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The Joan Shelk Fundamentals of Phototherapy WorkshopTM is an intensive one-day training for those administering light therapy under a physician's supervision. Presented by the National Psoriasis Foundation and the Dermatology Nurses' Association DNA ; , three new courses are being offered this year: June 24, at the Crowne Plaza Hotel, Minneapolis, Minn.; Sept. 23, at the Hilton Boston Back Bay, Boston, Mass.; and Nov. 4, at the Capitol Place Hotel Austin, in Austin, Texas. Each Saturday workshop is scheduled from 8 a.m. to 5 p.m. The phototherapy workshop covers psoriasis and other photo-responsive skin diseases; PUVA; narrow- and broad-band UVB therapy; equipment operation and metering; and other responsibilities associated with phototherapy administration. The emphasis is on safe and effective routines for the phototherapy setting. Upon completion of the workshop, attendees will receive a certificate of completion and 7.9 contact hours through the DNA. Cost is $320 for National Psoriasis Foundation Professional Members; $360 for non-Members. For more information and to register, please visit w w w. phototherapy You can also register by call ing 800.723.9166, or e-mail us at medicaloutreach psoriasis. Dysphagia is the medical term for swallowing problems. It is associated with a number of medical conditions as well as the aging process. It is also more common in laryngectomees because of the laryngectomy surgery and radiation. A simple exercise which has shown promise and continues to be tested is called the "Shaker Exercise." It is named after its inventor, Reza Shaker, MD. The exercise has been reported in several medical journals over the past several years, but has still not found its way into widespread use at the patient level. Patients are simply required to lie on their backs and raise their heads until they can see their feet, but without using their shoulders to do it. In the pilot study carried out by researchers at the Medical College of Wisconsin, the patients, includ- Reza Shaker, MD ing those whose swallowing problems were linked to radiation and surgery of the neck, performed the exercise three times a day for six weeks. The results were significant in the exercise group, and all patients returned to eating, at least to soft foods. One of the benefits of studying the exercise is that a better understanding is being developed of the complicated processes which allow us to swallow. Certainly the "Shaker Exercise" is not going to cure the swallowing problems of all, but it is nice to have a method developed which works for some which does not involve more surgery or pills!
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Applied to pneumoencephalography. The procedure seems particularly suited to study of the posterior fossa. Two of the seven patients survived surgical procedures; in a 47-year-old man the intrapontine hematoma was removed, and in the second case a 41-year-old man ; a ventriculoatrial shunt was placed. Review of the literature reveals eight cases of intrapontine hematoma treated successfully by the surgical approach. AB-950-72 Type IV Hyperiipoproteinemia. Clofibrate Without Dietary Therapy--Zelis R University of California School of Medicine, Davis, California 95616 ; , Amsterdam EA, Spann JF Jr, Mason DT--JAMA 222: 326-328 Oct 16 ; 1972 The treatment of choice in patients with type IV hyperiipoproteinemia endogenous hypertriglyceridemia ; is weight reduction and substitution of polyunsaturated fats for dietary carbohydrates. Since most patients fail to adhere to this strict regimen, clofibrate 2 gm day ; was evaluated in a double-blind study prior to diet therapy in 12 patients. Plasma triglyceride levels fell with clofibrate 429 mg 100 ml to 255 mg 100 ml ; but not with placebo 565 mg 100 ml ; . Cholesterol levels remained unchanged in most patients. Clofibrate alone may be effective in certain type IV patients if both cholesterol and triglyceride levels are substantially reduced. However, clofibrate is no substitute for adequate dietary therapy. AB-951-72 Management of Postcatheterization: Brachial Artery Thrombosis--Page CP Captain, USAF, Vascular Surgery Unit of the General Surgery Service, Wilford Hall, USAF Medical Center, Lackland Air Force Base, Texas ; , Hagood CO Jr, Kemmerer WT--Surgery 72: 619-623 Oct ; 1972 Brachial artery exploration was carried out in 33 patients, 28 for acute ischemic symptoms or bleeding and five for hand and forearm exercise pain. Thrombus was found in all patients and a mechanical predisposition for thrombus could usually be demonstrated in many acutely thrombosed arteries. Segmental resection and end-to-end anastomosis was the corrective procedure of choice. In those cases with chronic occlusion and exercise pain, autogenous vein bypass was required. All patients left the hospital with functioning hands and good pulses. The patient with postcatheterization brachial artery occlusion should undergo surgical exploration to restore normal blood flow, to ensure viability and to prevent disabling exercise pain. AB-952-72 and dutasteride.
More direct measure of this variable is needed in order to arrive at a more accurate calculation of the real costs involved. Nevertheless, there were no differences in the level of professional occupation between treatment groups. Sixth, sick leave days may reflect physical as well as mental disorders. Seventh, the small sample size of our study limited our ability to detect differences by diagnostic group. Finally, this trial followed patients for six months, which is longer in comparison to typical 6 8 week trials. However, in everyday clinical practice patients receive treatment for longer periods of time Simon et al., 1999 ; . A further limitation of the study is that no data was recorded on the incidence of side effects, since GPs poorly recorded them in the clinical charts. An indirect measure of tolerability is the rate of treatment change. In a comparison of SSRI versus TCA, Anderson and Tomenson 1995 ; found that the most frequent reason for treatment dropout was the presence of side effects. In our study, dropout rates are similar for both groups. A meta-analysis performed by Song et al. 1993 ; also revealed no significant differences in dropout rates between patients treated with SSRI and those treated with TCA. The data for this study and the unit costs were recorded during the period of 19992001. Drug prices have varied since then, and it is possible that direct costs do not reflect exact drug prices of today. However, in our study drug prices only represent 6% of total costs. In conclusion, this study demonstrates no differences in the effectiveness of antidepressants. Longer studies are needed to confirm these results and their applicability to clinical practice. Acknowledgments The authors gratefully acknowledge the contribution of Maria Mallen and Juan Vicente Torres Martin to the statistical analysis presented here. We also wish to acknowledge Susan M. DiGiacomo, Ph.D., of the Fundacio Sant Joan de Deu, for editorial assistance in the preparation of successive English-language versions of the manuscript. References. Gram 27 8.26 4.91 ounce 9 87.78 18.39 Cocaine gram 21 50.48 14.65 Crack "rock" 9 23.33 17.85 Heroin "bag" 2 10 0 gram 5 44.40 23.38 Barbiturates tab 2 2.75 1.77 Tranquillisers tab 9 1.04 1.11 * Prices in italics refer to `Midlands East Anglia Wales' where the analysis required amalgamation of regions to avoid smaller regions with no data points. * Single `Wales' tranquilliser price as `0', amalgamated data used in table.

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