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THAT you are guilty of unprofessional conduct or conduct which, when regard is had to your profession, is unprofessional in that during the period May 2003 to June 2003 in respect of Ms S Bhanprakash "your patient" ; you: 1. overcharged your patient for professional services rendered in respect of root canal treatment on teeth 44 and 45 in that you charged for obturation of additional canals in both these teeth when in fact both these have single canals. THAT you are guilty of unprofessional conduct, or conduct, which when regard is had to your profession, is unprofessional, in that during the period 30 April 2003 till 19 June 2003 or portions thereof ; and in respect of Mr MM Davern "your patient" ; you treated your patient in a manner that was incompetent, negligent, unsatisfactory and or not in accordance with generally accepted standards and norms of dental practice in that 1. 2. 3. you failed to diagnose and treat your patient's dental problems appropriately and or adequately; and or despite a charge for at least seven 7 ; radiographs only four 4 ; intra-oral radiographs were produced or made available; and or the nature and quality of the said radiographs is unacceptable in that they are undated, unnamed, distorted, inadequately fixed chemically [fogged] and have no diagnostic value; and or without apparent diagnostic material, you still persisted with totally inadequate costly treatment on the few remaining hopeless upper teeth; and or the lower teeth 47, 45 and 44, for which you treated and charged your patient, are unsatisfactorily treated, supposedly with root canal treatment, posts and crowns; and or in your statement of account [copy annexed and marked "A"] you repeatedly charged for the cost of bone whilst no bone was indicated in the treatment of your patient's dental problems and or you misused the specific tariff code; and or in your said statement of account you charged for a periodontal procedure on tooth 17 whilst no explanation could be ascertained for such treatment and charge.

In opposing the over-the-counter approval a year ago, we stated that the switch of orlistat to otc status would be a serious, dangerous mistake in light of its marginal benefits, frequent co-existence of other diseases, common, bothersome adverse reactions, significant inhibition of absorption of fat soluble vitamins , and problematic use in the millions of people using the blood thinner warfarin coumadin ; the latter because of orlistat-induced vitamin k deficiency. Another problem with herbals is worth mentioning. Unlike traditional medicines, herbals do not have to be tested to make sure they Herbals don't are safe and effective. For example, ginseng can have to be This limits our ability to cause problems if taken tested to w know whether they could with Co8madin warfarin ; make sure d be harmful and what or Lanoxin digoxin ; . One they're safe and effective. they can and can't do. It man who was taking warfarin to prevent blood also allows the sellers of herbals to make claims about their clots was doing well for many use that may or may not be true. months. But when he started taking ginseng, his blood tests showed that he could have serious bleeding. When In 1998, The National Center for Complementary and Alternative he stopped taking the ginseng, his Medicine was formed to look at blood tests returned to the desired herbals scientifically. Today, reliable levels without needing to change his dose of warfarin. Another patient with research is underway on this promising means to help manage your heart problems had been taking the health. See Check it out! in the same dose of digoxin for years. Then, all of a sudden, his tests showed that right column for tips on how to use he had too much medicine in his herbals safely. The Nomination Committee, which comprises of Stuart Wallis, Ann Hayes, Christopher Evans, Steven Powell and Michael Wyllie, is chaired by Ann Hayes and will meet as required. The Nomination Committee will consider the size, structure and composition of the Board, retirements and appointments of additional and replacement Directors and make appropriate recommendations to the Board. TRADING RECORD The Company has not traded since its incorporation on 25 January 2005. The following table, which has been extracted without material adjustment from the Accountants' Report set out in Part VI summarises the financial record of Plethora for the financial period ended 31 December 2004. Investors should read the whole of the Accountants' Report and not just rely on the summary below, for instance, coumadin manufacturer.

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Black men had average A1C levels that were 0.11 unit higher than those for white men 95% CI 0.11 to 0.34, P 0.34 ; , but the difference was not significant. Significant predictors of higher average A1C included baseline A1C, insulin or oral medication use, year squared, and higher baseline BMI. Older age age 65 years ; , a higher number of A1C tests, year, and the total number of other medications dispensed per year were significant predictors of lower average A1C. The average rate of increase in A1C over time was the same for black and white men. Among women with previously diagnosed diabetes, blacks had a 0.30 higher adjusted average A1C than whites 95% CI 0.14 0.46, P 0.0002 ; . Other significant predictors of higher average A1C in.
Because each individual responds to warfarin differently, it is necessary to monitor the levels to be sure the patient is at a safe and therapeutic level. The INR international normalized ratio ; is a blood test done to measure the level of warfarin medication in a patient's system. The levels of risk vary, the lower the INR value, the higher the patient's risk of having a blood clot or stroke. The higher the INR value, the higher the risk of bleeding and increased bruising. The blood sample is obtained by a simple finger stick to get a few drops of blood, which is then immediately processed. The patient has their INR reading within two minutes, compared with the 24 hours or longer it can take if the blood is drawn by a laboratory. This gives the patient immediate feedback to guide them in taking Coumadin. The nurse can then review any changes that may be affected by medication, diet, lifestyle or their health. Nationally it has been shown that if a patient is monitored regularly through a specialized clinic, they will stay within the proper INR range a higher percentage of the time. The nurse provides each patient with a printout at each visit outlining Cokmadin dose instructions along with the next follow-up appointment. Initially, a new and cozaar.

Discontinue the use of aspirin products, ticlid ticlopidine ; , plavix clopidogrel ; and iron pills for 7 days prior to the procedure. Discontinue all medication for arthritis for 24 hours prior to the procedure. If you are taking anticoagulants blood thinning medication eg.Coumadin ; contact your doctor who is doing your procedure at least one week before your appointment to discuss the dosages and arrangements to come in early for a blood test the day of the procedure If you are taking Insulin or other medication for diabetes, discuss with your family doctor the dosages to be taken the day of your procedure. All medications other than those mentioned above can be taken as usual. Prior to the day of your appointment, notify the doctor who will be doing your procedure if you have a Pacemaker , an Implanted Cardiac Defibrillator, a Heart murmur or an Artificial Heart Valve. Also notify him if you have had recent joint replacement and been advised to take antibiotics prior to procedures. For the best examination, the colon must be completely free of waste material: Please purchase one bottle of Fleet's Phosphasoda 44 ml ; and one bottle of Citromag 300 ml ; from your pharmacy or from St. Joseph's Hospital Prescription Shop. At 3: 00 the day before the procedure, drink the Phosphasoda 44 ml ; over ice or dilute one tablespoon at a time with 8 ounces of gingerale, lemonlime soft drink or apple juice. DRINK AS MUCH CLEAR FLUID AS YOU CAN including clear fluids only for supper ie: juices, black tea coffee, consomme, jello, Popsicles, koolaid, soft drinks and water. Gatorade is recommended. NO MILK or ORANGE JUICE or RED coloured liquids. At 6: 00 the day of the procedure, drink the Citromag 300 ml ; . Continue to drink as. Since coumadin works in the liver to suppress blood clotting, those with alcoholism and cirrhosis of the liver would not be able to take coumadin and cyclobenzaprine.

782 and healing of aortic homnografts, 161 in heart failure, congestive, 1219 in inflammatory reaction with myocardial infarction, 455 in rheumatic fever, 149 in rheumatic heart disease, 1219 Cottonseed oil, and cholesterol levels, 491 Coumadin. See Warfarini sodium Coxsackie virus in pericarditis, 1224 Cyanotic congenital heart disease, pulmonary thrombosis in, 1226 Cytochrome C affecting serum cholesterol, 687 Cytological differences of lipid metabolism in human and animal arterial wall, 746.
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As a pharmaceutical manufacturer concerned with people's wellbeing, our important management priorities are to protect the global environment and to help realize a prosperous society. To this end, our Shizuoka production and R&D facilities have obtained ISO14001 certification, the international standard for environment management, as part of the Company's environmental protection activities. These facilities work to minimize waste, incineration, and land reclamation, while reducing power consumption and otherwise saving energy. They also work to monitor and control the volumes of chemical used, minimize discharge of harmful substances into the atmosphere, and improve the quality of effluent. Our Shizuoka facilities have achieved a recycling ratio of over 99% for industrial waste. We have also established an environment committee to help promote environmental protection. In addition, we have initiated companywide activities aimed at promoting the "3 Rs" recycle, reduce, reuse ; in an effort to develop products and production technologies that have minimal impact on the environment.
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You might want to look for info on coumadin resistance, i would definitely ask your dr and diazepam. Researchers at Weill Cornell and Memorial Sloan-Kettering Medical Centers may have found a way to convert betulonic acid, found in the bark of white birch trees into a water-soluble compound that could be used as an agent against prostate cancer. You can read the news article at: : newsmedical ?id 19032 Researchers at the University of Liverpool found at environmental contaminates, such as pesticides may be causal factors in breast, testicular and prostate cancers. The key factor in controlling growth of these types of cancers is to reduce human exposure to the chemicals. - Medical Research News, for example, foods to avoid with coumadin. Prostaglandin E2 PGE2 ; is a potent lipid molecule that regulates a broad range of physiologic processes in the cardiovascular, endocrine, gastrointestinal, neural, pulmonary, reproductive, visual, and immune systems 1, 2 ; . PGE2 binds specific protein receptors on a diverse array of target cells. Pharmacologic and cDNA cloning studies have identified six different PGE2 receptors EPs ; , each of which is G proteinassociated and belongs to the rhodopsin family of serpentine receptors. Sequences encoding the extracellular domains of EP receptors are highly conserved and each binds PGE2 with similar affinity. However, the intracellular domains of these receptors are unique. Based on heterogeneous intracellular domains and their association with different intracellular signaling pathways 3 ; , EP receptors are divided into four different subtypes EP1-EP4 ; . EP1 receptors activate phospholipase C and phosphatidylinositol turnover and stimulate release of intracellular calcium via a poorly characterized G protein-mediated mechanism 3, 4 ; . EP2 receptors activate adenylate cyclase via a cholera toxin-sensitive, stimulatory G and diflucan.
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AGENERASE amprenavir ; Oral Solution Drinking alcoholic beverages is not recommended while taking AGENERASE Oral Solution because it may increase side effects related to propylene glycol content. Taking AGENERASE Oral Solution and NORVIR ritonavir ; oral solution together is not recommended because this may increase side effects related to propylene glycol and ethanol content. If you are on methadone therapy, talk to your doctor about possible interactions. Do NOT take the following medicines * with AGENERASE Oral Solution. You could develop serious or life-threatening problems. FLAGYL metronidazole, used to treat certain infections ; ANTABUSE disulfiram, used to treat alcohol dependence ; HALCION triazolam; used for insomnia ; CAFERGOT and other ergot medicines used for migraine headaches ; PROPULSID cisapride, used for certain stomach problems ; VERSED midazolam; used for sedation ; ORAP pimozide; used for Tourette's disorder ; You will need to be monitored with regular blood tests if you take the following medicines * with AGENERASE. CORDARONE amiodarone; used for certain abnormal heart rhythms ; Quinidine used for certain abnormal heart rhythms ; COUMADIN warfarin; used for blood thinning ; Lidocaine used for certain abnormal heart rhythms ; ELAVIL amitriptyline ; , TOFRANIL imipramine ; tricyclic antidepressants ; SANDIMMUNE or NEORAL cyclosporine ; , PROGRAF tacrolimus ; , RAPAMUNE rapamycin or sirolimus ; immunosuppressants ; You will need to have your dose adjusted if you take the following medicines * with AGENERASE. MYCOBUTIN rifabutin; used to prevent Mycobacterium avium complex [MAC] ; NORVIR Capsules ritonavir capsules; used to treat HIV infection ; VIAGRA sildenafil; used for impotence ; . You may get increased side effects such as low blood pressure, changes in vision, or erections that last more than 4 hours. If an erection lasts more than 4 hours, get medical help right away. The following medicines * may cause serious problems if you take them with AGENERASE. Tell your healthcare provider if you are taking any of these medicines. RESCRIPTOR delavirdine; used for HIV ; and certain other anti-HIV medicines St. John's wort hypericum perforatum ; or products containing St. John's wort VASCOR bepridil; used for chronic stable angina ; RIFADIN, RIFAMATE, RIFATER, or RIMACTANE rifampin, used for tuberculosis. CORDRAN .33 CORDRAN SP .33 CORDRAN TAPE .33 COREG .25 cormax.33 CORTANE-B .38 cortane-b-otic .38 CORTEF .32 cortic .38 cortic-nd .38 Corticosteroids EENT ; .38-39 CORTIFOAM .33 cortisone acetate.32 CORTISPORIN.14 CORTISPORIN-TC .13 cortomycin .13 CORZIDE .25 COSMEGEN.20 COSOPT .37 COUMADIN.24 COVERA-HS.26 COZAAR .25 c-phed tannate .42 c-phen.42 cpm pe msc .42 crantex.40 crantex er.40 crantex la.40 crantex lac .40 CREON .31 CRESTOR.26 CRESYLATE.38 CRIXIVAN .22 crolom .43 cromolyn sodium .43 cryselle-28.34 CUBICIN .14 CUPRIMINE.17 cyclobenzaprine hcl .44 cyclophosphamide solution.20 cyclophosphamide tablets .20 cyclosporine capsules .36 cyclosporine solution .36 CYKLOKAPRON .24 CYMBALTA.17 cyotic.38 cyproheptadine hcl.40 CYSTADANE.44 CYSTAGON .30 cystospaz-m.30 CYTADREN .32 cytarabine.20 CYTOMEL .35 CYTOVENE .23 cytra.44 and dilantin.
Through: Dr. Elizabeth Ominde-Ogaja Acting Chief Pharmacist, MOH By: Dr. Jonathan D. Quick.

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Since the publication of this meta-analysis, six further studies have been published. These new data have been recently reviewed [43]. Essentially, the new trials confirm the previous results. Some evidence emerged that St. John's wort is as effective as the newer synthetic antidepressants and that it also works in the more severe types of depression. Yet, so far, this evidence is not fully convincing. A large U.S. study organized by the National Institutes of Health NIH ; is on its way, which is expected to provide a definitive answer. St. John's wort was chosen here as an example. Other HMPs for which similarly compelling evidence of efficacy i.e., systematic reviews ; has been published include the following: ginkgo biloba for cerebral insufficiency [44] and dementias [45, 46] saw palmetto for benign prostate hyperplasia [47] horse chestnut seed extract for primary varicosis [48] peppermint oil for irritable bowel syndrome [49]. As hypothyroidism may affect heart muscle function and drug metabolism for such drugs as coumadin, the blood thinner ; , it seems reasonable to optimize thyroid status if it is safe to do so.

I know i will be very wary about taking any sort of medication in the future. Dhea supplementation should be done under the supervision of a health care professional to avoid hormone imbalances, for instance, coumadin patient education.
So a drug that blocks cannabis, it seems logical, should suppress appetite and cozaar. Before taking celexa, tell your doctor if you are using any of the following medicines: carbamazepine tegretol cimetidine tagamet lithium lithobid, eskalith a blood thinner such as warfarin coumadin any other antidepressants such as amitriptyline elavil ; , escelexa lexapro ; , fluoxetine prozac, sarafem ; , fluvoxamine luvox ; , imipramine tofranil ; , nortriptyline pamelor ; , paroxetine paxil ; , or sertraline zoloft or almotriptan axert ; , frovatriptan frova ; , sumatriptan imitrex ; , naratriptan amerge ; , rizatriptan maxalt ; , or zolmitriptan zomig.
Prior to the introduction of the Abortion and Sterilisation Act Act 2 of 1975 ; , there was no properly defined law on abortion. The Abortion and Sterilisation Act stipulated that abortion was to be performed in state-controlled institutions by two medical officers in specific circumstances only. Venezuelan equine encephalitis .663 Chagas' disease .663 Ebola fever .664 Other diseases due to insect borne-pathogens .664 Diseases Associated with Environmental Contact .664 Schistosomiasis .664 Plague .664 Sexually Transmitted Diseases .664 SPECIAL POPULATIONS OF TRAVELERS .664 Pregnant Women.664 Infants and Children.665 The Diabetic Traveler.665 The Immunocompromised Traveler .665 Severely immunocompromised, non-HIV-infected persons.665 HIV-infected persons .665 Immunosuppressed travelers at risk for specific infections .666 The Elderly Traveler.666 Travelers to High Altitudes .666 HEALTH CARE WHILE ABROAD .666 Insurance.666 Finding a Doctor Overseas.666 Prior to travel.666 While abroad .666 Air Medical Evacuation .667 INFORMATION SOURCES: PRINT, TELEPHONE, FAX, AND SUBSCRIPTION SOFTWARE.667 Reference Works .667 Periodicals, Bulletins, Directives, and Monographs .668 Computer Software-Based Services .668 INTERNET: WWW, FTP, AND E-MAIL.668 CARE OF THE RETURNED TRAVELER.670 CONCLUDING REMARKS .670 ACKNOWLEDGMENTS .671 REFERENCES .671 INTRODUCTION In a typical week in Travel Health Services THS ; , our travel clinic in Syracuse, N.Y., we counseled and immunized 21 travelers. It was the usual diverse, intelligent, vital group of people: a 45-year-old mother with her 12- and 15-year-old daughters who were preparing to meet her husband in Virginia and travel by air to Nairobi, Kenya, overland to Kampala, Uganda, and then by air to Mozambique; a 54-year-old man with a serious and progressive disabling neurologic disorder who was traveling first to Brazil and later to Thailand, Australia, and Europe--he was racing the clock before his advancing disability precluded travel; a 64-year-old woman embarking on a 2-week pilgrimage in Morocco, from Tangier to Fes to Meknes to Marrakech to Tarfaya, seeking the roots of her ancient Jewish family; a 65-year-old man who was traveling but wanted only his annual flu shot; a 59-year-old businessman who was leaving in 6 days for Bombay, Delhi, and Bhusawal in India and then on to Dhaka, Bangladesh--as we see all too often, he had not allowed adequate time for effective immunization; a 47-yearold man leaving for Quito, Ecuador, his base for high-peak technical climbing; a 63-year-old woman anticipating a 2-week high-elevation visit to LaPaz, Bolivia, and Machu Picchu, Peru, taking with her a history of frequent premature heartbeats; a 41-year-old businessman, 6 weeks postsplenectomy, leaving in 4 days for the Pacific Rim--he was sent on his way with immune globulin, extensive counseling, and a plan for a posttrip immunization program because of his splenectomy a 46year-old woman with a history of asthma, heading for a mission retreat in El Salvador, who received hepatitis A, influenza, and oral typhoid vaccines--3 h later, she called back with an acute asthma attack and hives, which responded readily to treatment; a 37-year-old businessman departing in 18 days for Bombay and Surat in India, the latter being the site of the recent "epidemic" of plague; a China-born couple in their late 50s returning home and desiring protection against "liver failure", with the sketchiest understanding of hepatitis viruses; a resident physician, his wife, and their 5-month-old daughter, preparing for a 2-month visit to Zambia, where he was to work in the mission hospital where he was born to missionary parents 28 years ago; a 34-year-old businesswoman off to the Pacific Rim; two daughters, age 4 months and 4 years, of a lady born in India returning home to her birth city of Bombay for 1 month; and a 59-year-old woman also attending the mission retreat in El Salvador. During this week at THS, we encountered the usual wide spectrum of demographics, travel experience, reasons for traveling, and itineraries. With just 21 travelers, the destinations included all continents except Antarctica. People were traveling for business, professional, and altruistic reasons and for pure touring pleasure. THS draws from an area of about 1, 000, 000 population; metropolitan Syracuse is the largest urban area at less than 500, 000 persons. Given the region's farming and small-enterprise economic base, we have been somewhat surprised at the amount and diversity of travel abroad. In fact, central New York appears to reflect the national and international scene. Around our shrinking globe, 500 million travelers cross national boundaries each year, including 40 million Americans. One concomitant of this massive movement is exposure to potential pathogens on an unprecedented scale. Perhaps even more worrisome is the increasing potential. 21. Smith, J. C. 1964. Radiation pneumonitis: case report of bilateral reaction after unilateral irradiation. Am. Rev. Respir. Dis. 89: 264269. 22. Cohen, Y., B. Gellei, and E. Robinson. 1974. Bilateral radiation pneumonitis after unilateral lung and mediastinal irradiation. Radiol. Clin. North Am. 43: 465471. 23. Byhardt, R. W., R. Abrams, and U. Almagro. 1988. The association of adult respiratory distress syndrome ARDS ; with thoracic irradiation. Int. J. Radiat. Oncol. Biol. Phys. 15: 14411446. 24. Kataoka, M., M. Kawamura, M. Ueda, H. Itoh, A. Lio, and K. Hamamoto. 1990. Diffuse gallium-67 uptake in radiation pneumonitis. Clin. Nucl. Med. 15: 707711. 25. Cordier, J. F., J. F. Mornex, Y. Lasne, J. P. Gerard, G. Cordier, R. Creyssel, and R. Touraine. 1984. Bronchoalveolar lavage in radiation pneumonitis. Bull. Eur. Physiopathol. Respir. 20: 369374. 26. Nakayama, Y., S. Makino, Y. Fukuda, K. Y. Min, A. Simizu, and N. Ohsawa. 1996. Activation of lavage lymphocytes in lung injuries caused by radiotherapy for lung cancer. Int. J. Radiat. Oncol. Biol. Phys. 34: 459467. 27. Hallahan, D. E., D. R. Spriggs, M. A. Beckett, D. W. Kufe, and R. R. Weichselbaum. 1989. Increased tumor necrosis factor mRNA after cellular exposure to ionizing irradiation. Proc. Natl. Acad. Sci. U.S.A. 86: 1010410107. 28. Brach, M. A., R. Hass, M. L. Sherman, H. Gunji, R. Weichselbaum, and D. Kufe. 1991. Ionizing radiation induces expression and binding activity of the nuclear factor kappa B. J. Clin. Invest. 88: 691695. 29. Datta, R., E. Rubin, V. Sukhatme, S. Qureshi, D. Hallahan, R. R. Weichselbaum, and D. W. Kufe. 1992. Ionizing radiation activates transcription of the EGR1 gene via CArG elements. Proc. Natl. Acad. Sci. U.S.A. 89: 1014910153. 30. Shaw, E. G., R. L. Deming, E. T. Creagan, S. Nair, J. Q. Su, R. Levitt, P. D. Steen, M. Wiesenfeld, and J. A. Mailliard. 1995. Pilot study of human recombinant interferon gamma and accelerated hyperfractionated thoracic radiation therapy in patients with unresectable stage IIIA B non small cell lung cancer. Int. J. Radiat. Oncol. Biol. Phys. 31: 827831. 31. Bjermer, L., L. Franzen, B. Littbrand, K. Nilsson, T. Angstrom, and R. Henriksson. 1990. Effects of smoking and irradiated volume on inflammatory response in the lung of irradiated breast cancer patients evaluated with bronchoalveolar lavage. Cancer Res. 50: 20272030. 32. Bjermer, L., Y. Cai, K. Nilsson, S. Hellstrom, and R. Henriksson. 1993. Tobacco smoke exposure suppresses radiation-induced inflammation in the lung: a study of bronchoalveolar lavage and ultrastructural morphology in the rat. Eur. Respir. J. 6: 11731180.
All doctors said no it cant be coumadin, it has to be kidney stones-if there are no kidney stones, you must have a preexisting condition with your kidneys that are contributing to the clotting the cardiologist, even though i was literally hemhoragging, told me to stay on the regimen.

Brothers 1996 ; notes that, in the U.S., the first generic entrant can sell at a 30% discount to the branded product, compared to a 75% discount for later entrants. Another newsletter reports that "Industry experts say.80 per cent [of profits] are milked out of a drug in the first 18 months of its reincarnation as a generic." CDRI 1996b ; . Being based in a country which does not grant product patents helps firms to get into the market earlier. McFetridge 1996 ; notes that when Canada stopped granting its generics manufacturers compulsory licenses to produce on-patent drugs, the firms "were Drugs and health includes all patents with an international patent classification in either A61 or A01N. Jonathan Putnam, Charles Rivers Associates, kindly provided these data.
John's wort; a blood thinner such as warfarin coumadin a cholesterol medication such as lipitor or zocor; an antibiotic such as clarithromycin biaxin ; , itraconazole sporanox ; , rifabutin mycobutin ; , or rifampin rifadin, rifater, rifamate, rimactane heart or blood pressure medications such as amlodipine norvasc ; , diltiazem tiazac, cartia, cardizem ; , felodipine plendil ; , nicardipine cardene ; , nifedipine procardia, adalat ; , nimodipine nimotop ; , nisoldipine sular ; , or verapamil calan, covera, isoptin, verelan other hiv medicines such as amprenavir agenerase ; , indinavir crixivan ; , lopinovir ritonavir kaletra ; , nevirapine viramune ; , ritonavir norvir ; , or saquinavir invirase or seizure medications such as phenytoin dilantin ; or carbamazepine tegretol.

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Coumadin only $ 4 coumadin treats or prevents blood clots that may occur in the veins and lungs. Michelle Ward is a practice nurse in Co Donegal. She has received an award for excellence in practice education, research and management from the Nursing and Midwifery Planning and Development Unit in the North-Western Health Board for her work in cardiovascular disease prevention. The author would like to acknowledge the secretarial support of Mari Quinn in writing this article.

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