon W, von Korff M, Lin E, Bush T, Ormel J. Adequacy and duration of antidepressant treatment in primary care. Med Care 1992; 30: 6776. Corya SA, Andersen SW, Detke HC, et al. Long-term antidepressant efficacy and safety of olanzapine fluoxetine combination: a 76-week open-label study. J Clin Psychiatry 2003; 64: 13491356. Papakostas GI, Petersen TJ, Nierenberg AA, et al. Ziprasidone augmentation of selective serotonin reuptake inhibitors SSRIs ; for SSRI-resistant major depressive disorder. J Clin Psychiatry 2004; 65: 217221. DeBattista C, Doghramji K, Menza MA, et al; Modafinil in Depression Study Group. Adjunct modafinil for the shortterm treatment of fatigue and sleepiness in patients with major depressive disorder: a preliminary double-blind, placebo-controlled study. J Clin Psychiatry 2003; 64: 10571064. Malone DM, Greenberg BD, Rezai AR. The use of deep brain stimulation in psychiatric disorders. Clin Neurosci Res 2004; 4: 107112. Hirschfeld RM, Lewis L, Vornik LA. Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic-depressive association 2000 survey of individuals with bipolar disorder. J Clin Psychiatry 2003; 64: 161174. Alarcon FJ, Isaacson JH, Franco-Bronson K. Diagnosing and treating depression in primary care patients: looking beyond physical complaints. Cleve Clin J Med 1998; 65: 251260. Lyness JM, King DA, Conwell Y, Cox C, Caine ED. Cerebrovascular risk factors and 1-year depression outcome in older primary care patients. J Psychiatry 2000; 157: 14991501. Baldwin RC, O'Brien J. Vascular basis of late-onset depressive disorder. Br J Psychiatry 2002; 180: 157160. Orengo CA, Fullerton G, Tan R. Male depression: a review of gender concerns and testosterone therapy. Geriatrics 2004; 59: 2430. Jackson JL, Kroenke K. Difficult patient encounters in the ambulatory clinic: clinical predictors and outcomes. Arch Intern Med 1999; 159: 10691075. Simon GE, Ludman EJ, Tutty S, Operskalski B, Von Korff M. Telephone psychotherapy and telephone care management for primary care patients starting antidepressant therapy. JAMA 2004; 292: 935942. Oxman TE, Dietrich AJ, Williams JW Jr, Kroenke K. A threecomponent model for reengineering systems for the treatment of depression in primary care. Psychosomatics 2002; 43: 441450. ADDRESS: George E. Tesar, MD, Department of Psychiatry and Psychology, P57, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195; e-mail tesarg ccf.
October 1, 2004 Mark B. McClellan Administrator Centers for Medicare & Medicaid Services Dept. of Health and Human Services Attention: CMS4068P P. O. Box 8014 Baltimore, MD 21244-8014 File Code: CMS4068P and phenoxybenzamine.
To earn CME credit, carefully read and evaluate four 4 ; of the articles designated for CME listed on the previous page ; . The CME evaluation form must be completed and faxed or mailed to the American Academy of Sleep Medicine. Journal CME is available for 90 days post publication date of the journal issue; this form must be sent postmarked by November 14, 2007. For items 1-2, please use the following scale: 5 Strongly Agree, 4 Agree, 3 Unsure, 2 Disagree, 1 Strongly Disagree Article 1 Page# 5 Article 2 Page# 5 Article 3 Page# 5 Article 4 Page# 5.
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Loss of normal facial movement and expression Fig. 10.2 ; . The speech is poorly articulated, and the voice is quiet and monotonous. Eating and swallowing become increasingly difficult. This may result in a tendency to drool sialorrhoea ; . It is estimated that up to 70% of patients ultimately experience drooling, which may lead to dermatitis and aspiration.
| What is StimateTEVA PHARMACEUTICAL INDUSTRIES LIMITED NOTES TO CONSOLIDATED FINANCIAL STATEMENTS continued ; NOTE 8 - COMMITMENTS AND CONTINGENCIES continued ; : reasonable basis to estimate the loss, or range of loss, that is reasonably possible with respect to such patent infringement cases. However, if Teva were to be required to pay damages in any such case, courts would generally calculate the amount of any such damages based on a reasonable royalty or lost profits of the patentee. If damages were determined based on lost profits, the amount of the damages would be related to the sales of the patentee's product. Teva's business inherently exposes it to potential product liability claims. Teva believes that it maintains product liability insurance coverage in amounts and with provisions that are reasonable and prudent in light of its business and related risks. However, Teva sells, and will continue to sell, pharmaceutical products that are not covered by insurance and accordingly may be subject to claims that are not covered by insurance as well as claims that exceed its policy limits. In addition, product liability coverage for pharmaceutical companies is becoming more expensive and increasingly difficult to obtain. As a result, Teva may not be able to obtain the type and amount of coverage it desires. In connection with certain development, supply and marketing, and research and collaboration or service agreements, Teva is required to indemnify, in unspecified amounts, the parties to such agreements "the other parties" ; against third party claims relating to: i ; infringement or violation of intellectual property or other rights of such third party; or ii ; damages to users of the related products. As of December 31, 2004, Teva is not aware of any material pending infringement action that may result in the other parties claiming such indemnification. Product Liability Matters Teva USA is a manufacturer of Adipex-P brand phentermine hydrochloride, and has been sued in both class actions and individual lawsuits relating to the alleged negative health effect of phentermine and fenfluramine. While neither drug had been indicated or approved for combination use by the FDA, physicians sometimes prescribed the two together in a combination treatment for weight control known as "fen-phen." Plaintiffs have filed lawsuits from August 1997 to the present in a variety of state and federal jurisdictions seeking monetary damages in unspecified amounts. The federal actions have been consolidated for pretrial purposes in the United States District Court for the Eastern District of Pennsylvania in a multidistrict litigation proceeding. On April 5, 2001, a claim was filed against Teva in the Tel Aviv District Court with respect to the use of a pharmaceutical product known as "Chorigon Ampoules 5000 Units." The plaintiffs claim that they were administered with allegedly defective ampoules of the product during the course of an in vitro fertilization treatment, resulting in the failure of the treatment and causing financial damages and mental anguish. The plaintiffs have filed a petition to certify the claim as a class action, which has not yet been decided. Intellectual Property Proceedings On September 14, 2001, Purdue Pharma L.P. filed an action in the U.S. District Court for the Southern District of New York, alleging that the filling of Teva USA's ANDA for 80 mg oxycodone hydrochloride extended-release tablets infringed three patents for OxyContin . Subsequently on April 3, 2003, Purdue sued Teva USA on its 10, 20 and 40 mg tablet products. On January 5, 2004, those three patents were held unenforceable in a related case, Purdue Pharma L.P. v. Endo Pharmaceuticals Inc., pending before the same judge as in Teva USA's case. Purdue has appealed that decision and oral argument was heard on November 3, 2004 before the Federal Circuit. On June 25, 2004, Teva USA's motion for summary judgment was granted on the ground that collateral estoppel applied to the inequitable conduct finding in the Endo case. On March 31, 2004, Teva USA commenced sales of its 80 mg tablets based upon the court's decision in the Endo case. The 2003 annual sales of the branded product in the U.S. were estimated to be approximately $707 million. Were Purdue to be successful on its appeal and if Teva USA does not receive a favorable decision in its own case, Teva USA could ultimately be required to pay damages related to the sales of 80 mg oxycodone hydrochloride extended-release tablets and be enjoined from selling this product. In August 2002, GlaxoSmithKline filed a complaint against Teva USA in the Pennsylvania Court of Common Pleas. The complaint alleges that Teva USA's amoxiclav products are derived from a strain of streptomyces clavuligerus stolen from GlaxoSmithKline. The complaint asserts causes of action for alleged trade secret misappropriation, unfair competition and conversion. The suit seeks equitable relief and imposition of a constructive trust related to Teva USA's amoxiclav products. Teva USA filed its answer to the amended complaint on October 8, 2003, denying all allegations of wrongdoing. F-31.
In 1999, actuarial valuation for German entities are based for the first time on the new German actuarial tables ``Heubeck tables 1998''. The life tables previously used ``PK Chemie 1996R'' ; dated from 1996. The actuarial losses occurring at the end of 1999 can principally be attributed to the changeover to the new actuarial tables. The components of net periodic costs for defined benefit plans consist of the following: 1999 5 in millions ; 20 143 5 and desmopressin.
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