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EXHIBIT 13. ANNUAL REPORT TO SHAREHOLDERS FOR THE YEAR ENDED DECEMBER 31, 1996 REVIEW OF OPERATIONS OPERATING RESULTS AND NET INCOME--1996 Worldwide sales rose 9 percent in 1996, to $7.3 billion. The factor that contributed most to the increase was an 11 percent growth in unit volume. Foreign exchange rates and selling prices each decreased sales by 1 percent. The company achieved sales increases both in the United States and abroad. Sales in the United States were $4.2 billion, a 12 percent increase. Sales outside the United States were $3.1 billion, an increase of 4 percent from 1995. Pharmaceutical sales for the year increased 9 percent, to $6.8 billion, led by the antidepressant Prozac up $290 million, or 14 percent, to approximately $2.4 billion ; . Prozac sales increased despite continuing competition from generic forms of Prozac in Australia and Canada and substantial competitive pressures in France. Other products contributing significantly to the worldwide pharmaceutical sales growth included the human insulin product Humulin up 11 percent, to $884 million ; and three of the company's new products, Gemzar, ReoPro and Zyprexa. Gemzar, an oncolytic launched in the U.S. in May 1996, contributed $62 million to sales, while sales of ReoPro, a cardiovascular product launched in February 1995, contributed $149 million, an increase of $127 million over 1995. Zyprexa, a treatment for schizophrenia and related psychoses, had a very strong first three months after its October launch with sales of $87 million. The company's sales also benefited from increased health-care-management revenues, which rose $112 million, to $370 million, in 1996, substantially all of which was in the U.S. The company anticipates that Humulin, Prozac and the newer products Gemzar, ReoPro and Zyprexa, among others, will experience continued sales growth in 1997. The pharmaceutical sales growth for the year was partially offset by a reduction in worldwide anti-infectives sales, discussed further below, and slightly lower sales of Axid down 3 percent, to $531 million ; as a result of increased competitive pressures. Worldwide anti-infectives sales of $1.5 billion reflected a 13 percent decline, most of which occurred in the U.S. where the company experienced a decline of 37 percent due largely to continued generic competition. Although sales growth was achieved in many of the emerging markets, sales of anti-infectives outside the U.S. reflected a 2 percent decline compared with 1995. The primary contributor to this worldwide decline was cefaclor, which was down 25 percent. In spite of continued strong generic competition and substantial pricing pressures, worldwide sales of cefaclor for 1996 exceeded $540 million. All the company's other anti-infective products, except Dynabac, experienced declines in the U.S. where competition has stiffened in a field increasingly crowded by both generic products and newer branded products. The company expects that worldwide anti-infectives sales in 1997 are likely to be approximately equal to 1996 levels. Pharmaceutical sales in the United States in 1996 increased 12 percent, to $4.0 billion, all of which was due to increased volume. Major products contributing to this growth were Humulin up $37 million ; , Prozac up $292 million, or 20 percent ; , ReoPro up $112 million ; , and Zyprexa, which had U.S. sales of $78 million since its October 1996 launch. Also, Gemzar contributed $32 million in U.S. sales. This growth was offset, in part, by the decline in anti-infectives sales and an increase in Medicaid rebates compared with 1995. The company anticipates that rebates associated with Medicaid programs will increase in 1997. Pharmaceutical sales outside the U.S. increased 4 percent, to nearly $2.8 billion, in 1996. The increase reflects volume growth of 10 percent resulting from the company's continued globalization 1.
Even with all that our educators do, a prime vehicle for delivering vital healthcare and treatment information remains the written word. ACRIA therefore publishes ACRIA Update, an HIV treatment quarterly, and topic-specific brochures--five so far--on issues of importance to people with HIV. Like all ACRIA materials, our publications are written for lay audiences, in easy-to-understand language, and the brochures a re available in both English- and Spanish-language editions. All are distributed free, in bulk and by request, to CBOs a c ross the United States and abroad, for use with and redistribution to their HIV-positive clients. All ACRIA publications are available on our Website, acria . ACRIA Update and the brochures can also be seen on the Website of The Body, thebody , and ACRIA Update is on the site of the AIDS Education Global Information System AEGIS ; , aegis.
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Transport activity for PAH, no significant hOAT1-mediated uptake of amoxicillin or cefaclor was detected Figure 6A ; . It unlikely that the lack of transport activity of amoxicillin and cefaclor by hOAT1-expressing cells was due to restricted substrate access to the basolateral aspect of the MDCK monolayer, because cells used in all uptake studies were unpolarized and high level of PAH uptake was observed. Our finding differs from a previous report where a moderate increase in 3H-labled amoxicillin uptake by CHO cells expressing hOAT1 was observed Hill et al., 2002 ; . The reason for this discrepancy is unclear and may be due to different experimental conditions used. Nevertheless, the low affinity of hOAT1 in interacting with amoxicillin and cefaclor and its minimal uptake of these antibiotics suggest that hOAT1 does not play a.
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Research goals Bioinformatics in Microarray Gene Expression Analysis. The main goal of the project is to analyze, extract and interpret vital information from the massive amounts of data produced by microarrays. Current projects use various clustering algorithms including hierarchical clustering and self-organizing-maps, a neuron based machine learning algorithm. The laboratory also develops software tools for data mining from gene lists based on gene ontology GO ; terms, and for annotating and combining microarray data sets. Applications for these methods come from expression profiling experiments in model systems to determine the actions of neuroprotective drugs or from disease models in neurodegeneration. Neurodegenerative Models in C. elegans. The main goal of the project is to produce transgenic worm models to understand the molecular and cellular events leading to neurodegeneration. Various putative or candidate neurotoxicity causing genes are overexpressed in worms using coexpression of green-fluorescent protein GFP ; in neurons as a marker, followed by fluorescent microscopy. Behavioural screens are used to evaluate phenotypes in transgenic disease models. Transgenic C. elegans have been produced for the study of Parkinson's disease. RNA interference screens are used to identify suppressors or enhancers of the disease phenotypes. Aging studies are applied to determine the effects of transgenes and neuroprotective agents in C. elegans and
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Patients with the disease have a higher risk of committing suicide than those with other psychiatric or medical disorders, and without effective treatment, bipolar disorder can lead to suicide in nearly 20 percent of cases and
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Administration. People under the influence of PCP often become violent or suicidal. Thus, a treatment that could quickly detoxify PCP abusers with a single injection would be valuable in reducing the harm that PCP abusers can cause to themselves or others. It could also shorten hospital stays and reduce the long-term costs associated with their recovery. In their studies, the researchers showed that a single large dose of "Fab" completely removed PCP within 15 minutes from the brains of living rats whose bodies had been saturated with PCP. The body processes "Fab" more quickly than it does the whole antibody and can eliminate it rapidly through the kidneys along with the PCP that is bound to it, Dr. Owens explains. "Fab's fast-in fast-out action makes it perfect for treating the acute toxic effects of drug overdose in hospital emergency rooms, " he says. With NIDA's support, Dr. Owens plans to complete the necessary preclinical research and apply for approval from the Federal Food and Drug Administration FDA ; to begin clinical trials of "Fab" in humans. Long-Term Treatment for PCP Abuse The researchers found that, in contrast to the short-term effects of "Fab, " a single, large dose of IgG, given 24 hours after they started infusing rats with PCP, significantly reduced PCP brain concentrations during 27 days of continuous high-dose PCP infusion. In other studies, a single injection of IgG greatly reduced such PCP-induced effects as hyperactivity and distance traveled by rats given escalating doses of PCP every 90 minutes, on every third day, over 2 weeks. Measurements of these behavioral effects during the experiment showed that IgG-treated rats had and atacand.
Does ventricular synchrony change with exercise in healthy men? P. Mullan1, J. Silberbauer2, G. Llyod2, G. Carr-White2 and G. Brickley1 1Chelsea School, University of Brighton, Eastbourne, East Sussex, UK and 2Coronary School Research Centre, Eastbourne District General Hospital, Eastbourne, East Sussex, UK Cardiac output is thought to be the main limiting factor of maximal aerobic exercise in healthy subjects Coats, 2001 ; .Alterations, for example, cefaclor ratiopharm.
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MORE INFORMATION Please consult your doctor or pharmacist with any questions or concerns you may have regarding your individual condition. This document plus the full product monograph, prepared for health professionals can be found at: : novartis or by contacting the sponsor, Novartis Pharmaceuticals Canada Inc., at: Novartis Pharmaceuticals Canada Inc. 385 Bouchard Blvd. Dorval, Quebec, H9S 1A9 1-800-363-8883 and
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Bacterial Endocarditis: American Heart Association recommendations for the prevention of bacterial endocarditis are available at: : americanheart Hepatitis: CDC recommendations on the treatment of hepatitis are available at: : cdc.gov ncidod diseases hepatitis index Guidelines for the management of chronic hepatitis B by the American Association for the Study of Liver Disease are available at: : aasld Guidelines for diagnosis, management, and treatment of hepatitis C by the American Association for the Study of Liver Disease are available at: : aasld HIV AIDS: Guidelines for the treatment of HIV patients by the U.S. Department of Health and Human Services are available at: : aidsinfo.nih.gov Influenza: Recommendations of the Advisory Committee on Immunization Practices are available at: : cdc.gov ncidod diseases flu fluvirus International Travel: CDC recommendations for international travel are available at: : cdc.gov travel Sexually Transmitted Diseases: CDC Sexually Transmitted Diseases Guidelines are available at: : cdc.gov Respiratory Tract Infection Antibiotic Use Community Acquired Pneumonia Other: Principles of appropriate antibiotic use for treatment of nonspecific upper respiratory tract infection in adults are available at: : cdc.gov drugresistance community healthcare provider Practice guidelines and statements developed and endorsed by the Infectious Diseases Society of America are available at: : idsociety ANTIBACTERIALS Cephalosporins First Generation cefadroxil cephalexin Second Generation ceaclor cefprozil cefuroxime axetil Third Generation cefdinir ceftibuten Erythromycins Macrolides erythromycin stearate clarithromycin ext-rel erythromycin sulfisoxazole azithromycin.
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1. Patients should be asked to quantify their pain on an analog pain scale 0 least severe to 10 most severe ; . This number should be documented and used to measure the effectiveness of analgesia. Nitrous Oxide self-administered see Medical Procedure 4.22 and
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The service model linked the patient with their usual GP and pharmacist Key process in the intervention was establishing effective collaboration in primary health care team mainly linking GPs and pharmacists ; 2 education sessions were included for pharmacists and GPs. First was followed by a voluntary workshop which involved case discussions. The education sessions related to geriatric therapeutics, QUM, adverse drug reactions, how to unprescribe, how to use other members of the healthcare team and how to implement medication reviews GPs provided a structured written referral including patient diagnoses and current medications to the community pharmacist Home visits occurred approx 2 weeks after referral Medication reviews were conducted by an AACP accredited pharmacist. When local pharmacist 38% ; was not accredited an accredited pharmacist was linked with the local pharmacy A medication review report was prepared and forwarded to the GP and within 2 weeks of medication review report preparations recommendations were discussed at a.
Hospital and Other Discounts FHBP stated that all PPO Preferred Provider Organization ; rates are automated in t ss naet op a b hsil is r e the FHBP system. Until December 2006, attempts to negotiate non-PPO provider discounts were cnut b F B doa T a . odc d y H vct em Sn t services of Innovative Cost Solutions ICS ; , a subsidiary of FiServ Health. FHBP stated that no fees will be transferred to PEBP for this service. PEBP Executives were not satisfied with the ICS established guideline levels and requested FiServ Benefit Planners to comply with the previous agreed upon levels. FiServ Benefit Panrhs r et a ecm ash bs l e the established ICS guidelines and the established ones currently utilized by PEBP.
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Mental health: effects on mental status back to top may cause nervousness; case reports of euphoria, delusion, illusions, and depersonalization with cephalosporins mental health: effects on psychiatric treatment back to top may rarely cause neutropenia; use caution with clozapine and carbamazepine dosage forms back to top capsule ceclor ; : 250 mg, 500 mg powder for oral suspension: 125 mg 5 ml 75 ml, 150 ml 187 mg 5 ml 50 ml, 100 ml 250 mg 5 ml 75 ml, 150 ml 375 mg 5 ml 50 ml, 100 ml ; ceclor: 125 mg 5 ml 150 ml 187 mg 5 ml 100 ml 250 mg 5 ml 75 ml, 150 ml 375 mg 5 ml 100 ml ; tablet, chewable raniclor ; : 125 mg , 187 mg , 250 mg , 375 mg tablet, extended release ceclor cd ; : 375 mg, 500 mg references back to top american thoracic society, guidelines for the initial management of adults with community-acquired pneumonia: diagnosis, assessment of severity, and initial antimicrobial therapy, rev respir dis , 1993, 148 5 ; : 1418-2 boguniewicz m and leung dym, hypersensitivity reactions to antibiotics commonly used in children, pediatr infect dis j , 1995, 14 3 ; : 221-3 donowitz gr and mandell gl, beta-lactam antibiotics, n engl j med , 1988, 318 7 ; : 419-26 and 318 8 ; : 490-50 hyslop dl, cefaclor safety profile: a ten year review, clin ther , 1988, 11 suppl a ; : 83-9 levine lr, quantitative comparison of adverse reactions to cefaclor vs amoxicillin in a surveillance study, pediatr infect dis , 1985, 4 ; : 358-6 marshall wf and blair je, the cephalosporins, mayo clin proc , 1999, 74 2 ; : 187-9 saxon a, beall gn, rohr as, et al, immediate hypersensitivity reactions to beta-lactam antibiotics, ann intern med , 1987, 107 2 ; : 204-1 smith gh, oral cephalosporins in perspective, dicp , 1990, 24 1 ; : 45-5 wright aj, the penicillins, mayo clin proc , 1999, 74 3 ; : 290-30 international brand names back to top adco-cefaclor za alfacet yu alfatil fr altaclor it apo-cefaclor ca, pl bactigram it biocef bd capabiotic id cec at, cz, de, do, lu, ro, za ceclodyne ro ceclor at, au, bd, be, br, ca, ch, co, cr, cz, do, es, gt, hn, hr, hu, id, il, lu, mx, nl, nz, pa, pl, pt, ro, ru, si, sv, tr, za ceclorbeta de cecloretta hu ceclor mr ro cefabac bg, jo, kw, lb, ma, my, sy cefaclor 1a pharma de cefaclor abc it cefaclor acis de cefaclor ahimsa ar cefaclor al de cefaclor azu de cefaclor basics de cefaclor beta de cefaclor bexal es cefaclor biochemie co, ro cefaclor cz, gb, ro cefaclor doc it cefaclor eg it cefaclor fabra ar cefaclor heumann de cefaclor k24 it cefaclor lindo de cefaclor merck it cefaclor mk cr, do, gt, hn, pa, sv cefaclor normon es cefaclor pb de cefaclor pliva it cefaclor ranbaxy es cefaclor-ratiopharm de, hu, it cefaclor richet ar cefaclor s250 stada th cefaclor sandoz de cefaclor stada de cefaclor-teva il cefaclor-wolff de cefacl si cefager ie cefahexal at cefaklor yu cefalcor it cefalor il cefaltrex do cefamid do cefastad at cef-diolan de cefin do cefkor au cefor pl cefral ar cefulton it cek pl celco th cephaclor von ct de cephalodoc de citiclor it cleancef sg cloracef hk, id, jo, kw, lb, mt, my, ro, za clorad it clorazer it clorotir nz dbl cefaclor au distaclor gb, hk, ie, sg, th dista mr gb doccefaclo be dorf it especlor id eurocefix it faclor br falcef do fuclode it geniclor it hefa clor de infectocef de kefaclor th keflor au, cl, in kefolor fi kefsid tr keftid gb, ie kliacef it kloracef pl kwicap ar lafarclor it lilly-cefaclor za loracef bd losefar tr medikoncef id medoclor ro navacef bd necloral it novacef br novo-cefaclor ca nu-cefaclor ca oralcef it panacef it panclor pl panoral de performer it pinaclor ie pms-cefaclor ca razicef bg remeclor cy rolab-cefaclor za selviclor it serviclor cz, pl sifaclor th sigacefal de sinclor ro soficlor sg suclor do taracef pl, ru, si tibifor it vercef cz, hu, pl, ro, ru, sg, th, za vercef mr cz, hu, pl ; , inc is accredited by urac, also known as the american accreditation healthcare commission site.
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Creased to 31 % and chloramphenicol resistance also rose 7% to 20% ; . However, the level of resistance to co-trimoxazole and cefaclor, although high up to 42% and 20% ; , declined in 1993 to 11% and 2%, respectively. There was an increase in resistance to penicillin in S pneumoniae isolates from nil in 1987 1988 to 10% in 1993. All penicillin-resistant strains were isolated from sputum. Resistance to tetracycline, chloramphenicol, and erythromycin remained high at 71%, 24%, and 17%, respectively. Resistance to cefaclor was low, at an average of 3%. A comparison of antimicrobial resistance in gram negative organisms as reported in various studies 11, I2J7 is shown in Table 5. Generally, the level of antimicrobial resistance found in our study is similar to previous findings" except for the increased resistance to cefuroxime, ofloxacin, and co-trimoxazole seen in E coli and Klebsiella spp., and to carbenicillin in P aeruginosa. Hospital and community isolates of.
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