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1. Roujeau JC, Kelly JP, Naldi L, et al. Medication use and the risk of StevensJohnson syndrome and toxic epidermal necrolysis. N Engl J Med. 1995; 333: 1600-1609. Wolkenstein P, Latarjet J, Roujeau JC, et al. Randomised comparison of thalidomide versus placebo in toxic epidermal necrolysis. Lancet. 1998; 352: 15861589. Lipper GM, Arndt KA, Dover JS. Recent therapeutic advances in dermatology. JAMA. 2000; 283: 175-177. Garcia-Doval I, LeCleach L, Bocquet H, Otero XL, Roujeau JC. Toxic epidermal necrolysis and Stevens-Johnson syndrome. Arch Dermatol. 2000; 136: 232237. Rzany B, Hering O, Mockenhaupt M, et al. Histopathologic and epidemiologic characteristics of patients with erythema exudativum multiforme major, StevensJohnson syndrome and toxic epidermal necrolysis. Br J Dermatol. 1996; 135: 611. Paul C, Wolkenstein P, Adle H, et al. Apoptosis as a mechanism of keratinocyte death in toxic epidermal necrolysis. Br J Dermatol. 1996; 134: 710-714. Viard I, Wehrli P, Bullani R, et al. Inhibition of toxic epidermal necrolysis by blockade of CD95 with human intravenous immunoglobulin. Science. 1998; 282: 490493. Prins C, Kerdel FA, Padilla S, et al, for the TEN-IVIG Study Group. Treatment of toxic epidermal necrolysis with high-dose intravenous immunoglobulin: multicenter retrospective analysis of 48 consecutive cases. Arch Dermatol. 2003; 139: 26-32. Bastuji-Garin S, Fouchard N, Bertocchi M, Roujeau JC, Revuz J, Wolkenstein P. SCORTEN: a severity of illness score for toxic epidermal necrolysis. J Invest Dermatol. 2000; 115: 149-153. Lehrer-Bell KA, Kirsner RS, Tallman PG, Kerdel FA. Treatment of cutaneous involvement in Stevens-Johnson syndrome and toxic epidermal necrolysis with silver nitrateimpregnated dressings. Arch Dermatol. 1998; 134: 872-879. Liddell FD. Simple exact analysis of the standardized mortality ratio. J Epidemiol Community Health. 1984; 38: 85-88. Pacheco H, Araujo T, Kerdel FA. Toxic epidermal necrolysis in a pregnant, HIVinfected woman. Int J Dermatol. 2002; 41: 600-601. Roujeau JC. The spectrum of Stevens-Johnson syndrome and toxic epidermal necrolysis: a clinical classification. J Invest Dermatol. 1994; 102: 28S-30S. Jolles S, Hughes J, Whittaker S. Dermatologic uses of high dose intravenous immunoglobulin. Arch Dermatol. 1998; 134: 80-86. Phan TG, Wong RC, Crotty K, Adelstein S. Toxic epidermal necrolysis in acquired immunodeficiency syndrome treated with intravenous immunoglobulin. Aust J Dermatol. 1999; 40: 153-157. Stella M, Cassano P, Bollero D, Clemente A, Giorio G. Toxic epidermal necrolysis treated with intravenous high-dose immunoglobulins: our experience. Dermatology. 2001; 203: 45-49. Paquet P, Jacob E, Damas P, Pierard GE. Treatment of drug-induced toxic epidermal necrolysis Lyell's syndrome ; with intravenous human immunoglobulins. Burns. 2001; 27: 652-655. Corne P, Dereure O, Guilhou JJ, Jonquet O. Toxic epidermal necrolysis treated with intravenous immunoglobulins. Rev Med Interne. 2001; 22: 491-492. Andresen M, Boghero Y, Molgo M, Dougnao A, Diaz O. Toxic epidermal necrolysis: therapy in ICU with intravenous immunoglobulins in a case. Rev Med Chil. 2000; 128: 1343-1348. Magina S, Lisboa C, Goncalves E, Conceicao F, Leal V, Mesquita-Guimaraes J. A case of toxic epidermal necrolysis treated with intravenous immunoglobulin. Br J Dermatol. 2000; 142: 191-192. Cheap xanax within easy xanax valium seroquel lithium side effects cheap xanax within easy reach. 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Palliative Medicine. 2001: 15 4 ; : 329-36. Bailey C. Nursing as therapy in the management of breathlessness in lung cancer. European Journal of Cancer Care 1995; 4: 184 - 190. Bredin M. Corner J. Krishnasamy M. Plant H. Bailey C. A'Hern R. Multicentre randomised controlled trial of nursing intervention for breathlessness in patients with lung cancer. British Medical Journal. 1999; 318 7188 ; : 901-4. Corner J. O'Driscoll M. Development of a breathlessness assessment guide for use in palliative care. Palliative Medicine. 1999; 13 5 ; : 375-84. Cox C. Non-pharmacological treatment of breathlessness. Nursing Standard. 2002; 16 24 ; : 33-6. Davis CL. Palliation of breathlessness. Cancer Treatment & Research. 1999; 100: 59-73. Davis C. ABC of palliative care: Breathlessness, cough, and other respiratory problems. British Medical Journal. 1997; 315: 931-4. Edmonds P. Karlsen S. Khan S. Addington-Hall J. A comparison of the palliative care needs of patients dying from chronic respiratory diseases and lung cancer. Palliative Medicine, 2001: 15 4 ; : 287-95. Flowers B. Palliative care for patients with end-stage heart failure. Nursing Times, 2003; 99: 30-2. Janssens JP. de Muralt B. Titelion V. Management of dyspnea in severe chronic obstructive pulmonary disease. Journal of Pain & Symptom Management. 2000; 19 5 ; : 378-92. LeGrand SB. Walsh D. Palliative management of dyspnea in advanced cancer. Current Opinion in Oncology. 1999; 11 4 ; : 250-4. Mancini I. Body JJ. Assessment of dyspnea in advanced cancer patients. Supportive Care in Cancer. 1999; 7 4 ; : 229-32. O'Driscoll M. Corner J. Bailey C. The experience of breathlessness in lung cancer. European Journal of Cancer Care. 1999: 8 1 ; : 37-43. Ripamonti C. Management of dyspnea in advanced cancer patients. Supportive Care in Cancer. 1999; 7 4 ; : 233-43. Shee CD. Palliation in chronic respiratory disease. Palliative Medicine. 1995: 9 1 ; : 3-12. Wilcock A. Crosby V. Hughes A. Fielding K. Corcoran R. Tattersfield AE. Descriptors of breathlessness in patients with cancer and other cardiorespiratory diseases. Journal of Pain & Symptom Management. 2002; 23 3 ; : 182-9. Zeppetella G. The palliation of dyspnea in terminal disease. American Journal of Hospice & Palliative Care. 1998; 15 6 ; : 322-30, for instance, xanax pic. Biovail's product-development efforts are subject to the process and regulatory requirements of the FDA in the U.S ; and the TPD in Canada ; . Since Biovail focuses on enhanced formulations of existing drugs with well-established safety and efficacy profiles ; , the development path is generally less onerous than that facing companies pursuing new chemical entities. The following chart summarizes the steps required to bring the Company's pipeline products to market. 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Impact of work patterns on the health of Certified Registered Nurse Anesthetists Jessica M. Na, RN, BSN; Mariana C. Bordei, RN, BSN Wayne State University Introduction: The number of hours worked by health care providers has recently been under intense scrutiny. Substandard performance, medical errors, and detrimental effects on the provider's mental and physical health have been associated with extended work hours. The purpose of this survey research was to determine the prevalence of extended work schedules in anesthesia providers employed in a large suburban medical center and to evaluate the impact on the practitioner and his or her practice. Methods: After IRB approval was obtained, a survey piloted for content and context reliability ; was developed and administered to 300 CRNAs working for the Detroit Medical Center and affiliated sites. A cover letter accompanied the survey explaining the purpose of the research. The 42-item instrument required the respondents to provide demographic data and information regarding their typical work schedule. The questions that addressed the provider's mental, physical, and psychosocial health were rated using a Likert Scale. Results: The response rate was 46% N 139 ; . Thirty nine percent N 54 ; of the respondents reported working 41-48 hours per week. Thirty five percent of respondents N 49 ; reported working 6-10 hours of overtime per week. Increased work hours were positively correlated with caffeine consumption and BMI. The average BMI of respondents working less than 40 hours was 23, and for those working greater than 40 hours per week the average BMI was 27. Conclusions: Although this data revealed that the providers working more than 40 hours per week were heavier and consumed more caffeine, there were no differences in the respondents' perceptions of their physical and mental health. The health care providers working in excess of 40 hours per week did not experience more job related injuries. Future research may evaluate the impact of extended work hours on job performance and critical thinking skills and actos.
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