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In both 1-year studies n 425, 576 ; , overall glycaemic control worsened with both repaglinide and glibenclamide to a similar extent, with HbA 1c and FPG 13, 14 levels increasing from baseline. The 3-day study evaluated the effects of missed meals on glycaemic control where patients n 43 ; were allowed 2 or 3 meals a day. A repaglinide dose was not taken if a meal was omitted. Overall, no significant differences were seen between treatment groups in the increase in mean blood glucose from fasting plasma levels, and the mean 24 hour blood glucose levels. On days of 3 meals, minimum blood glucose levels were similar in both treatment groups 4.2mmol l repaglinide vs 4.3mmol l glibenclamide ; . On days of 2 meals, minimum blood glucose levels were significantly lower with glibenclamide than repaglinide 3.4mmol l vs 15 4.4mmol l, p 0.05 ; . Data from two 1-year studies, published as abstracts, comparing repaglinide to other sulphonylureas 1 16 17 gliclqzide , 1 glipizide ; suggest that repaglinide demonstrates similar glycaemic control to gliclazide, and improved efficacy compared to glipizide. Full publication is required to evaluate these findings. Studies in combination with metformin A small n 83 ; fully published 4-5 month study evaluated repaglinide and metformin combination therapy in patients not optimally controlled on 18 metformin alone HbA1c 7.1% ; . Patients randomised to metformin continued on their pre-study dosages mean 1.7-1.8 grams day ; . The dose of repaglinide was titrated from 0.5mg-4mg tds. In this study, HbA1c and FPG levels fell significantly with combination therapy, both from baseline p 0.0016 ; and compared to either drug alone p 0.05 ; . By the end of the study, nearly 60% of patients receiving combination therapy n 27 ; had optimal glycaemic control HbA1c 7.1% ; , compared with 20% in both monotherapy groups. Adverse Events The most common adverse events across the studies were those related to hypoglycaemia. Most were mild to moderate events external help not required ; . The frequency of hypoglycaemic events with repaglinide was greater than placebo, and appeared largely similar to glibenclamide. Cardiovascular events were noted in some studies eg changes in electrocardiogram values, blood pressure, or pulse rate. None of the cardiovascular events were reported to be statistically significant, and causality has not been established. Post-marketing data do not indicate an excess cardiovascular risk with repaglinide. Weight changes in repaglinide-treated patients were also noted in some studies, but no consistent effect was seen. Diarrhoea occurred in more patients treated with metformin 29.6% alone, 18.5% in combination ; than with repaglinide 7.1% ; in the combined therapy study. Refer to the Summary of Product Characteristics for further details of adverse events and digoxin.

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FIG. 1. Measurement of PI3-kinase activity in rat soleus muscle. A ; Effect of lgiclazide 300 g ml ; on IRS-1-mediated PI3-kinase activity. B ; Effect of insulin 100 nM ; on IRS-1-mediated PI3-kinase activity. PI3-kinase activity is expressed as a percentage of basal activity. Results represent the means SEM of 5 independent experiments. * p 0.05 vs basal activity. A representative autoradiograph is shown. The position of phosphatidylinositol 3-phosphate is indicated. FIG.2. Effect of 300 g ml gliclazid and 100 nM insulin on IRS-1 tyrosine phosphorylation. A 500 g sample of muscle lysate was immunoprecipitated with anti PY-20 antibody followed by SDS-PAGE and transferred to nitrocellulose. IRS-1 tyrosine phosphorylation was detected by immunoblotting using anti-IRS-1 antibody. IRS-1 tyrosine phosphorylation is expressed as a percentage of basal value. Results represent the means SEM of 5 independent experiments. * p 0.05 vs basal. A representative autoradiograph is shown. FIG. 3. Time-dependent effects of insulin 100 nM ; and gliclazide 300 g ml ; on PKCalpha, PKC-theta and PKC-epsilon levels in membrane white squares ; and cytosolic black rhombus ; fractions of rat soleus muscles incubated in vitro. Results represent meanSEM values of 5 comparisons of insulin and gliclazide-treated versus control muscles at each time point. * p 0.05 vs basal. a ; Representative immunoblot of the PKC-alpha, PKC-theta and PKC-epsilon subcellular distribution at 10 min of insulin treatment. b ; Representative immunoblot of the PKC-alpha, PKC-theta and PKCepsilon subcellular distribution at 10 min of gliclazide treatment. FIG. 4. Hypothetical signaling pathway of gliclazide in skeletal muscle. Broken arrows indicate unknown pathway; thin arrows indicate the signaling pathway, and thick.

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MAGNESIUM OXIDE Mag-Ox, Maox, Uro-Mag, and others, 60.32% Elemental Mg Oral magnesium salt Tabs: 400, 420, 500 mg Caps: 140 mg 400 mg magnesium oxide is equivalent to 241.3 mg elemental Mg or 20 mEq Mg. Results The pass-fail performance of the 40 participants on the ABLA test and auditory matching tasks are presented in Table 2. The four auditory matching tasks were hierarchically ordered in relation to each other and in relation to the ABLA test. The two-choice task to produce a matching sound bell-tambourine task ; was positioned between ABLA Levels 4 and 6, and the two-choice task to produce a nonmatching sound rice-rattle task ; , auditory-auditory identity matching AAIM, pen-pen task ; , and auditory-auditory nonidentity matching AAIM, ballfield task ; were positioned higher than ABLA Level 6, with one exception. Participant 6, as illustrated in Table 2, passed the two-choice task to produce a nonmatching sound, but failed ABLA Level 6. Six to eight month test-retest reliability was computed for the 23 participants included in both Harapiak et al. 1999 ; and the current study, and was high, r .94, p .0001. Order Analysis Order To examine, statistically, hierarchical relations between adjacent discriminations, an order analysis was used Krus, Bart, & Airasian, 1975 ; . Participants were classified as confirmations C ; or disconfirmations D ; . A confirmation indicated that a participant passed a presumably less difficult task, and failed a more difficult one. A disconfirmation indicated that a participant failed a presumably less difficult task, and passed a more difficult one. Participants who passed or failed both discriminations, were excluded from the analysis because their performance could not be used to evaluate ordering among the discriminations. A standard score was derived by the formula [ z C - for each pair of discriminations, using a binomial distribution to test the significance of each standard score. The top portion of Table 3 shows the results of six pairs of adjacent discriminations. Comparisons 1 and 2 were significant at p .001. Although Comparisons 3, 4, and 5 supported the proposed hierarchy, the N was too small to attain significance, for instance, rxlist.
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Centers for Disease Control and Prevention. A strategic plan for the elimination of tuberculosis from the United States MMWR 1989; 38 Suppl No.S-3 ; . Centers for Disease Control and Prevention. Tuberculosis elimination revisited: obstacles, opportunities, and a renewed commitment. MMWR 1999; 48 No. RR-9 ; . American Thoracic Society and Centers for Disease Control and Prevention. Targeted tuberculin testing and treatment of latent tuberculosis infection. J Respir Crit Care Med. In press. Centers for Disease Control and Prevention. Screening for tuberculosis and tuberculosis infection in high-risk populations. MMWR 1995; 44 No.RR-11 ; : 19-34. Centers for Disease Control and Prevention. Prevention and treatment of tuberculosis among patients infected with human immunodeficiency virus: principles of therapy and revised recommendations. MMWR 1998; 47 No.RR- 20 ; . Centers for Disease Control and Prevention. Essential components of a tuberculosis prevention and control program. MMWR 1995; 44 No.RR-11 ; : 1-16. Centers for Disease Control and Prevention. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care facilities, 1994. MMWR 1994; 43 No.RR-13 ; . Centers for Disease Control and Prevention. Management of persons exposed to multidrugresistant tuberculosis. MMWR 1992; 41 No.RR-11 ; : 59-71. Centers for Disease Control and Prevention. National action plan to combat multidrugresistant tuberculosis. MMWR 1992; 41 No.RR-11 ; : 1-48. Centers for Disease Control and Prevention. Reported Tuberculosis in the United States, 1998. August 1999. Centers for Disease Control and Prevention. Recommendations for prevention and control of tuberculosis among foreign-born persons. MMWR 1998; 47 No.RR-16 ; . Simone PM, Dooley SW. Multidrug-Resistant Tuberculosis. Atlanta: Centers for Disease Control and Prevention; 1994.

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