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Ethidium, which intercalates with DNA in the cell nucleus. Hydroethidine was purchased from Molecular Probes Eugene, OR ; and dissolved in DMSO 1 g l ; Vessels were placed in petri dishes containing a 10 5 hydroethidine solution in PSS and incubated for 20 min. After incubation, the vessels were removed, rinsed with PSS, and placed on microscope slides for subsequent observation utilizing a confocal microscope. O2 production, as revealed by intensity of fluorescence, was quantified using image analysis software Metamorph 4.01, Universal Imaging ; . The mean fluorescence intensity of all stained nuclei in an image was used to assess the average level of O2 production in each treatment group. Fluorescence intensity was estimated for each treatment group and expressed in arbitrary units. To ascertain the effectiveness of the scavengers used in the isolated vessel experiments, a portion of the vessels were incubated with PEG-SOD and catalase in PSS for 15 min before the addition of the hydroethidine solution. The scavengers were added in concentrations comparable to those used in the isolated vessel experiments. As a positive control, 1, -dimethyl-4, 4 bipyridylium dichloride paraquat; 10 4 M, Sigma ; , a known stimulator of O2 production 11, 20 ; , was added to middle cerebral arteries from animals on a LS diet to assess the effectiveness of the DHEt assay in detecting O2 . As negative control, 2.3 10 5 M III ; tetrakis 4-benzoic acid ; porphyrin chloride MnTBAP; Cayman Chemical; Ann Arbor, MI ; , a membrane-permeable SOD mimetic 8 ; , was added to middle cerebral arteries of animals on a LS diet as a further verification of the effectiveness of the DHEt assay. Western blotting. Muscarinic type 3 M3 ; receptor protein expression was evaluated utilizing a Western blotting protocol modified from Mattson and Higgins 38 ; . Each experimental group consisted of tissues pooled from four to eight Sprague-Dawley rats fed an acute LS or HS diet. Rats were anesthetized with pentobarbital sodium, and aortas and cerebral vessels including middle cerebral arteries, basilar arteries, and similar-sized arteries from the Circle of Willis ; were freshly dissected and cleared of adhering parenchymal tissue. The vessels were snap-frozen in liquid nitrogen and stored in 0.5-ml microcentrifuge tubes in a freezer 85C ; until the time of homogenization. Tissues were subsequently placed in homogenization buffer composed of in mM ; 100 K2HPO4, 100 KH2PO4, 475 sucrose, 100 EDTA, 1.0 pepstatin, 1.0 leupeptin, and 100 phenylmethylsulfonyl fluoride. Cerebral vessels were hand homogenized in microcentrifuge tubes using a pestle Kontes; Vineland, NJ ; . Aortas were homogenized at 3, 000 rpm with a Potter-Elvehjem tissue grinder. The homogenates were centrifuged for 20 min at 14, 000 g for protein isolation. The supernatant was collected, and the protein content was estimated using a standard protein determination assay Coomassie Protein Assay, Pierce; Rockford, IL ; . Fifty micrograms of protein from each sample were suspended in a loading buffer, incubated 10.
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It has not proved possible to produce deep sedation, or marked cortical deactivation, by the local injection of pentobarbital into the brain stem reticular formation. Therefore, a search was instituted for other subcortical sites which might prove more sensitive to the action of this drug.
Address Correspondence to: Hagop Kantarjian, M.D., Department of Leukemia, Box 428, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030. Phone: 713-792-7026; Fax: 713-794-4297; Email: jcortes mdanderson.
The mechanisms involved in the local control of skeletal muscle blood flow are incompletely understood 1 ; , but it appears that several factors act in concert to produce the increase in flow associated with exercise 2, 3 ; . We have recently reported studies which support this idea and suggest that different factors dominate the control of vascular resistance in different experimental situations 4, 5 ; . In particular, we have found that the vascular response to a brief tetanus is apparently too rapid to be caused by factors directly associated with muscle oxidative metabolism 4 ; . A myogenic response to the extravascular compressive forces associated with a brief tetanus could be responsible for one-third to one-half of the response 6 ; . Since the potassium ion K + ; has been strongly implicated as a metabolic vasodilator 2, 7, 8 ; , we undertook the present study to determine the magnitude and the time course of K + concentration changes associated with brief tetanic exercise and to evaluate the role of these changes in the vascular response to a brief tetanus. Methods We used seven mongrel dogs 20-25 kg ; anesthetized with sodium pentobarbital 30 mg kg, iv, supplemented.
3. Improving patient outcomes. Final emphasis takes a longerterm perspective, assessing the effects of program changes on client outcomes. This evaluation step uses outcome evaluation methods exclusively. Many of the measures developed to assess effects in the second and third evaluation phases can be used by the programs for ongoing monitoring. The RAND evaluation for the low back pain guideline demonstration encompasses the first two evaluation phases. Lessons were drawn from the implementation process itself to strengthen future guideline implementation activities introducing new practices ; , and data were analyzed to assess the early effects of the low back pain guideline on health care processes achieving intended changes in practices and pentostatin.
Measurements. IOP was determined using a manometrically calibrated pneumatonograph Alcon; Ft. Worth, TX ; . Baseline pressures were obtained prior to topical drug applications. Drugs were made up freshly in isotonic saline at the indicated concentrations, neutralized to pH 7, and 50 n\ instilled into the conjunctival sac of one eye, with saline given to the contralateral eye. IOP measurements were taken at 30, 60, 120, and 360 min after drug treatment. These experiments adhered to the ARVO Resolution on the Use of Animals in Research. Measurements of Cyclic-AMP and Adenylate Cyclase Rabbits were killed with sodium pentobarbital at predetermined times and anterior chamber paracentesis performed immediately afterward. The cyclicAMP assay method was based on the procedure of Ferrendelli.19 Aqueous cyclic-AMP concentrations in control eyes varied from 12-26 nM. For adenylate cyclase activity, untreated albino rabbits were used. Eyes were enucleated, cooled in ice and the iris and ciliary body dissected free and immediately frozen at -80C. The pooled tissues were thawed at 4C for membrane preparation and adenylate cyclase assay as previously reported.20 Basal enzyme activities varied in different preparations but were in the range 8-15 pmol min mg protein. Activities of adenylate cyclase and cyclic-AMP levels are expressed in terms of stimulation index where the basal activity or control eye concentration of cyclic-AMP in that experiment is set equal to 1.00. Membrane Preparation Iris-ciliary body was dissected from the eyes of New Zealand albino rabbits 2-2.5 kg ; . Tissues from animals that were killed either by air embolism, CO 2 narcosis, or overdose of sodium pentobarbital were collected from several laboratories. Fresh tissues were pooled in groups of three and frozen at -80C. Each set of three ICBs was thawed at 4C and homogenized in 1 ml Tris buffer pH 7.5, in a Dounce ball homogenizer using 20 strokes of the A-size pestle and washed into a centrifuge tube with 1 ml of buffer. The "wad" of connective tissue and muscle fibers was picked out and discarded. The combined homogenate of six ICBs, approximately 5 ml, was centrifuged at 16, 000 rpm, 30 min SS-34 rotor, Sorvall RC2-B centrifuge ; , the supernatant decanted. The pellet was washed by resuspending in 5.0 ml of buffer and recentrifuged. After a second wash, the final pellet was resuspended in 4.5 ml of buffer and rehomogenized with 35 strokes of the B-size pestle in.
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793 Taub, A., see Kitahata, L. M., 101 Taylor, D. B., see Creese, R., 418 Tetrahydrocannabinols, two , pentobarbital and, effects on cortico-cortical evoked responses in squirrel monkey, 480 Tetrahydroisoquinoline, N-substituted, new, NC 7197, adrenergic blocking and cardiovascular effects of, 655 Tetrodotoxin antagonism of batrachotoxin-induced membrane depolarization and muscle contracture, 497 antagonism of effect of batrachotoxin on resting membrane potential and spontaneous transmitten release, 511 influence on batrachotoxin-induced effects in heart Purkinje fibers, 529 Thebaine, effects on locomotor activity and brain catecholamine content in mouse, 472 Thiamine, consumption, effect on liver microsomal drug-metabolizing pathways, 758 Thiol compounds, protection and reversal of effect of sulfhydryl-binding reagents on islet tissue permeability by, 42 Thiopental, capacity of albumin preparations to bind, 261 Thompson, S., see Robson, R. D., 662 Thrasher, K., see Choi, Y., 27 Thrombus, formation, in vitro, platelets, coagulation and, 76 Thyroxine, response to exercise before and after treatment of myxedema with, 212 Toad, bladder, excised, effect of K-sparing diuretics on ion transport across, 580 Toadfish, islet of Langerhans, tissue permeability of, effect of sulfhydryl-binding reagents on, protection and reversal by thiol compounds, 42 Trachea atnia and, guinea pig, beta adrenergic receptors of, 634 guinea pig, effects of K# 1313 and K# 1366 on, 339 guinea pig, use of isomeric activity ratio as criterion to differentiate adrenergic receptors in, 622 Trendelenburg, U., see Bnimijoin, S., 149 Triamterene, effect on ion transport across excised and peppermint
However, those that lost 10% of their initial weight in the previous 1 year gained weight during the second study regardless of medication received. Those that gained 10% in the initial study lost a further amount of weight in the second study with those taking sibutramine + orlistat losing more weight than those taking sibutramine alone ns ; . Further sub-group analyses of patients thought most likely to benefit from combination therapy did not increase their weight loss.
Lowering the attachment point to , 000 would increase a plan's savings or the government's costs ; to 13 percent of the plan's claim costs. Lowering the attachment point to , 000 would further increase a plan's savings or the government's costs ; to 22 percent. Note, however, that this is just one example of how reinsurance costs would vary by attachment point. Although other data sources would likely reveal similar patterns, the specific savings at different attachment points could va ry significantly using different data. Reducing claim costs would, in turn, reduce premiums, although the costs of administering reinsurance would lessen these savings. A reinsurance program would result in a one-time premium savings on ly. Tra n s ferring losses from a health plan or insurer to the government would not reduce overa ll health cost trends unless measures are taken to encourage plans to further manage costs. Reinsurance programs themselves could contain disincentives to manage costs. Therefore, policy-makers need to consider the impact of the program on total health care expenditures. Would the incentives implicit in a proposed reinsurance program lead to decreased cost management? If so, how would this concern be addressed? If overall expenditures were to increase as a result of the reinsurance program, the premium savings wi ll be reduced. This issue is considered in more detail bel ow. Poten tial diffusion of responsibi l i ty and align m ent of incentives. Policy-makers may want to consider implementing incentives to ensure that large indivi dual losses do not increase in incidence or severi ty as a sult of the reinsurance program. An insurer who takes the risk for large losses i.e. does not purchase reinsurance ; generally does all it can to manage its risks efficien t ly Shifting some of the insurance risk to . the reinsurer may reduce the insurance company's incentives to manage its claims. Therefore, reinsurers often take measures to encourage insurers to manage their claims. For instance, reinsurers can require that insurers pay a portion of claims even after the attachment point is reached. Although this is still less of an incentive to manage claims than if the insurer bore the full risk for all of its claims, this method does encourage insurers to manage their high-cost claims. Another method that reinsurers can use to encourage claim management is to cover claim adjustment expenses. As discussed above, these expenses may include paym ents to vendors who help reduce the cost of a claim. Policy-makers should consider designing any government reinsurance program to hold entities at partial risk for high-cost claims and including claim adjustment expenses as a reimbursable loss. The short-term nature of most commercial reinsurance contracts typically one year ; also encourages insurers and self-funded plans to manage their claims. Because reinsurance premiums can be reset at renewal, premiums will increase significantly for entities with patterns of large claims. This incentive would not be available, however, in a government provi ded-reinsurance program where the insurer simply passes losses to the government and doesn't pay a reinsurance premium. Disease managem ent and care managem ent programs. Policy-makers may design a government-provided reinsurance program to include provisions that require or encourage participation in a disease management or care management program. It is important to note that current health plans custom de s i their care management and disease management programs around the specific characteristics of the population in their plan. When choosing which program to implement, health plans genera lly consider the following factors: The ability of the program to achieve the desired health outcomes The impact on the behavi or and attitude of the membership affected The direct and indirect cost of implementing the program Because of these considerations and the uniqueness of e ach particular plan population, it might not be appropriate to require a uniform disease management or care management plan for all plans and percodan.
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[Mr. Roche.] is a mixture of domestic and non-domestic use, such as a farm, an allowance is made by the local authority for the domestic element, which is deducted from the overall charge to the consumer. Local authorities, in line with the above policies, are moving towards the metering of all nondomestic water use. The effect of this will be to enable local authorities to measure the amount of water supplied to each non-domestic connection to the water service. This will provide a transparent and equitable cost recovery mechanism for water services in accordance with the polluter pays principle and should incentivise all nondomestic users to conserve their use of water and thus minimise this element of their running costs. Under existing arrangements, the Exchequer makes no contribution towards the funding of non-domestic water services provision. However, the Exchequer fully funds the capital cost of water and waste water infrastructure for all existing domestic consumers and contributes to the funding of future domestic water services provision where this is incorporated in proposed schemes, with the balance of this portion being met from development levies. The marginal capital cost and operational costs for the nondomestic sector must be met through water charges and development levies. The domestic element of the operational cost of local authority water services falls to be met through the Local Government Fund. The provision for this fund has increased from some 0m in 2000 to over 0m in 2006. Yesterday I announced general purpose grants of some 8m to local authorities for 2007, from the Local Government Fund. This represents an increase of 8% in the compared with the final allocations for 2006. The 2007 allocations figure moreover represents an increase of some 35% over the initial allocations provided in 1997. Additionally a special local government fund allocation of m has been made in Budget 2007 to assist local authorities with extra running costs incurred in the operation of new water services infrastructure. Register of Electors. 73. Mr. J. O'Keeffe asked the Minister for the Environment, Heritage and Local Government the number of people incorrectly removed from the electoral register in the recent drive to update it; and if he will make a statement on the matter. [42534 06] 101. Mr. J. O'Keeffe asked the Minister for the Environment, Heritage and Local Government the status of the electoral register; and if he will make a statement on the matter. [42533 06] 115. Mr. Gogarty asked the Minister for the Environment, Heritage and Local Government.
I dedicate this book to my husband Chris, young son Brendan, and my parents Edward and Nancy Kennedy, for their years of support, encouragement, and understanding throughout this endeavor. L.K.-M. I dedicate this book to my husband Steve, my son Ian, and my mother Eleanor, who understand my professional commitments and provide unfailing support and encouragement. K.R.F. I dedicate this book to my husband Rick and daughter Erin and to my dear aunt, Madeleine Plank, for sharing her end-of-life experience with us. L.M.P and pergolide.
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Of the results of the review of clinical studies with RTS's results. As noted, RTS doctors diagnosed 17, 877 of the 32, 119 persons 55.7% ; screened by RTS--whose records had been analyzed in the course of MDL 875--as having asbestosis.157 If we superimpose the results of the Koskinen Study of 18, 943 occupationally exposed workers, then instead of 17, 877 having been diagnosed with asbestosis by RTS doctors, the number would have been 209. Additionally, if we superimpose the results of the review of clinical studies on the 32, 119 persons screened by RTS whose records have been analyzed in the course of MDL 875, then approximately 3800 would have had their X-rays read as indicating evidence of fibrosis graded 1 0 or higher, and of these, approximately 950 or less would have been diagnosed with asbestosis. RTS doctors, however, diagnosed 17, 877 of those RTS screened with asbestosis.158 The results of the Murphy and Koskinen Studies, as well as those of the review of clinical studies, are consistent with the medical literature that states that new manifestations of asbestosis largely ceased by 1990. Indeed, more than fifteen years ago, medical experts called asbestosis a "disappearing disease, "159 and a condition that is "exceedingly rare."160 1. Other Causes of Fibrosis in Addition to Asbestos Exposure.
Novel IGC Protein Candidates In addition, and most interestingly, we found 32 proteins for which no available biological information is available except for sequence information Table III ; . Each of these proteins was analyzed for known motifs. Four proteins have various similarities to other proteins involved in RNA metabolism. These examples include a protein with a 12 and permax.
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Induction and treatment of P. aeruginosa endocarditis. Eighty female New Zealand White rabbits, weighing 2 to 2.5 kg each, were anesthetized with 50 mg of ketamine hydrochloride given intramuscularly Bristol Laboratories, Syracuse, N.Y. ; . The left ventricle was catheterized with a polyethylene catheter by passing the catheter tip across the aortic valve as previously described 1 ; . The catheter remained in place for the duration of the study. Each animal was inoculated intravenously with -108 CFU of PA-96 24 h after catheterization. Positive blood cultures for P. aeruginosa at 24 h postinoculation were taken as presumptive evidence of endocarditis 1 ; . Macroscopic and bacteriologic data acquired at the time of sacrifice provided ultimate confirmation of vegetative endocarditis. The 80 rabbits were randomized by computer-generated code ; to one of four therapy groups of 20 rabbits each: untreated controls, amikacin at 15 mg kg per day intramuscularly, in two divided doses-8 a.m. and 5 p.m. ; , ceftazidime at 100 mg kg per day intramuscularly, in two divided doses-8 a.m. and 5 p.m. ; , and amikacin-ceftazidime at the above dosages and schedules. Therapy was begun 48 h after inoculation. The above regimens were identical to those that produced an excellent in vivo response in a previous study on experimental tricuspid valve endocarditis produced by the same P. aeruginosa strain PA-96 [2a] ; . Pilot studies in our laboratory indicated that these dosage regimens consistently produced supra-MBC serum levels at -1 h postinjection. Sacrifice of animals. Animals were sacrificed by rapid intravenous injection of 150 mg of sodium pentobarbital on either day 7 or 14 therapy or on day 5 after stopping therapy to determine bacteriologic relapse ; . At sacrifice, aortic valve vegetations were individually excised and weighed. Each vegetation was homogenized in MHB and quantitatively subcultured as previously described 5 ; . No attempt was made to inactivate amikacin or ceftazidime in vegetation homogenates, as sacrifices were performed at least 18 h after the last drug dose 18 ; . Animals that had been dead longer than 6 h before postmortem examination were excluded from bacteriologic evaluation 18 ; . Portions of each homogenate were also subcultured onto MH agar containing 50 p, g of either ceftazidime or amikacin per ml depending on the therapeutic regimen ; to detect in vivo development of resistance. Concentrations of 50 , ug were chosen because they were at or above the breakpoints for resistance of either agent .32 , ug ml [11] ; . In calculating mean titers, culturenegative vegetations were considered to contain c2 log1o CFU g based on average vegetation weight 0.01 g [3] ; . To delineate the relative proportions of antibiotic-resistant and antibiotic-susceptible isolates contained within individual vegetations, a resistance ratio was calculated 4 ; . This is defined as the log1o of the ratio of the number of resistant organisms to the total number of organisms within a vegetation [log1o number of resistant isolates per total number of isolates ; ]. In vitro passage studies. Stabilities of antimicrobial resistances induced in vivo were determined by in vitro passage experiments. Two ceftazidime-resistant and two amikacinresistant P. aeruginosa variants, isolated from vegetations of animals receiving the respective single agents, were studied. Each strain was grown in antibiotic-free MHB overnight and then parallel plated onto both antibiotic-free and antibioticcontaining MH agar 50 , g of amikacin or ceftazidime per ml, depending on the therapy group ; . The serial passage of each strain in antibiotic-free MHB, with parallel plating as above, was performed an additional 14 times and perphenazine.
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ATTORNEY GENERAL WARNS CONSUMERS TO BE WARY OF POSSIBLE BOGUS CHARITIES FOLLOWING TRAGIC EVENTS ON EAST COAST Carson City--Attorney General Frankie Sue Del Papa is warning Nevadans to be vigilant regarding possible bogus charities that may crop up at this time due to the tragic incidents on the East Coast. "In light of our past experience following the Oklahoma City bombing, I would encourage everyone to deal only with reputable, known charities, " Del Papa said. "Of course, everyone is experiencing heartfelt grief over what has happened. It is horrible to think that someone would try to capitalize on the pain of others, but there are often individuals who attempt financially gain by extorting money from good people who want to lend a helping hand to those in true need of assistance. " In Nevada, charities do not have to register with the state. But you can play it smart by calling the Better Business Bureau or the Bureau of Consumer Protection to ask for advice about a particular charity or group. Nevada law prohibits misrepresentation in the solicitation of charitable donations. A first offense is a misdemeanor if the individual willfully engages in a deceptive trade practice. A second offense is a gross misdemeanor. Violations are punishable by a civil penalty of , 500, or can be prosecuted as a criminal offense. Subsequent violations are felonies. Del Papa offers the following tips to help determine if the charity you are being solicited by is on the level: Give directly to a known charity of your choice. It is often better to give to someone you know from past dealings. Avoid sound-alike names. Many scams use names that are easily confused with well-respected charities. Ask questions. Do not rely upon promises made on the phone. Ask to be provided with a written description of the program, and a copy of the annual report that shows what percent of the income goes specifically to the programs and services. --more and pentobarbital.
There are two proposed mechanisms by which calcium channel blockers might ameliorate the effect of cerebral ischemia: relaxation of vascular smooth muscle, resulting in vasodilation and improved cerebral perfusion; and prevention of calcium flux into neurons, thereby limiting activation of phospholipases, proteases, and consequent membrane and protein degradation and production of damaging metabolic by-products such as free radicals.22"31 Although data are conflicting, there is a consensus that dihydropyridines increase cerebral blood flow CBF ; after ischemia in animals and humans.1-9"12 Our previous studies indirectly suggest that NC is also effective by the second mechanism, prevention of calcium flux into neurons, since NC improved function even when administered after CBF had returned to normal1 and since we demonstrated availability of NC to neuronal as well as to vascular dihydropyridine receptors.21 Furthermore, studies of nimodipine treatment for vasospasm after subarachnoid hemorrhage demonstrated improved outcome but no reduction of angiographic spasm, also indirectly supporting a direct neuronal protective effect of dihydropyridines.32 Since our previous studies failed to demonstrate that NC reduced the morphologic extent of ischemic injury but showed improvement of functional outcome SEPs ; , our present study was designed to evaluate the effect of NC on learning, another accepted measure of functional outcome in the rat four-vessel ischemia model, and to clarify the effect of the drug on CBF and and phenazopyridine.
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Ments in routine clinical care when planning local delivery arrangements. This has been illustrated here by the variety of regimens used by clinicians. Thus retrospective studies can compliment randomised trials. In everyday practice, factors other than actual treatment regimen may affect efficacy, such as counselling regarding compliance, availability and accuracy of advice and clinician interest in the problem. These factors are removed in a formal randomised trial but may have had an effect in the retrospective review. It was not possible to assess the effect of seniority or speciality of clinician prescribing therapy on eradication because of the many doctors in training associated with each team, rendering it impossible be certain who specifically provided advice to the patient and final choice of eradication therapy. Analysis of those regimens prescribed by multiple teams, did not show any significant effect of team speciality on eradication rates. RBC-containing regimens were only used by the gastroenterologist with a specific interest in H. pylori; this may have contributed to the excellent results by improving compliance. It is worthwhile noting that results for PPI-A-C from this team were not superior to other teams. Recent studies have confirmed that ranitidine bismuth citrate combined with clarithromycin and either a nitroimidazole or amoxicillin is an effective first line therapy for H. pylori. Results are not generally different from the corresponding PPI-based therapy in clinical trials and although not widely used, some authors have suggested that RBC-triple therapy should also be regarded as a first line therapy of choice [1315]. In the current study RBC-AC was the most efficacious first line therapy, the reason for the apparent superiority compared PPItriple therapies is not clear. No attempt to assess compliance was made and clinical trials suggest little difference in compliance between RBC- and PPI- based therapies [13, 14]. However in everyday clinical practice, as opposed to a closely monitored trial overall compliance may be lower, although the enthusiasm of the relevant clinician may have a role as discussed above. There appears to be synergism between RBC and antibiotics and this enhanced antibacterial effect may offset any loss of effect induced by failure to complete the antibiotic course [24]. RBC-containing regimens may also overcome bacterial resistance to metronidazole or clarithromycin but in this predominantly rural Caucasian population primary antibiotic resistance is unlikely to be substantial and this is unlikely to explain the improved results of RBC-A-C [25]. Even in the best clinical studies 1525% of patients will fail to clear H. pylori with one course of appropriate therapy. The challenge therefore is to design an overall
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