Prophylactic indomethacin therapy in the first twenty-four hours of life for the prevention of patent ductus arteriosus in preterm infants treated prophylactically with surfactant in the delivery room.

Indomethacin reduces the risks of severe intraventricular hemorrhage.

Administration of indomethacin for the prevention of periventricular-intraventricular hemorrhage in high-risk neonates.

Early intravenous indomethacin prolongs respiratory support in very low birth weight infants.

Low-dose indomethacin therapy and extension of intraventricular hemorrhage: a multicenter randomized trial.

Long-term effects of indomethacin prophylaxis in extremely-low-birth-weight infants.

Randomized low-dose indomethacin trial for prevention of intraventricular hemorrhage in very low birth weight neonates.

Prophylactic indomethacin for prevention of intraventricular hemorrhage in premature infants.

Effects of early indomethacin administration on oxygenation and surfactant requirement in low birth weight infants.

Prevention of symptomatic patent ductus arteriosus with a single dose of indomethacin.

Randomized indomethacin trial for prevention of intraventricular hemorrhage in very low birth weight infants.

[Indomethacin in the prevention of subependymal-intraventricular hemorrhage in preterm newborns with conventional mechanical ventilation].

Indomethacin therapy on the first day of life in infants with very low birth weight.

Indomethacin prophylaxis for patent ductus arteriosus (PDA) in infants with a birth weight of less than 1250 grams.

Abstract:
To determine whether a course of low-dose indomethacin therapy, when initiated within 24 hours of birth, would decrease ductal shunting in premature infants who received prophylactic surfactant in the delivery room.
                Ninety infants, with birth weights of 600 to 1250 gm, were entered into a prospective, randomized, controlled trial to receive either indomethacin, 0.1 mg/kg per dose, or placebo less than 24 hours and again every 24 hours for six doses. Echocardiography was performed on day 1 before treatment and on day 7, 24 hours after treatment. A hemodynamically significant patent ductus arteriosus (PDA) was confirmed with an out-of-study echocardiogram, and the nonresponders were treated with standard indomethacin or ligation.
                Forty-three infants received indomethacin (birth weight, 915 +/- 209 gm; gestational age, 26.4 +/- 1.6 weeks; 25 boys), and 47 received placebo (birth weight, 879 +/- 202 gm; gestational age, 26.4 +/- 1.8 weeks; 22 boys) (P = not significant). Of 90 infants, 77 (86%) had a PDA by echocardiogram on the first day of life before study treatment; 84% of these PDAs were moderate or large in size in the indomethacin-treated group compared with 93% in the placebo group. Nine of forty indomethacin-treated infants (21%) were study-dose nonresponders compared with 22 (47%) of 47 placebo-treated infants (p < 0.018). There were no significant differences between both groups in any of the long-term outcome variables, including intraventricular hemorrhage, duration of oxygen therapy, endotracheal intubation, duration of stay in neonatal intensive care unit, time to regain birth weight or reach full caloric intake, incidence of bronchopulmonary dysplasia, and survival. No significant differences were noted in the incidence of oliguria, elevated plasma creatinine concentration, thrombocytopenia, pulmonary hemorrhage, or necrotizing enterocolitis.
                The prophylactic use of low doses of indomethacin, when initiated in the first 24 hours of life in low birth weight infants who receive prophylactic surfactant in the delivery room, decreases the incidence of left-to-right shunting at the level of the ductus arteriosus.

Abstract: A prospective, random selection, double-blind clinical trial was carried out to determine the efficacy of indomethacin in preventing periventricular-intraventricular hemorrhage (PV-IVH). Babies who were born in our institution, had birth weights less than or equal to 1500 gm, and had no PV-IVH or grade 1 PV-IVH were given either placebo (n = 70) or indomethacin (n = 71), 0.2 mg/kg intravenously at 6 hours of age and 0.1 mg/kg at 18 and 30 hours. Two major outcomes were determined: the development of grades 2 to 4 PV-IVH and the development of severe PV-IVH (i.e., hemorrhages with blood filling greater than 50% of the ventricles and in some cases with associated parenchymal echodensities). Grades 2 to 4 PV-IVH occurred in 16 (23%) of the indomethacin group and 27 (39%) of the placebo group (p less than 0.03). The incidence of severe PV-IVH was 3% in the indomethacin-treated babies and 14% in the control group (p less than 0.02). The influence of other perinatal factors on the incidence of grades 2 to 4 or severe PV-IVH was determined by stepwise logistic regression. Placebo use, early grade 1 PV-IVH, lower birth weight, and higher fraction of inspired oxygen at 6 hours of life were associated with higher estimated odds of the development of grades 2 to 4 PV-IVH. Placebo use, male gender, lower 5-minute Apgar score, and a large base deficit were predictive of severe PV-IVH. Estimated odds ratios of severe PV-IVH with placebo use and male gender were 11.25:1 and 9:1, respectively. Thus indomethacin prophylaxis reduced the relative risk of grades 2 to 4 PV-IVH and severe PV-IVH, but other perinatal variables contributed significantly to the overall risk of PV-IVH.

Abstract: One hundred twenty-two preterm infants were enrolled in a placebo-controlled, double-blind trial using intravenous indomethacin for the prevention of periventricular-intraventricular hemorrhage (PVH-IVH). Before random assignment, data on the infants were stratified according to low-weight (500 to 999 g) or high-weight (1000 to 1500 g) subgroups. Cranial sonography was used to document the absence of PVH-IVH before enrollment and the occurrence of PVH-IVH during the 7-day protocol. Indomethacin, 0.1 mg/kg, or placebo was administered before 12 hours of age and at 24, 48, and 72 hours of age. Five patients receiving indomethacin and six receiving placebo were withdrawn before completion of the study. In the remaining 111 patients, the indomethacin and placebo groups were comparable with respect to gestational ages, maternal complications, Apgar scores, ventilatory requirements, complications of prematurity, and mortality rate. PVH-IVH developed in six of 56 infants who received indomethacin and 11 of 55 infants who received placebo (P = 0.174). Analysis of the individual strata showed that the indomethacin-treated infants in the low-weight subgroup sustained a higher mortality rate (11/17 vs 3/16; P = 0.008) without a reduction in the incidence of PVH-IVH. Infants in the indomethacin-treated high-weight subgroup demonstrated a significantly lower incidence of PVH-IVH (2/39 vs 8/39; P = 0.04), but the frequency of high-grade hemorrhages was comparable for both indomethacin- and placebo-treated groups. In summary, the prophylactic administration of intravenous indomethacin for the prevention of PVH-IVH cannot be recommended for infants less than 1000 g. In preterm infants between 1000 and 1500 g birth weight, indomethacin significantly reduced the incidence of PVH-IVH.

Abstract: Infants weighing 1500 g at birth requiring either intermittent positive pressure ventilation or continuous positive airway pressure by 12 hours of age were entered in a randomized double blind controlled trial to test the efficacy of early intravenous indomethacin therapy in preventing chronic pulmonary disease of prematurity. Of the 30 newborns enrolled, 15 were treated with indomethacin and 15 were treated with placebo at 12, 24 and 36 hours of age. The groups were similar for birth weight, gestational age, sex, hyaline membrane disease and intracranial hemorrhage. Infants in the placebo group were successfully weaned from intermittent positive pressure ventilation at an earlier age than infants in the indomethacin group (p less than 0.05). Furthermore, chronic pulmonary disease of prematurity was similar in the two groups despite a reduction in the incidence of patent ductus arteriosus in the indomethacin group.

Abstract: We enrolled 61 neonates of 600 to 1250 gm birth weight with evidence of low-grade intraventricular hemorrhage at 6 to 11 hours of age in a prospective, randomized, placebo-controlled trial to test the hypothesis that indomethacin (0.1 mg/kg given intravenously at 6 to 12 postnatal hours and every 24 hours for two more doses) would prevent extension of intraventricular hemorrhage. Twenty-seven infants were assigned to receive indomethacin; 34 infants received saline placebo. There were no significant differences between the two groups in birth weight, gestational age, sex, Apgar scores, percentage of infants treated with surfactant, or distribution of hemorrhages at the time of the first cranial sonogram (echo-encephalogram). Within the first 5 days, 9 of 27 indomethacin-treated and 12 of 34 saline solution-treated infants had extension of their initial intraventricular hemorrhage (p = 1.00). Four indomethacin-treated and three saline solution-treated infants had parenchymal extension of the hemorrhage. Indomethacin was associated with closure of a patent ductus arteriosus by the fifth day of life (p = 0.003). There were no differences in adverse events attributed to indomethacin. We conclude that in very low birth weight infants with low grade intraventricular hemorrhage within the first 6 postnatal hours, prophylactic indomethacin therapy promotes closure of the patent ductus arteriosus and is not associated with adverse events, but does not affect the cascade of events leading to parenchymal involvement of intracranial hemorrhage.

Abstract:
The prophylactic administration of indomethacin reduces the frequency of patent ductus arteriosus and severe intraventricular hemorrhage in very-low-birth-weight infants (those with birth weights below 1500 g). Whether prophylaxis with indomethacin confers any long-term benefits that outweigh the risks of drug-induced reductions in renal, intestinal, and cerebral blood flow is not known.
                Soon after they were born, we randomly assigned 1202 infants with birth weights of 500 to 999 g (extremely low birth weight) to receive either indomethacin (0.1 mg per kilogram of body weight) or placebo intravenously once daily for three days. The primary outcome was a composite of death, cerebral palsy, cognitive delay, deafness, and blindness at a corrected age of 18 months. Secondary long-term outcomes were hydrocephalus necessitating the placement of a shunt, seizure disorder, and microcephaly within the same time frame. Secondary short-term outcomes were patent ductus arteriosus, pulmonary hemorrhage, chronic lung disease, ultrasonographic evidence of intracranial abnormalities, necrotizing enterocolitis, and retinopathy.
                Of the 574 infants with data on the primary outcome who were assigned to prophylaxis with indomethacin, 271 (47 percent) died or survived with impairments, as compared with 261 of the 569 infants (46 percent) assigned to placebo (odds ratio, 1.1; 95 percent confidence interval, 0.8 to 1.4; P=0.61). Indomethacin reduced the incidence of patent ductus arteriosus (24 percent vs. 50 percent in the placebo group; odds ratio, 0.3; P<0.001) and of severe periventricular and intraventricular hemorrhage (9 percent vs. 13 percent in the placebo group; odds ratio, 0.6; P=0.02). No other outcomes were altered by the prophylactic administration of indomethacin.
                In extremely-low-birth-weight infants, prophylaxis with indomethacin does not improve the rate of survival without neurosensory impairment at 18 months, despite the fact that it reduces the frequency of patent ductus arteriosus and severe periventricular and intraventricular hemorrhage.

Abstract: We admitted 36 preterm neonates (600 to 1250 gm birth weight) with normal 6-hour echoencephalograms to a randomized, placebo-controlled prospective trial to determine whether a low dose of indomethacin would prevent germinal matrix or intraventricular hemorrhage and permit adequate urinary output. Between the sixth and tenth postnatal hours, indomethacin (0.1 mg/kg) or placebo was administered intravenously every 24 hours for a total of three doses. Cardiac ultrasound studies to assess the status of the ductus arteriosus were performed at 6 postnatal hours and on day 5. Urinary output, serum electrolytes, serum indomethacin levels, and renal and clotting functions were monitored. No differences in birth weight, gestational age, or Apgar scores were noted between the two groups of infants. Two indomethacin-treated infants and three infants given placebo had significant urinary output difficulties, requiring that the study medication be withheld. Of 19 infants given indomethacin, two had germinal matrix or intraventricular hemorrhage, in comparison with 8 of 17 infants given saline solution (p = 0.02). Of the infants who had a left-to-right patent ductus arteriosus shunt before treatment, 64% of the indomethacin-treated and 33% of the saline solution-treated infants no longer had a patent ductus arteriosus on day 5. Ductal status appeared unrelated to the development of germinal matrix or intraventricular hemorrhage.

Abstract: The impact of early prophylactic use of intravenous indomethacin on the incidence and severity of periventricular-intraventricular hemorrhage and patent ductus arteriosus in 199 oxygen-requiring premature infants (less than or equal to 1300 g birth weight) was prospectively investigated. The trial was controlled, the infants were randomized, and the investigators were unaware of the group assignments. Patients with minimal (grade I) or no periventricular-intraventricular hemorrhage determined by prestudy echoencephalography were randomized within two birth weight subgroups (500 to 899 and 900 to 1300 g) to receive either prophylactic indomethacin (n = 99) or an equal volume of saline-vehicle placebo (n = 100). The first dose (0.2 mg/kg) was given within 12 hours of delivery and two subsequent doses (0.1 mg/kg) were administered at 12 hourly intervals. Prophylactic indomethacin significantly reduced the incidence of grades II to IV periventricular-intraventricular hemorrhage. Intraventricular hemorrhage was half as common in infants given prophylactic indomethacin as in control infants (23% v 46%, P less than .002). The reduction was manifested in both birth weight subgroups. Results of this study also confirmed a lower incidence of clinically significant patent ductus arteriosus in infants who received prophylactic indomethacin in contrast to those who received placebo (11% v 42%, P less than .001). No significant differences were found between treatment and control groups in the duration of oxygen therapy, mechanical ventilation, or hospitalization or in the incidence of pneumothorax, chronic lung disease, sepsis, necrotizing enterocolitis, retinopathy of prematurity, or death. Early prophylactic indomethacin initiated within 12 hours of delivery is effective in reducing the incidence of intraventricular hemorrhage as well as clinically significant patent ductus arteriosus in very low birth weight premature infants.

Abstract: A previous study found that early intravenous indomethacin administration prolonged respiratory support in very low birth weight infants. We have, therefore, designed a randomized, double blind controlled study to evaluate the oxygenation, and surfactant requirements in preterm low birth weight infants receiving early indomethacin administration. Premature neonates who received surfactant therapy and on mechanical ventilation were prospectively randomized to receive either placebo or indomethacin (0.2 mg/kg intravenously at 12 postnatal hours and every 24 h for two more doses). Oxygenation was assessed by FiO2 required and arterial/alveolar oxygen (a/A O2) ratio during the first 48 h of life. The doses of surfactant were compared between the two groups. Twenty-seven infants (n = 14 of early indomethacin and n = 13 of placebo group) fulfilled inclusion criteria. At admission to the study, there were no differences in the birth weight, gestational age, sex, Apgar scores, a/A O2 ratio, and FiO2. The control group exhibited a significant improvement in oxygenation (FiO2 requirement and a/A O2 compared with the early indomethacin group at 24 (P = 0.026 and 0.02, respectively) and 48 h of life (P = 0.037 and 0.026, respectively). The requirement of surfactant was significantly larger in the early indomethacin group (P = 0.029). Early indomethacin administration increases oxygen and surfactant requirement.

Abstract: To determine the efficacy of indomethacin to prevent the occurrence of symptomatic patent ductus arteriosus (PDA), a randomized clinical trial was conducted involving 32 preterm infants weighing 750 to 1500 g at birth who had hyaline membrane disease. By random assignment, 15 infants were given a single dose of indomethacin, 0.2 mg/kg intravenously, 24 hours after birth. Seventeen infants composed a control group for which indomethacin was reserved as treatment for symptomatic PDA. Birth weight, gestational age, male/female ratio, black/white ratio, and severity of disease were similar for both groups. Only one of the 14 survivors who received prophylactic indomethacin had symptomatic PDA, compared with nine of the 16 survivors in the control group (P = 0.007). There was no difference between the groups in development of bronchopulmonary dysplasia, duration of time endotracheal intubation, was required, duration in oxygen, duration to reach full feedings and regain birth weight, and duration of hospital stay. There was no difference between the two groups in incidence of intraventricular hemorrhage, and none developed necrotizing enterocolitis. These results indicate that the use of prophylactic indomethacin is beneficial in prevention of symptomatic PDA; the lack of differences in pulmonary sequelae or other complications may have been related to a population sample size not large enough to impart sufficient statistical power.

Abstract: We admitted 48 preterm neonates (600 to 1250 gm birth weight, normal 6-hour echoencephalograms) to a randomized prospective indomethacin or placebo trial for the prevention of neonatal intraventricular hemorrhage. Beginning at 6 postnatal hours, indomethacin or placebo was administered intravenously every 12 hours for a total of five doses. Cardiac ultrasound studies to assess the status of the ductus arteriosus were performed at 6 postnatal hours and on day 5. Urinary output, serum electrolytes, and renal and clotting functions were monitored. No differences in birth weight, gestational age, Apgar scores, or ventilatory needs were noted between the two groups. Six infants given indomethacin had intraventricular hemorrhage, compared to 14 control infants (P = 0.02). The indomethacin-treated group had significant decreases in serum prostaglandin values 30 hours after the initiation of therapy. The overall incidence of patent ductus arteriosus was 82% at 6 postnatal hours; 84% of the indomethacin-treated infants experienced closure of the ductus, compared to 60% of the placebo-treated patients. Closure of the ductus was not related to incidence of intraventricular hemorrhage. We speculate that indomethacin may provide some protection against neonatal intraventricular hemorrhage by acting on the cerebral microvasculature.

Abstract: The results of a double blind study to evaluate the efficiency of prophylactic endovenous indomethacin versus placebo for prevention of intraventricular hemorrhage (IVH) in newborn infants between 28 to 36 weeks of age who were intubated at the delivery room and required mechanical ventilation in NICU are presented. Fourty six patients required mechanical ventilation, but 14 neonates had IVH evaluated by ultrasound when were admitted to the Unit. At least 32 infants were studied, 16 for each group. There were no differences between the groups in weight, gestational age, sex and delivery way. The mobility was the same in relation to hialine membrane disease, sepsis, pneumonie and pneumotorax. The placebo group had more frequency of PDA and mortality (P < 0.5). There were no differences in mean airway pressure and arterial gases, also in glucose, platelets and urinary volume. The indomethacin group had mayor urinary density and FeNa but the results were always in normal ranges. The IVH was the same in both groups. We concluded that the indomethacin at the levels used did not produced alterations, and if the IVH is not prevented, were observed lesser severity of the same and the frequency of PDA and mortality are lesser. But still is necessary more number of cases for best conclusions.

Abstract: To investigate the optimal timing for treatment of small premature infants, we performed a double-blind, controlled trial of indomethacin therapy on the first day of life in 104 infants weighing between 700 and 1300 gm. Infants were given indomethacin or placebo at a mean age of 15 hours. Eleven of the 56 infants given placebo developed large left-to-right shunts through a patent ductus arteriosus. In contrast, only two of the 51 infants given indomethacin developed large shunts (P less than 0.025). There were no significant differences in incidence of surgical ligation, duration of oxygen therapy, duration of endotracheal intubation, days required to regain birth weight, or incidence of complications. However, the power of the tests of significance was low because of the small number of patients. Thus, although the incidence of large left-to-right ductus shunts was decreased in the indomethacin group, morbidity was not otherwise altered for the entire group of patients, possibly because of the relatively low incidence (21%) of large shunts in the placebo group. We conclude that although treatment with indomethacin on the first day of life appears to be safe, there is little advantage to its use in centers where the incidence of large shunts through a patent ductus arteriosus is relatively low.

Abstract:
Very low birth weight (VLBW, less than 1500 g) and extremely low birth weight infants (ELBW, less than 1000 g) are the premature infants that are most likely to develop symptomatic PDA. Intravenous indomethacin has proven effective in prevention of PDA in many prospective trials. This strategy will be a useful adjunctive therapy for premature infants in Thailand.
                To answer the following questions: 1. Will multiple doses of intravenous indomethacin, given to VLBW infants within the first day of life, effectively prevent the occurrence of symptomatic PDA? Are there any side effects or complications? 2. Will this strategy be more beneficial in ELBW?
                The study included thirty VLBW infants born at Ramathibodi Hospital, with birth weights ranging from 630 to 1230 g. They were randomized into 2 groups of 15 infants each. One group received 3 doses of intravenous indomethacin at the dosage of 0.2 mg/kg initially and then 0.1 mg/kg every 12 hours for 2 more doses; the second group received a placebo. The study was performed by a double blind control.
                Sixteen infants developed symptomatic PDA, 4 in the indomethacin group and 12 in the placebo group. The decrease in incidence of PDA is statistically significant. But when the data was analyzed separately for the VLBW and ELBW groups. The effects were only significantly different in ELBW but not yet significant in the VLBW group. There was a statistically significant difference in the incidence of severe intraventricular hemorrhage (IVH) (grade 3 or higher) in the ELBW infants.
                Intravenous indomethacin therapy given to VLBW infants with a birth weight of less than 1250 g decreased incidence of symptomatic PDA with no significant permanent side effects. The effect was markedly noticeable in ELBW infants. Incidence of severe IVH was also markedly decreased in the ELBW infants who received indomethacin.

Prophylactic indomethacin has short-term benefits for preterm infants including a reduction in the incidence of symptomatic PDA, PDA surgical ligation, and severe intraventricular haemorrhage. However, there is no evidence of effect on mortality or neurodevelopment.


White phosphorus burns and massive hemolysis.

The treatment of chemical burns: specialized diagnostic, therapeutic, and prognostic considerations.

First aid for phosphorus burns involves the common sense measures of acting promptly to remove the patient's clothes, irrigating the wound(s) with water or saline continuously, and removing phosphorus particles. There is no evidence that using copper sulphate to assist visualisation of phosphorus particles for removal is associated with better outcome, and some evidence that systemic absorption of copper sulphate may be harmful. We have so far been unable to identify any other comparisons relevant to informing other aspects of the care of patients with phosphorus burns. Future versions of this review will take account of information in articles published in languages other than English, which may contain additional evidence based on treatment comparisons.


Trial of long-term anticoagulant therapy in the treatment of small stroke associated with a normal carotid arteriogram.

CEREBRAL VASCULAR DISEASE IN RELATION TO LONG-TERM ANTICOAGULANT THERAPY.

Anticoagulant therapy in cerebral infarction. Report on cooperative study.

CEREBRAL APOPLEXY. A CLINICAL, RADIOLOGICAL, ELECTROENCEPHALOGRAPHIC AND PATHOLOGICAL STUDY WITH SPECIAL REFERENCE TO THE PROGNOSIS OF CEREBRAL INFARCTION AND THE RESULT OF LONG-TERM ANTICOAGULATION THERAPY.

Abstract: The clinical features of 49 patients who had sustained small strokes in the internal carotid artery territory, who were normotensive, free from cardiac or other relevant disease, and who each had a normal appropriate single vessel angiogram are presented. These were randomized into two groups: group A, 25 patients, who received only supportive treatment; group B, 24 patients who were treated with anticoagulants for an average period of 18 months. There was a reduced incidence of neurological episodes during the administration of anticoagulant therapy but, after treatment was discontinued, there was no significant difference between the two groups. In view of the relatively benign prognosis for this syndrome, unless special facilities exist for the personal control of anticoagulant treatment, the dangers may outweigh the benefits.

Compared with control, there was no evidence of benefit from long-term anticoagulant therapy in people with presumed non-cardioembolic ischaemic stroke or transient ischaemic attack, but there was a significant bleeding risk.


Computer-aided retraining of memory and attention in people with multiple sclerosis: a randomized, double-blind controlled trial.

Neuropsychological counseling improves social behavior in cognitively-impaired multiple sclerosis patients.

An evaluation of cognitive-behaviour therapy for depression in patients with multiple sclerosis.

Efficacy of stress-inoculation training in coping with multiple sclerosis.

A randomized clinical trial of a wellness intervention for women with multiple sclerosis.

Evaluation of cognitive assessment and cognitive intervention for people with multiple sclerosis.

Effects of treatment for depression on fatigue in multiple sclerosis.

Group psychotherapy: benefits in multiple sclerosis.

Telephone-administered cognitive-behavioral therapy for the treatment of depressive symptoms in multiple sclerosis.

Comparative outcomes for individual cognitive-behavior therapy, supportive-expressive group psychotherapy, and sertraline for the treatment of depression in multiple sclerosis.

Unit management of depression of patients with multiple sclerosis using cognitive remediation strategies: a preliminary study.

Effects of neuropsychological treatment in patients with multiple sclerosis.

Symptom management and adjustment of patients with multiple sclerosis: a 4-year longitudinal intervention study.

Abstract:
Cognitive compromise is one of the main contributing factors to activity and participation restrictions in people with multiple sclerosis (MS). Computer-aided programs are used for retraining memory and attention, but data on the efficacy of these interventions are scarce.
                To assess the efficacy of computer-aided retraining of memory and attention in people with MS impaired in these abilities.
                Randomized, double-blind, controlled trial.
                Outpatients (n=82) with subjective complaints of poor attention or memory, confirmed by a score <80th percentile in at least two tests of the Brief Repeatable Battery of Neuropsychological Tests (BRBNT).
                Participants were randomized to two computer-assisted retraining interventions: memory and attention (study arm), and visuo-constructional and visuo-motor coordination (control arm). Both groups received 16 training sessions over 8 weeks.
                Improvement of 20% or more in at least two BRBNT test scores at 8 weeks compared to baseline (primary end point). Changes in depression and health-related quality of life.
                An improvement occurred in 45% of study patients vs. 43% of control patients (odds ratio 1.07, 95% confidence interval 0.44-2.64). The study treatment was better than the control treatment only on the word list generation test (p=0.016).
                This trial does not support the efficacy of specific memory and attention retraining in MS.

Abstract: We studied the effectiveness of a newly-developed cognitive-behavioral intervention in 15 patients with marked cognitive impairment and behavior disorder. The design was a single-blind test of a neuropsychological intervention, with pre- and post-treatment assessments of personality and social behavior. MS patients underwent neurological examination and neuropsychological testing at baseline. The patients were then randomly assigned to neuropsychological counseling or standard, non-specific supportive psychotherapy. The active 12-week treatment emphasized enhancement of insight through education, social skills training, and behavior modification. All patients were re-examined within 2 weeks of the termination of treatment. Neuropsychological technicians were blind to treatment condition. Both groups showed evidence of cognitive impairment and personality/behavior disorder prior to treatment and were well matched on demographic, disability, and cognitive measures. Patients who underwent neuropsychological counseling showed significant positive response on measures of social behavior (e.g. excessive ego-centric speech) compared to those who underwent standard counseling. We conclude that these data support the use of non-pharmacological, neuropsychological counseling in patients with acquired, MS-associated behavior disorder.

Abstract: Twenty depressed multiple sclerotic patients were randomly allocated either to cognitive-behaviour therapy or to a waiting list control condition. Assessment of depressive symptoms was conducted at pre-treatment, post-treatment, and a four-week follow-up. In comparison to the waiting list condition, cognitive-behaviour therapy was found to result in clinically and statistically significant improvement on most measures. Although the mechanism by which such treatment achieves its effects is unclear, these results clearly support the use of cognitive-behavioural treatments for depression in this population.

Abstract:
To examine the effects of a wellness intervention program for women with multiple sclerosis (MS) on health behaviors and quality of life (QOL).
                Randomized clinical trial.
                Community setting in the southwestern United States.
                Convenience sample of 113 women with physician-confirmed MS (mean age, 45.79y).
                The 2-phase intervention program included lifestyle-change classes for 8 weeks, then telephone follow-up for 3 months. Participants were followed over an 8-month period.
                A series of self-report instruments to measure barriers, resources, self-efficacy for health behaviors, health promotion behaviors, and health-related QOL were completed at baseline, 2 months (after the classes), 5 months (after telephone follow-up), and at 8 months. Principal outcomes measures were health-promoting behaviors (scores on the Health Promoting Lifestyle Profile II) and QOL (scores on the Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36] scales).
                Hierarchical linear modeling techniques revealed a statistically significant group by time effect for self-efficacy for health behaviors, health-promoting behaviors, and the mental health and pain scales of the SF-36.
                These data provide initial support for the positive effects of wellness interventions to improve health behaviors and selected dimensions of QOL for women with MS.

Abstract:
Cognitive problems in multiple sclerosis are common but any possible benefits of treatment remain uncertain. The aim of the study was to evaluate the benefits of providing a psychology service, including cognitive assessment and intervention, to patients with multiple sclerosis.
                The study was a single blind randomised controlled trial. A total of 240 patients with clinically definite, laboratory supported, or clinically probable multiple sclerosis were recruited from an multiple sclerosis management clinic and assessed on a brief screening battery. They were randomised into three groups. The control group received no further intervention. The assessment group received a detailed cognitive assessment, the result of which was fed back to staff involved in the patients' care. The treatment group received the same detailed cognitive assessment and a treatment programme designed to help reduce the impact of their cognitive problems. Patients were followed up 4 and 8 months later on the general health questionnaire (GHQ-28), extended activities of daily living scale, SF-36, everyday memory questionnaire, dysexecutive syndrome questionnaire, and memory aids questionnaire.
                The three groups were compared on the outcome measures at 4 and 8 months after recruitment. There were few significant differences between the groups and those that occurred favoured the control group. Overall, the results showed no effect of the interventions on mood, quality of life, subjective cognitive impairment or independence.
                The study failed to detect any significant effects of cognitive assessment or cognitive intervention in this cohort of people with multiple sclerosis.

Abstract:
There has long been a belief that depression contributes to fatigue in multiple sclerosis (MS) although supporting data are minimal at best. Clinical guidelines for the treatment of fatigue include recommendations for the treatment of depression in the absence of clear empirical support. The goal of this study was to examine the effects of treatment for depression on fatigue in MS.
                Sixty patients with a relapsing form of MS and moderate to severe depression were randomly assigned to one of three validated 16-week treatments for depression: individual cognitive behavioral therapy, group psychotherapy, or sertraline. Assessments at baseline and treatment cessation included the primary outcome measure, fatigue assessment instrument (FAI), and Beck depression inventory (BDI).
                The total FAI and the global fatigue severity subscale were significantly reduced over the course of treatment (p values <.02). Other subscales did not change significantly. Secondary analyses showed change in global fatigue severity was associated with change in BDI (p =.03) but change in total FAI was only marginally related to change in BDI (p =.05). These relationships were due entirely to change in mood (p values <.02) and not to change in cognitive or vegetative symptoms (p values >.17).
                These findings suggest that treatment for depression is associated with reductions in the severity of fatigue symptoms, and that this relationship is due primarily to treatment related changes in mood.

Abstract: This study investigates the relationship between group psychotherapy and the psychologic adjustment of patients with a primary diagnosis of multiple sclerosis (MS). It was speculated that such a program would decrease both patient depression and anxiety, at the same time increasing self-concept and self-direction. Forty-one hospitalized MS patients were screened for mental status, then administered a test battery consisting of the Depression 30, IPAT Anxiety Scale, Nowicki-Strickland Internal-External Scale, and Rosenberg Self-Esteem Scale. Following this, patients were matched into triads on the basis of pretest scores. Each member of the triad was then randomly assigned to one of three groups: insight-oriented, current events, control (nontreatment). At the end of 50 group sessions, all patients were reassessed using the same test battery. Results were analyzed by means of analysis of covariance and the nonparametric Friedman test. Post-hoc procedures were performed with the following results: 1) the insight-oriented therapy group was significantly less depressed than both the current events group and the control group and 2) both the therapy and the current events groups were significantly more internally oriented than the control. Not only does group therapy per se seem to benefit the MS patient, but any supervised group involvement appears to improve significantly patient emotional state.

Abstract: This study examined the efficacy of an 8-week telephone-administered cognitive-behavioral therapy (CBT) for the treatment of depressive symptomatology in multiple sclerosis (MS) patients. The treatment, Coping with MS (CMS), included a patient workbook designed to structure the treatment, provide visual aids, and help with homework assignments. Thirty-two patients with MS, who scored at least 15 on the Profile of Mood States Depression-Dejection scale, were randomly assigned to either the telephone CMS or to a usual-care control (UCC) condition. Depressive symptomatology decreased significantly in the CMS condition compared with the UCC condition. Furthermore, adherence to interferon beta-1a, a disease-modifying medication for the treatment of MS, was significantly better at the 4-month follow-up among patients who received CMS as compared with those in the UCC condition.

Abstract: This study compared the efficacy of 3 16-week treatments for depression in 63 patients with multiple sclerosis (MS) and major depressive disorder (MDD): individual cognitive-behavioral therapy (CBT), supportive-expressive group therapy (SEG). and the antidepressant sertraline. Significant reductions were seen from pre- to posttreatment in all measures of depression. Intent-to-treat and completers analyses using the Beck Depression Inventory (BDI; A. T. Beck, C. H. Ward. M. Medelson. J. Mock, & J. Erbaugh, 1961) and MDD diagnosis found that CBT and sertraline were more effective than SEG at reducing depression. These results were largely supported by the BDI-18, which eliminates BDI items confounded with MS. However, the Hamilton Rating Scale for Depression (M. Hamilton, 1960) did not show consistent differences between treatments. Reasons for this inconsistency are discussed. These findings suggest that CBT or sertraline is more likely to be effective in treating MDD in MS compared with supportive group treatments.

Abstract: Multiple sclerosis (MS) is a chronic, often progressive neurologic disorder characterized by cerebral and spinal cord lesions. Patients with advanced MS often require continuous supervision in a long-term skilled nursing facility. Many of these patients experience clinical levels of depression. For this experiment, we randomly assigned MS patients living in a skilled nursing facility to either a control condition or an extended treatment protocol. The protocol consisted of assigning individual certified nursing assistants (CNAs) to each patient, in-service training for the CNAs, and the use of memory notebooks. All patients completed the short version of the Beck Depression Inventory and several measures of cognitive functioning at the start and end of the study. The results indicate statistically and clinically significant improvements in the depression of patients in the treatment but not in the control condition. These results led to recommendations for the treatment of MS patients living in long-term skilled nursing facilities and for additional research.

Abstract: The chronic and progressive nature of multiple sclerosis (MS) often excludes patients from neuropsychological treatment. At the Multiple Sclerosis Rehabilitation Hospital, Haslev, 40 patients with mild to moderate cognitive and behavioral impairment associated with MS were randomized to either specific cognitive treatment (20 pts) by direct training, compensatory strategies and neuropsychotherapy, or to non-specific, deliberately diffuse mental stimulation (20 pts). Treatment was for a mean of 46 days. The effects of treatment were evaluated by neuropsychological tests before treatment, immediately after treatment (short-term effects) and 6 months later (long-term effects). After short-term treatment, effects on cognitive measures were not convincing, but on the Beck Depression Inventory (BDI) the specific cognitive treatment group reported significantly less depression. After 6 months only this group showed an effect, since the visuo-spatial memory was improved. However, the depression ratings (BDI) were almost maintained from the short-term level. Interestingly, the non-specific treatment group rated themselves as significantly more depressed. Conclusively, it is worth while to offer specific neuropsychological treatment to MS patients with cognitive and behavioral dysfunction.

Abstract: The researchers studied the effectiveness of a nursing intervention in promoting adjustment and symptom management in individuals with multiple sclerosis (MS). This was a 4-year longitudinal study to determine whether the 4-week intensive outpatient program was effective in increasing adjustment to MS and if the treatment effect would last over time. A sample of 27 individuals with MS participated in the study. Treatment participants had significant improvements in symptom management at the 4-year follow up. This improvement was attributable to signficant improvements in sleep and fatigue levels. Although adjustment and self-efficacy scores improved in the treatment group over time, this improvement was not superior to the control group. This was anticipated because the behavioral changes would precede improvement in adjustment to life following the diagnosis of MS.

The diversity of psychological interventions identified indicates the many ways in which they can potentially help people with MS. No definite conclusions can be made from this review. However there is reasonable evidence that cognitive behavioural approaches are beneficial in the treatment of depression, and in helping people adjust to, and cope with, having MS.


Efficacy of nonprescription doses of ibuprofen for treating migraine headache. a randomized controlled trial.

Placebo-controlled comparison of effervescent acetylsalicylic acid, sumatriptan and ibuprofen in the treatment of migraine attacks.

Rofecoxib in the acute treatment of migraine: a randomized controlled clinical trial.

Rizatriptan vs. ibuprofen in migraine: a randomised placebo-controlled trial.

Rofecoxib versus ibuprofen for acute treatment of migraine: a randomised placebo controlled trial.

Acetaminophen, aspirin, and caffeine in combination versus ibuprofen for acute migraine: results from a multicenter, double-blind, randomized, parallel-group, single-dose, placebo-controlled study.

The efficacy of metoclopramide in the treatment of migraine headache.

Effectiveness of ibuprofen-arginine in the treatment of acute migraine attacks.

Abstract:
To evaluate the efficacy and safety of ibuprofen, 200 mg and 400 mg, compared with placebo and each other for the treatment of pain of migraine headache.
                Migraine headache is a common illness with significant social and economic impact.
                Randomized, placebo-controlled, double-blind trial of 6 hours' treatment duration.
                Fifteen investigators at 17 private practice and referral centers in the United States participated in this study of 660 outpatient adults aged 18 to 84 years with migraine headache of moderate to severe intensity. Each patient was randomly assigned to a single dose of study medication: ibuprofen 200 mg (n = 216) or 400 mg (n = 223), or placebo (n = 221). The percentage of patients with a reduction in baseline headache intensity from severe or moderate to mild or none 2 hours after treatment and the headache pain intensity difference from baseline at 2 hours were the primary efficacy measures. Secondary outcomes included other measures of pain relief, severity differences from baseline for migraine-associated symptoms of nausea, photophobia, phonophobia, and functional disability, and percentage of patients with migraine-associated symptoms reduced to none.
                Significantly (P < or = .006) more patients treated with ibuprofen, 200 mg or 400 mg, reported mild to no pain after 2 hours (41.7% and 40.8%, respectively), compared with those treated with placebo (28.1%). The mean pain intensity difference from baseline measured at 2 hours was significantly (P < or = .001) greater for patients treated with ibuprofen 200 mg or 400 mg (0.68 and 0.65, respectively), compared with those treated with placebo (0.39). Statistically significant differences in favor of both doses of ibuprofen over placebo were observed for mean pain intensity difference at 1 hour after treatment. In patients with severe baseline pain intensity, ibuprofen, 400 mg, was significantly (P < or = .048) superior to placebo for the primary efficacy end points, while ibuprofen, 200 mg, was not. Ibuprofen, 200 mg and 400 mg, were statistically significantly more effective than placebo for all clinically important secondary pain relief outcomes. Mean severity changes of migraine-associated symptoms of nausea, photophobia, phonophobia, and functional disability at 2 and 6 hours were significantly (P < or = .03) in favor of both doses of ibuprofen over placebo, and results for the percentage of patients with symptoms reduced to none consistently, although less often statistically significant, favored ibuprofen. No statistically significant differences in adverse events were found among treatment groups.
                Ibuprofen at doses of 200 mg and 400 mg is an efficacious, cost-effective, well-tolerated, single-ingredient nonprescription treatment for pain of migraine headache. In addition, while not always statistically significant, ibuprofen provided a beneficial effect on associated symptoms of migraine including nausea, photophobia, phonophobia, and functional disability.

Abstract: Acetylsalicylic acid (ASA) in combination with metoclopramide has been frequently used in clinical trials in the acute treatment of migraine attacks. Recently the efficacy of a new high buffered formulation of 1000 mg effervescent ASA without metoclopramide compared to placebo has been shown. To further confirm the efficacy of this new formulation in comparison with a triptan and a nonsteroidal anti-inflammatory drug (ibuprofen) a three-fold crossover, double-blind, randomized trial with 312 patients was conducted in Germany, Italy and Spain. Effervescent ASA (1000 mg) was compared to encapsulated sumatriptan (50 mg), ibuprofen (400 mg) and placebo. The percentage of patients with reduction in headache severity from moderate or severe to mild or no pain (primary endpoint) was 52.5% for ASA, 60.2% for ibuprofen, 55.8% for sumatriptan and 30.6% for placebo. All active treatments were superior to placebo (P < 0.0001), whereas active treatments were not statistically different. The number of patients who were pain-free at 2 h was 27.1%, 33.2%, 37.1% and 12.6% for those treated with ASA, ibuprofen, sumatriptan or placebo, respectively. The difference between ASA and sumatriptan was statistically significant (P = 0.025). With respect to other secondary efficacy criteria and accompanying symptoms no statistically significant differences between ASA and ibuprofen or sumatriptan were found. Drug-related adverse events were reported in 4.1%, 5.7%, 6.6% and 4.5% of patients treated with ASA, ibuprofen sumatriptan or placebo. This study showed that 1000 mg effervescent ASA is as effective as 50 mg sumatriptan and 400 mg ibuprofen in the treatment of migraine attacks regarding headache relief from moderate/severe to mild/no pain at 2 h. Regarding pain-free at 2 h sumatriptan was most effective.

Abstract:
To investigate the efficacy, tolerability, and safety of rofecoxib and ibuprofen for acute migraine treatment.
                Rofecoxib was effective and well tolerated in a previous study of treatment of a single migraine attack. We sought to replicate these findings for a single attack and also study the clinical profile of rofecoxib in the acute treatment of multiple migraine attacks. Ibuprofen was included as a reference nonselective NSAID.
                Adult migraineurs (n = 783) treated one migraine attack with either rofecoxib (25 or 50 mg), ibuprofen 400 mg, or placebo in a randomized, double-blind study. Patients could elect to enroll in a 3-month double-blind extension phase.
                In the single-attack phase, headache relief at 2 hours postdose was reported by 59.4%, 62.2%, and 57.7% of patients who took rofecoxib 25 mg, rofecoxib 50 mg, and ibuprofen 400 mg, respectively, versus 30.5% for placebo (all P < .001 vs placebo). The active drugs were statistically superior to placebo on a variety of additional measures. In the extension phase, the mean percentage of patients' attacks with headache relief at 2 hours postdose was 61.8% for rofecoxib 25 mg, 65.4% for rofecoxib 50 mg, and 59.3% for ibuprofen 400 mg. The mean percentage of patients' attacks with 24-hour sustained headache relief was greater for rofecoxib 50 mg (52.0%) than for rofecoxib 25 mg (47.8%, P < .050) or ibuprofen (39.0%, P < .010). In the single-attack phase, the adverse event rate was higher for rofecoxib 50 mg (37.8%) than placebo (27.8%, P < .050); rates were similar to placebo for rofecoxib 25 mg (32.0%, n.s.) and ibuprofen 400 mg (28.1%, n.s.). In the extension phase, treatment groups had similar adverse event rates.
                Rofecoxib 25 and 50 mg and ibuprofen 400 mg were effective and generally well tolerated in the acute treatment of migraine.

Abstract: The objective of this study was to compare the efficacy of rizatriptan and ibuprofen in migraine. The study was a randomised placebo-controlled trial in a tertiary care teaching hospital. Migraine patients with <8 attacks/months were included. One hundred and fifty-five migraine patients were randomised to rizatriptan 10 mg (53), ibuprofen 400 mg (52) and placebo (50). Efficacy was assessed by headache relief, and headache freedom at 2 h and 24 h. Two-hour headache relief, was noted in 73% in rizatriptan, 53.8% in ibuprofen and 8% in placebo groups. Headache freedom was achieved in 37.7% in rizatriptan, 30.8% in ibuprofen and 2% in placebo groups. Rizatriptan was superior to ibuprofen and placebo in relieving headache at 2 h but not at 24 h. Side effects were noted in 9 patients in rizatriptan, 8 in ibuprofen and 3 in placebo, all of which were nonsignificant. Rizatriptan and ibuprofen are superior to placebo. Rizatriptan is superior to ibuprofen in relieving headache, associated symptoms and functional disability.

Abstract:
Rofecoxib is a potent cyclo-oxygenase-2 inhibitor with a long duration of action. Its role in migraine has not been systematically evaluated.
                To study the efficacy of rofecoxib in migraine.
                In a randomised placebo controlled trial rofecoxib 25 mg, ibuprofen 400 mg, and placebo were compared regarding their efficacy in relieving acute migraine attack. Migraine patients with 2-6 attacks per month were recruited. Headache severity, functional disability, and severity of associated symptoms were graded on a 0-3 scale. The primary endpoint was pain relief at two hours. Relief of associated symptoms and sustained pain relief for 24 hours were also noted.
                One hundred and twenty four patients were randomised into rofecoxib (42), ibuprofen (40), and placebo (42) groups. One hundred and one patients were followed up: 33 on rofecoxib, 35 ibuprofen, and 33 placebo. Patients' ages ranged from 16-62 (mean 31.4) years, and 83 were females. Pain relief at two hours was noted in 45.5% on rofecoxib, 55.6% on ibuprofen, and 9.1% in the placebo group. The associated symptoms at two hours were reduced in 39.4% on rofecoxib, 50% on ibuprofen, and 9.1% in the placebo group. Sustained 24 hour pain relief was noted in 36.4% on rofecoxib, 41% on ibuprofen, and 6.1% in the placebo group. In the ibuprofen group, five patients had abdominal pain but there were no side effects in those on rofecoxib or in the control group. Both rofecoxib and ibuprofen were significantly effective in relieving pain, associated symptoms at two hours, and in sustained pain relief. There was no significant difference between rofecoxib and ibuprofen in aborting acute migraine attacks.
                Both ibuprofen and rofecoxib were superior to placebo in aborting an acute migraine attack, and there was no significant difference in their efficacy in an acute migraine attack.

Abstract:
Compare the effectiveness of a combination analgesic containing acetaminophen, aspirin, and caffeine to that of ibuprofen in the treatment of migraine.
                Multicenter, double-blind, randomized, parallel-group, placebo-controlled, single-dose study. A total of 1555 migraineurs were included in the analysis. No patients were excluded solely because of severity of symptoms or degree of disability. A single 2-tablet dose for each of the 3 treatment groups: a combination product containing acetaminophen 250 mg, aspirin 250 mg, and caffeine 65 mg per tablet (AAC); ibuprofen 200 mg per tablet (IB); or matching placebo. The primary efficacy endpoint was the weighted sum of pain relief (PAR) scores at 2 hours postdose (TOTPAR2) and an important secondary endpoint was the time to onset of meaningful relief.
                There were 669 patients in the AAC group, 666 patients in the IB group, and 220 patients in the placebo group. The 3 treatment groups had similar demographic profiles, migraine histories, and baseline symptom profiles. While both active treatments were significantly better than placebo in relieving the pain and associated symptoms of migraine, AAC was superior to IB for TOTPAR2, as well as for PAR, time to onset of meaningful PAR, pain intensity reduction, headache response, and pain free. The mean TOTPAR2 scores for AAC, IB, and placebo were 2.7, 2.4, and 2.0, respectively (AAC vs. IB, P < .03). The median time to meaningful PAR for AAC was 20 minutes earlier than that of IB (P < .036).
                AAC and IB are safe, cost-effective treatments for migraine; AAC provides significantly superior efficacy and speed of onset compared with IB.

Abstract:
By evaluating the efficacy of metoclopramide alone and in combination with ibuprofen versus placebos, this study was designed to both evaluate the efficacy of metoclopramide and elucidate its mechanism of action in the treatment of migraine headache.
                The study was conducted over a two-year period and was a randomized, double-blind, placebo-controlled study.
                An urban teaching hospital.
                Patients enrolled were at least 18 years old and had recurring headaches with one or more of the following characteristics: unilateral, preceded by neurologic symptoms, significant nausea and vomiting, or mood changes and photophobia.
                Ten milligrams of metoclopramide or an equal volume of IV normal saline was given and 600 mg of ibuprofen or identical-appearing placebo was given orally at time 0. Patients rated their pain and nausea at time 0, 30 minutes, and 60 minutes using visual-analog scales.
                The differences in pain and nausea scores for the metoclopramide + placebos group versus the other three groups were tested using exact nonparametric (Mann-Whitney) statistical procedures. The metoclopramide + placebos group had significantly better relief of pain compared with the placebos + ibuprofen and placebos + placebos groups. The metoclopramide + placebos group had significantly better relief of nausea than the ibuprofen + placebos group; nausea scores for the placebos + placebos group could not be analyzed due to excessive variance from the other groups at baseline. The differences between the metoclopramide + placebos group and the metoclopramide + ibuprofen group were not statistically significant with regard to either pain or nausea.
                Metoclopramide is efficacious in the treatment of both the pain and nausea of migraine headache. This is a direct action that is not dependent on the concomitant administration of another agent.

Abstract: The purpose of this study was to evaluate the effectiveness of a new formulation of ibuprofen (ibuprofen-arginine [IA]) in the treatment of migraine attacks. This is a faster absorbed formulation as compared with ibuprofen alone. The rapidity of action is considered to be a crucial factor in the treatment of migraine attacks. Forty migraine patients participated in this multicenter, double-blind, crossover, randomized, placebo-controlled trial. Each patient was treated with a single oral dose of IA 400 mg or placebo during two consecutive migraine attacks. The results confirm the efficacy of IA, with a significant (p < 0.05) improvement in pain relief at 30 min after treatment. A statistically significant (p < 0.001) reduction in pain intensity was observed at 1, 2, 4 and 6 h after treatment with ibuprofen as compared with placebo. IA was well tolerated and our data indicate that this new formulation of ibuprofen is valuable in the treatment of acute migraine attacks.

We found no new studies since the last version of this review. Ibuprofen is an effective treatment for acute migraine headaches, providing pain relief in about half of sufferers, but complete relief from pain and associated symptoms for only a minority. NNTs for all efficacy outcomes were better with 400 mg than 200 mg in comparisons with placebo, and soluble formulations provided more rapid relief. Adverse events were mostly mild and transient, occurring at the same rate as with placebo.


A randomized, controlled trial of the effectiveness of community-based case management in insuring uninsured Latino children.

The State Children's Health Insurance Program: a multicenter trial of outreach through the emergency department.

Abstract:
Lack of health insurance adversely affects children's health. Eight million US children are uninsured, with Latinos being the racial/ethnic group at greatest risk for being uninsured. A randomized, controlled trial comparing the effectiveness of various public insurance strategies for insuring uninsured children has never been conducted.
                To evaluate whether case managers are more effective than traditional methods in insuring uninsured Latino children.
                Randomized, controlled trial conducted from May 2002 to August 2004.
                A total of 275 uninsured Latino children and their parents were recruited from urban community sites in Boston.
                Uninsured children were assigned randomly to an intervention group with trained case managers or a control group that received traditional Medicaid and State Children's Health Insurance Program (SCHIP) outreach and enrollment. Case managers provided information on program eligibility, helped families complete insurance applications, acted as a family liaison with Medicaid/SCHIP, and assisted in maintaining coverage.
                Obtaining health insurance, coverage continuity, the time to obtain coverage, and parental satisfaction with the process of obtaining insurance for children were assessed. Subjects were contacted monthly for 1 year to monitor outcomes by a researcher blinded with respect to group assignment.
                One hundred thirty-nine subjects were assigned randomly to the intervention group and 136 to the control group. Intervention group children were significantly more likely to obtain health insurance (96% vs 57%) and had approximately 8 times the adjusted odds (odds ratio: 7.78; 95% confidence interval: 5.20-11.64) of obtaining insurance. Seventy-eight percent of intervention group children were insured continuously, compared with 30% of control group children. Intervention group children obtained insurance significantly faster (mean: 87.5 vs 134.8 days), and their parents were significantly more satisfied with the process of obtaining insurance.
                Community-based case managers are more effective than traditional Medicaid/SCHIP outreach and enrollment in insuring uninsured Latino children. Case management may be a useful mechanism to reduce the number of uninsured children, especially among high-risk populations.

Abstract:
We evaluated emergency department (ED)-based outreach for the State Children's Health Insurance Program (SCHIP).
                We conducted a multicenter trial among uninsured children (< or = 18 years) who presented to 5 EDs in 2001 and 2002. On-site staff enrolled consecutive subjects for a control period followed by an intervention period during which staff handed out SCHIP applications to the uninsured. The primary outcome was state-level confirmation of insured status at 90 days.
                We followed 223 subjects (108 control, 115 intervention) by both phone interview and state records. Compared to control subjects, those receiving a SCHIP application were more likely to have state health insurance at 90 days (42% vs 28%; P<.05; odds ratio [OR]=3.8; 95% confidence interval [CI]=1.7, 8.6). Although the intervention effect was prominent among 118 African Americans (50% insured after intervention vs 31% of controls, P<.05), lack of family enrollment in other public assistance programs was the primary predictor of intervention success (OR=3.7; 95% CI=1.6, 8.4).
                Handing out insurance applications in the ED can be an effective SCHIP enrollment strategy, particularly among minority children without connections to the social welfare system. Adopted nationwide, this simple strategy could initiate insurance coverage for more than a quarter million additional children each year.

The two studies included in this review provide evidence that in the US providing health insurance information and application assistance, and handing out application materials in hospital emergency departments can probably both improve insurance coverage of children. Further studies evaluating the effectiveness of different outreach strategies for expanding health insurance coverage of children in different countries are needed, with careful attention given to study design.


Umbilical artery catheters: high, low, or no.

Low positioning of umbilical-artery catheters increases associated complications in newborn infants.

Randomized trial of umbilical arterial catheter position: clinical outcome.

Umbilical artery catheterization in newborns. I. Thrombosis in relation to catheter type and position.

The association of heparin exposure with intraventricular hemorrhage among very low birth weight infants.

Abstract: We performed a randomized prospective study of the effect of placement position of umbilical-artery catheters on complication rates in high-risk newborn infants. A higher complication rate (31 of 40 vs. 13 of 33) (P less than 0.005) occurred in the group with the catheter tip at the third to fourth lumbar segment, as compared to those with the tip at the seventh to eighth thoracic segment, owing to more episodes of blanching and cyanosis of the extremities. There was no difference between groups in the rate of complications requiring catheter removal. Aortography revealed thrombosis in 21 of 23 patients studied, but there was no clinical evidence of impaired circulation. In retrospect, we found that, independently of catheter position, administration of antibiotics through the catheter was associated with an increased rate of complications (63 vs. 20 per cent). Umbilical-artery catheterization entails potential risks regardless of the position of the catheter; placement of the catheter with its tip at the seventh to eighth thoracic segment may be associated with fewer complications than at lower positions.

Abstract: In order to determine if umbilical arterial catheter position affects the incidence of necrotizing enterocolitis, clinical outcome was analysed in 308 infants whose umbilical arterial catheter had been randomly allocated to a high (n = 162) or a low (n = 146) position. Necrotizing enterocolitis was classified as suspected or confirmed; all renal, lower limb and local catheter complications were also recorded. High umbilical arterial catheters were in place for longer than low catheters, provided more samples and were removed as an emergency less often. Lower limb blanching and cyanosis were more common with low catheters. Eleven cases of confirmed necrotizing enterocolitis occurred in the "high" group and nine in the "low" group. One case of fatal aortic thrombosis was encountered in the high group. Positioning umbilical arterial catheters in a high position allowed longer functional use and did not increase the incidence of necrotizing enterocolitis.

Abstract: Seventy-one sick newborn infants, who had an umbilical artery catheterized, were randomized in one of four catheter groups: long end-hole-, short end-hole-, long side-hole- or short side-hole catheter. A long catheter means a high position of the catheter tip (Th6--11) and a short catheter a low position of the tip (L3--5). An angiography through the indwelling catheter in order to diagnose thrombosis was performed before the catheter was withdrawn. Dissection of the aorta and its brances was performed on infants who died. The total frequency of thromboses was 26%. There were no thromboses among infants with long end-hole catheters while infants with short end-hole catheters had thrombosis in 26%, long side-hole catheters in 33% and short side-hole catheters in 64%. Long end-hole catheters functioned better than the others. Only 6 of 16 infants with thrombosis had physical signs from the legs, while 12 infants without thrombosis had similar signs.

Abstract: To determine whether there is a relationship between exposure to heparin and an increased risk of intraventricular hemorrhage (IVH), we analyzed data from a cohort of infants who had been subjects in a randomized clinical trial of umbilical artery catheter placement. Data from 862 infants who survived the first 6 days of life were used for analysis. The incidence of IVH (grades 1 through 4) was 28.6%. The mean (SD) birth weight for infants with IVH was 954 gm (247 gm) compared with 1053 gm (253 gm) among infants without IVH (p < 0.01). The mean (SD) heparin intake among infants with an IVH was 83.5 units/kg/day (48.7) compared with 59.4 units/kg/day (48.7) among infants without an IVH (p < 0.01). With the use of logistic regression modeling to adjust for a number of potentially confounding variables, including fluid intake and birth weight, we observed an odds ratio for an IVH of 1.96 (95% confidence interval = 1.32, 2.91) for infants with second through fourth quartile intakes of heparin compared with that for infants with first quartile heparin intakes. Although we cannot rule out the possibility that the observations from this model may be confounded by factors associated with the severity of illness of the infant, these data support the findings of previous reports of an association between heparin exposure and the risk for an IVH.

There appears to be no evidence to support the use of low placed umbilical artery catheters. High catheters should be used exclusively.


The counselor helped the laborer because

he is a very kind person.
she is a very kind person.


The lawyer talked with the counselor because

she needed to gather additional evidence for the case.


The driver offered a ride to the teacher but

he refused the offer.
she refused the offer.


The cleaner got mad at the farmer because

she brought lots of dirt.
he brought lots of dirt.


The carpenter met with the teacher so that

she could fix the cabinets in the classroom.


The salesperson met with the counselor because


The receptionist reminded the cook to wear suits because


The sheriff told the counselor that

he was under investigation.
she was under investigation.


The supervisor was impressed by the tailor because

she is easily impressed.
he is easily impressed.


The driver picked up bread from the baker because


In particular, train journeys are very entertaining because we pass through many stations, meet many...
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While the OCRF has significant community reach and remains a major funding body for ovarian cancer research, we are staffed by a very small team of six. By having a small, agile and cross-skilled team, we continue to ensure that there is a sustainable and generous funding pool for our researchers to access.


When we were 20 our parents got together and married, so it's not like we grew up together or anything. I was in college and not living at home and she was living her life. We would spend family meals together every now and then, but that was about it. My mother died a few years later and I lost track of my step-family for over 20 years. Life happens like that.
Now we got back in touch with each other a couple of years ago and I see what's up with her thru Facebook and a call about once a month, until recently, the calls have been 3 or 4 times a week.
I have not said anything to her, nor have I really tried but sometimes she'll drop in a comment on how handsome I am. That in itself means nothing but she does like saying how much she loves having me back in her life. We talk for hours every week and it is nice to have someone to share stories of family with.
But tonight we were texting and she said that she wished that she was with me. I figured it was because she was feeling stressed at home I told her I was writing and it would be boring just the us and Al Green (who I was playing on my iTunes). "Sounds great, I would have peace and quiet." I asked does she think about me as much as i think of her and she said "yes". I had to leave the chat before I said something stupid but I kept on with crap like I miss the beaches and if I came for a visit we should have dinner on one and she agreed.
At this point my mind was racing. So told her I had stuff to do, which wasn't true, I was just noticing how hot I was getting. She then said "I'm going to take a shower." I don't think she meant anything sexual by that, I was taking that visual and running with it. I just need to stop thinking of her like she's a woman and go back to how I saw her 30 years ago.
By Anonymous Mar 9, 2019
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Sniff her dirty panties first!! If you like the smell,then go for it brother!!!!
Mar 11, 2019
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Go visit her, stay in a hotel with a restaurant/bar so you two can eat & drink with no need to be out in public.
Ensure your room has two beds & when you get tired or need a change of scenery hope for the truths to become a known.


Associate Professor, Daniel J. Epstein Department of Industrial and Systems Engineering, USC Viterbi School of Engineering
Shinyi Wu, PhD's contact information
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Shinyi Wu, PhD's Bio
Trained in industrial and systems engineering and specializing in health systems research, Shinyi Wu, PhD, brings a cross-disciplinary perspective to her research on improving quality and cost-effectiveness of health services and population health, especially for patients with chronic illnesses and underserved populations.
Her research addresses goals important for American social and health policy and program analysis: to design effective health systems that deliver better patient-centered outcomes at lower cost and to advance scientific knowledge leading to solutions to human problems. Her research integrates quality improvement methods, implementation science, cost-effectiveness analyses, simulation modeling and innovative technology applications.
Wu led the Diabetes-Depression Care-Management Adoption Trial to design and evaluate an innovative application of an integrated technological system to implement evidence-based depression-care management to improve outcomes for underserved diabetes populations. She has also led studies of the effectiveness of systems redesign approaches, such as the Chronic Care Model and Toyota's Lean management implementation. Wu's cost-effectiveness studies have helped close the gap between research and clinical practice. Studies include evaluating a national program for implementing Spanish-language access programs, comparing effective interventions to promote physical activity and to prevent HIV, and modeling a national policy for a fall-prevention program for older populations.
An associate professor at the USC Dworak-Peck School of Social Work with a joint appointment in the Daniel J. Epstein Department of Industrial and Systems Engineering in the USC Viterbi School of Engineering, Wu creates opportunities for new interdisciplinary connections to integrate social work science and practice, health policy and systems engineering. Prior to joining USC, she was a RAND researcher and co-director of the Roybal Center for Health Policy Simulation, where she was honored for her contributions to improving health policy and decision-making.
Recent Work
Demographic, Clinical, and Psychosocial Factors Identify a High-Risk Group for Depression Screening among Predominantly Hispanic Patients with Type 2 Diabetes in Safety Net Care
In this study, researchers identified the biopsychosocial factors associated with depression for patients with Type 2 diabetes, and reported that knowing biopsychosocial factors could help primary care physicians and endocrinologists identify a high-risk group of patients needing depression screening.
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Journal Articles
Low-Income Minority Patient Engagement with Automated Telephonic Depression Assessment and Impact on Health Outcomes
In this investigation of the dimensions of low-income minority patient engagement in the context of diabetes-depression care-management with automated telephone assessment (ATA) calls as a facilitator, the researchers identified barriers to aid the design and implementation of future automated screening and monitoring systems to optimize patient engagement.
Categorized in
Research
Journal Articles
Integrating Biopsychosocial Intervention Research in a Changing Health Care Landscape
This article demonstrated both need and opportunity to develop, apply, and test social work integrated biopsychosocial and technology activated care within a large safety net care system.


I can't believe that this still happens, but it does. A lot! And I'm disgusted by it. We need to spread the word that you shouldn't buy an animal for a pet if you aren't ready for a lifetime commitment.
The reason I'm bringing this up is because of this Facebook post I saw at a Texas no-kill shelter:
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That's right -- someone dropped off a three-month old puppy because it was GETTING TOO BIG! At three months. What the hell do you think happens to animals when they grow up?
Now, I completely understand getting your kids a pet. And I understand getting them one for a present, too. But if YOU the parent aren't prepared to take care of the pet for its whole life, then don't get it.
Your kids might not be old enough or responsible enough to care for it properly. That doesn't mean you return it. That means that YOU are responsible for it. And if you aren't ready to make a commitment to care for that animal for its entire life, then don't get it.
Please be sure to share this with anybody and everybody you can, because too many pets are euthanized every day due to people being selfish and stupid. And when you're ready for a pet, consider adopting a shelter pet first. You don't need a purebred animal; they aren't better than any other animal.


Cooking Camp Jr. seeks to teach kids kids life skills but in a way where they experience God and his desire for them to live a life that pleases him. We focus the experience around food and cooking while showing children how they intersect all parts of daily life including science, nutrition, family, and love for your community. Packed with activities like Bible Lessons, gardening, cooking, and community work, we seek to show them in a practical way what God can do.
Cooking Camp Jr. - Summer 2022
June 13th -17th Sign Up
Experience our week long VBS summer camp learning how to cook and how the food we eat intersects our lives through science,community, and God. Kids will be cooking there own food for lunch everyday in a safe environment. Kids 1st -6th welcome. 7th-12th grade students take on a leadership role as sous chefs, aiding working in addition to more advanced cooking.
Worker/ Helper Sign-up
Cooking Camp Jr. - Summer
June 13th -17th
With Having 50+ kids in our Cooking Camp Jr., We require a multitude of workers put on this production. If you feel you can help in areas like the kitchen, teaching, registration, or just being a group leader or aid we appreciate if you would sign up here and let us know where are some areas you desire to work. Thanks for your interest in volunteering for our camp.


It is possible to use AmenitizPay for the automation of payments so you can automatically charge your guests based on the rules that you have set. You will need to set these rules once and AmenitizPay takes care of the rest.
In order to activate AmenitizPay for the booking engine, go to AmenitizPay > Settings > Tick the box indicating Amenitiz booking engine and/or OTA.
Payments can be automated for each of your sales terms:
You can schedule the automated payment at booking, x days before the check-in or x days before the check-out.
For example, let's say you have two different types of sales terms: the standard sales terms and the non-refundable sales term for which you want to assign different payments rules.
Standard sales terms: Charge 75% at booking, and the remaining 25% five days before the check-in
Non refundable sales terms: Charge 100% at booking
Once that is done, your payments will be automatically charged based on the rules for all the bookings booked with those sales terms.


They paved paradise and put up a parking lot
With a pink hotel, a boutique, and a swingin hot spot
Dont it always seem to go
That you dont know what youve got til its gone?
They paved paradise, put up a parking lot
(Shoo-bop-bop-bop-bop
Shoo-bop-bop-bop-bop)
They took all the trees, put em in a tree museum
And they charged the people a dollar and a half just to see em
Dont it always seem to go
That you dont know what youve got til its gone?
They paved paradise, put up a parking lot
(Shoo-bop-bop-bop-bop
Shoo-bop-bop-bop-bop)
Hey farmer, farmer, put away the DDT now
Give me spots on my apples
But leave me the birds and the bees, please
Dont it always seem to go
That you dont know what youve got til its gone?
They paved paradise, put up a parking lot
(Shoo-bop-bop-bop-bop
Shoo-bop-bop-bop-bop)
Late last night, I heard the screen door slam
And a big yellow taxi took away my old man
Dont it always seem to go
That you dont know what youve got til its gone?
They paved paradise, put up a parking lot
I said, dont it always seem to go
That you dont know what youve got til its gone?
They paved paradise, put up a parking lot
They paved paradise, put up a parking lot
They paved paradise, put up a parking lot


Just before our love got lost you said
I am as constant as a northern star
And I said, Constantly in the darkness
Wheres that at?
If you want me Ill be in the bar
On the back of a cartoon coaster
In the blue TV screen light
I drew a map of Canada
Oh, Canada
With your face sketched on it twice
Oh, you are in my blood like holy wine
You taste so bitter and so sweet
Oh, I could drink a case of you, darling
And I would still be on my feet
Oh, I would still be on my feet
Oh, I am a lonely painter
I live in a box of paints
Im frightened by the devil
And Im drawn to those ones that aint afraid
I remember that time you told me, you said
Love is touching souls
Surely you touched mine
Cause part of you pours out of me
In these lines from time to time
Oh, you are in my blood like holy wine
You taste so bitter and so sweet
Oh, I could drink a case of you, darling
Still Id be on my feet
I would still be on my feet
I met a woman
She had a mouth like yours
She knew your life
She knew your devils and your deeds
And she said
Go to him, stay with him if you can
But be prepared to bleed
Oh, but you are in my blood, you are my holy wine
Youre so bitter, bitter and so sweet
Oh, I could drink a case of you, darling
Still Id be on my feet
I would still be on my feet


Rows and floes of angel hair
And ice cream castles in the air
And feather canyons everywhere
Ive looked at clouds that way
But now they only block the sun
They rain and snow on everyone
So many things I would have done
But clouds got in my way
Ive looked at clouds from both sides now
From up and down, and still somehow
Its cloud illusions I recall
I really dont know clouds at all
Moons and Junes and Ferris wheels
The dizzy dancing way that you feel
As every fairy tale comes real
Ive looked at love that way
But now its just another show
You leave em laughing when you go
And if you care, dont let them know
Dont give yourself away
Ive looked at love from both sides now
From give and take, and still somehow
Its loves illusions I recall
I really dont know love at all
Tears and fears and feeling proud
To say I love you right out loud
Dreams and schemes and circus crowds
Ive looked at life that way
But now old friends are acting strange
They shake their heads, they say Ive changed
Well somethings lost, but somethings gained
In living every day
Ive looked at life from both sides now
From win and lose and still somehow
Its lifes illusions I recall
I really dont know life
At all
Ive looked at life from both sides now
From up and down and still somehow
Its lifes illusions I recall
I really dont know life
At all


Its coming on Christmas
Theyre cutting down trees
Theyre putting up reindeer
And singing songs of joy and peace
Oh, I wish I had a river I could skate away on
But it dont snow here
It stays pretty green
Im gonna make a lot of money
Then Im gonna quit this crazy scene
I wish I had a river I could skate away on
I wish I had a river so long
I would teach my feet to fly
Oh, I wish I had a river I could skate away on
I made my baby cry
He tried hard to help me
You know, he put me at ease
And he loved me so naughty
Made me weak in the knees
Oh, I wish I had a river I could skate away on
Im so hard to handle
Im selfish and Im sad
Now Ive gone and lost the best baby
That I ever had
I wish I had a river I could skate away on
I wish I had a river so long
I would teach my feet to fly
Oh, I wish I had a river I could skate away on
I made my baby say goodbye
Its coming on Christmas
Theyre cutting down trees
Theyre putting up reindeer
And singing songs of joy and peace
I wish I had a river I could skate away on


Blue
Songs are like tattoos
You know Ive been to sea before
Crown and anchor me
Or let me sail away
Hey, blue
There is a song for you
Ink on a pin
Underneath the skin
An empty space to fill in
Well, theres so many sinking now
You gotta keep thinking
You can make it through these waves
Acid, booze, and ass
Needles, guns, and grass
Lots of laughs
Lots of laughs
Everybodys saying that
Hells the hippest way to go
Well, I dont think so
But Im gonna take a look around it, though
Blue, I love you
Blue, there is a shell for you
Inside youll hear a sigh
A foggy lullaby
There is your song from me


Sitting in a park in Paris, France
Reading the news and it sure looks bad
They wont give peace a chance
That was just a dream some of us had
Still a lot of lands to see
But I wouldnt wanna stay here
Its too old and cold and settled in its ways here
Oh, but California
California, Im coming home
Im going to see the folks I dig
Ill even kiss a Sunset pig
California, Im coming home
I met a redneck on a Grecian isle
Who did the goat dance very well
He gave me back my smile
But he kept my camera to sell
Oh, the rogue, the red red rogue
He cooked good omelets and stews
And I might have stayed on with him there
But my heart cried out for you, California
Oh, California, Im coming home
Oh, make me feel good rock n roll band
Im your biggest fan
California, Im coming home
Oh, it gets so lonely
When youre walking
And the streets are full of strangers
All the news of home you read
Just gives you the blues
Just gives you the blues
So I bought me a ticket
I got on a plane to Spain
Went to a party down a red dirt road
There were lots of pretty people there
Reading Rolling Stone, reading Vogue
They said, How long can you hang around?
I said a week, maybe two
Just until my skin turns brown
Then Im going home to California
California, Im coming home
Oh, will you take me as I am
Strung out on another man
California, Im coming home
Oh, it gets so lonely
When youre walking
And the streets are full of strangers
All the news of home you read
More about the war
And the bloody changes
Oh, will you take me as I am?
Will you take me as I am?
Will you?
Will you take me as I am?
Hmmm mmmmm
Take me as I am


I am on a lonely road and I am traveling
Traveling, traveling, traveling
Looking for something, what can it be?
Oh, I hate you some, I hate you some, I love you some
Oh, I love you when I forget about me
I want to be strong, I want to laugh along
I want to belong to the living
Alive, alive, I want to get up and jive
I want to wreck my stockings in some jukebox dive
Do you want, do you want, do you want to dance with me, baby?
Do you want to take a chance
On maybe finding some sweet romance with me, baby?
Well, come on
All I really, really want our love to do
Is to bring out the best in me and in you too
All I really, really want our love to do
Is to bring out the best in me and in you
I want to talk to you, I want to shampoo you
I want to renew you again and again
Applause, applause, life is our cause
When I think of your kisses, my mind see-saws
Do you see, do you see, do you see how you hurt me, baby?
So I hurt you too
Then we both get so blue
I am on a lonely road and I am traveling
Looking for the key to set me free
Oh, the jealousy, the greed is the unraveling
Its the unraveling
And it undoes all the joy that could be
I want to have fun, I want to shine like the sun
Want to be the one that you want to see
I want to knit you a sweater
Want to write you a love letter
I want to make you feel better
I want to make you feel free
Want to make you feel free
I want to make you feel free


Phillips was signed as a solo artist with Myrrh Records under her given name and recorded four Christian pop albums : Beyond Saturday Night , Dancing with Danger , Black and White in a Grey World and , The Turning .


In addition to being named Top Female Vocalist by the Academy of Country Music ( ACM ) twice and Female Vocalist of the Year by the Country Music Association ( CMA ) , she also won a Grammy Award ( earning seven nominations ) , People 's Choice Award and an American Music Award ( AMA ) .


Since the introduction of the 50 / 50 voting system in 2009 , the juries and the voters have disagreed on the winner on five occasions , in Eurovision Song Contest 2011 , Eurovision Song Contest 2015 , Eurovision Song Contest 2016 , Eurovision Song Contest 2018 and Eurovision Song Contest 2019 .


Barney Bubbles directed several videos , including the Specials ' Ghost Town , Squeeze ' s Is That Love and Tempted , Elvis Costello ' s Clubland and New Lace Sleeves , and Fun Boy Three ' s The Lunatics Have Taken Over the Asylum .


Singer Marcia Barrett ( from Jamaica ) joined the group , who brought in Liz Mitchell , a former member of the Les Humphries Singers and Boney M. was finalised .


Reed 's 1984 album New Sensations marked the first time that Reed had charted within the US Top 100 since 1978 's Street Hassle , and the first time that Reed had charted in the UK altogether since 1976 's Coney Island Baby .


In 1970 , Korner and Thorup formed a big-band ensemble , CCS - short for The Collective Consciousness Society - which had several hit singles produced by Mickie Most , including a version of Led Zeppelin ' s Whole Lotta Love , which was used as the theme for BBC 's Top of the Pops between 1970 and 1981 .


The territory band s operating out of Kansas City , the Bennie Moten orchestra , Jay McShann , and the Count Basie Orchestra were also concentrating on the blues , with 12-bar blues instrumentals such as Basie 's One O 'Clock Jump and Jumpin ' at the Woodside and boisterous blues shouting by Jimmy Rushing on songs such as Going to Chicago and Sent for You Yesterday .


In February 1984 , Queen released their eleventh studio album , The Works , which included the successful singles Radio Ga Ga , Hammer to Fall and I Want to Break Free .


After Ice Cube made a cameo appearance in Dr. Dre 's Let Me Ride video in 1993 , the two recorded the hit song Natural Born Killaz for Snoop Doggy Dogg ' s 1994 short film and soundtrack Murder Was the Case .


CONTENTS GREAT BRITAIN AT THE COMMENCEMENT OF THE YEAR 1843 LESURQUES; OR THE VICTIM OF JUDICIAL ERROR CALEB STUKELY PART X


BY WALTER SAVAGE LANDOR TASSO AND CORNELIA THE WORLD OF LONDON SECOND SERIES PART I


THE DREAM OF LORD NITHSDALE TWO HOURS OF MYSTERY THE EAST AND SOUTH OF EUROPE THE CURSE OF GLENCOE


Greg/Phillip,  Attached is the Grande Communications Service Agreement.
The business points can be found in Exhibit C.  I Can get the Non-Disturbance agreement after it has been executed by you and Grande.
I will fill in the Legal description of the property one I have received it.
Please execute and send to:  Grande Communications, 401 Carlson Circle, San Marcos Texas, 78666 Attention Hunter Williams.
<<Bishopscontract.doc>>

Greg/Phillip, Attached is the Grande Communications Service Agreement.
The business points can be found in Exhibit C. I Can get the Non-Disturbance agreement after it has been executed by you and Grande.
I will fill in the Legal description of the property one I have received it.
Please execute and send to: Grande Communications, <NUMBER> Carlson Circle, San Marcos <STATE>, <NUMBER> Attention Hunter Williams.
<<Bishopscontract.doc>>

bishopscontract doc hunter williams agreement executed grande exhibit non disturbance communications service attached legal description property marcos state number


Phillip & Keith  Attached is the first draw request, I will need some of these funds immediately.
I think checks out of Bishops Corner, L.P. may be the easiest, or you can wire money to me and I can write the checks when needed.
Please let me know how you wish to handle this and I will proceed.
Additionally, it is getting close to closing.
I will need to get contracts signed at this point as soon as possible.
We can handle this in two ways.
I prefer that you elect me as a Vice - President of the General Partner and then I will sign all documents, or I can Federal Express contracts (this is more difficult).
I have a funeral at 10:00 and I will be back about 1:00.
I look forward to hearing from you.
Greg     - Draw # 1 - 10.25.01.xls

Phillip & Keith Attached is the first draw request, I will need some of these funds immediately.
I think checks out of Bishops Corner, L.P. may be the easiest, or you can wire money to me and I can write the checks when needed.
Please let me know how you wish to handle this and I will proceed.
Additionally, it is getting close to closing.
I will need to get contracts signed at this point as soon as possible.
We can handle this in two ways.
I prefer that you elect me as a Vice - President of the General Partner and then I will sign all documents, or I can Federal Express contracts (this is more difficult).
I have a funeral at <NUMBER>:<NUMBER> and I will be back about <NUMBER>:<NUMBER>.
I look forward to hearing from you.
Greg - Draw # <NUMBER> - <NUMBER>.00.xls

contracts signed elect vice president handle proceed additionally hearing greg draw phillip let know close closing request need funds bishops corner easiest


Your Internet Banking accounts are now setup again for accessing.
The login id is still your main acct.
# with the password being reset to the last six (6) digits of your ssn# (this is the ssn# or tin# of the primary account holder).
You will then be directed to a screen that asks for information such as: Name Address City, State Zip+4 Phone # E-Mail Address  After entering this information and clicking submit, you will then be instructed to change your password to anything that you desire.
Always remember that your password is case sensitive.
One major change is the wording of your accounts names (they have changed to product types and not descriptions).
You can change your account descriptions by clicking on the Nicknames button and entering your own account description.
We are still working on getting the information to post again correctly (your old account information has been removed, and we hope to have this information converted shortly and back on-line), so you will notice that credits and debits do not show up in the appropriate columns.
Transaction descriptions are correct and the balances information is correct as of our last day of processing (11/16/01).
We appreciate your patience and continued support.
Our goal is to be fully operational and all information corrected before the holiday season.
Please make sure to record any suggestions (or problems) that you might have concerning our web site.
Again, thanks for banking with State Bank & Trust and happy surfing.
Sincerely,

Your Internet Banking accounts are now setup again for accessing.
The login id is still your main acct.
# with the password being reset to the last six (<NUMBER>) digits of your ssn# (this is the ssn# or tin# of the primary account holder).
You will then be directed to a screen that asks for information such as: Name Address City, State Zip+<NUMBER> Phone # E-Mail Address After entering this information and clicking submit, you will then be instructed to change your password to anything that you desire.
Always remember that your password is case sensitive.
One major change is the wording of your accounts names (they have changed to product types and not descriptions).
You can change your account descriptions by clicking on the Nicknames button and entering your own account description.
We are still working on getting the information to post again correctly (your old account information has been removed, and we hope to have this information converted shortly and back on-line), so you will notice that credits and debits do not show up in the appropriate columns.
Transaction descriptions are correct and the balances information is correct as of our last day of processing (<NUMBER>/<NUMBER>/<NUMBER>).
We appreciate your patience and continued support.
Our goal is to be fully operational and all information corrected before the holiday season.
Please make sure to record any suggestions (or problems) that you might have concerning our web site.
Again, thanks for banking with State Bank & Trust and happy surfing.
Sincerely,

primary types descriptions change state zip number button entering converted shortly line holiday season make patience continued internet banking accounts site thanks