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FIG. 8. The effects of antiandrogens on the Adiol-induced transcriptional activity of AR. CAT activity was determined in PC-3 cells transiently cotransfected with wtAR or mtAR877, in DU145 cells with ARA70 and wtAR or mtAR877, or in LNCaP cells without cotransfection of AR expression vector. After transfection, 1 M HF or casodex was added simultaneously with 2 nM Adiol or 1 nM The first bars show the activity of Adiol alone or T alone, respectively set as 100% ; . Values represent the means SD of at least three determinations.
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Ment. Little or no benefit for the combined approach over castration therapy alone, has been found in patients with regional or metastatic prostate cancer. Labrie et al. 23 ; demonstrated that total androgen blockage caused more than a 90% reduction in serum T level, but only a 2649% reduction in the serum adrenal androgen level. Blocking the activity of the remaining Adiol 12 nM in patient's serum ; may, therefore, be worthy of consideration. To investigate the effects of antiandrogens in conditions mimicking those of patients with advanced prostate cancer, we set up a transient transfection system by using human prostate cancer cell lines. PC-3 and DU145 cotransfected with wtAR or mtAR877, and LNCaP without transfection of the AR, were cultured in media with charcoal-stripped serum, in the presence of 2 nM Adiol plus 1 M HF casodex. As shown in Fig. 8, these antiandrogens only marginally reduced CAT activities mediated by Adiol, although T-mediated AR transcriptional activity could be reduced significantly. These only marginal reductions were observed irrespective of whether wtAR or mutant AR species were present. This observation suggests that treatment with HF or casodex, in combination with castration may be insufficient to block Adiol's action in AR-positive prostate cancer and may provide a possible explanation for the well documented disappointing clinical findings. This becomes even more of an issue as antiandrogenic therapies, either alone or in combination with castration, have been advocated for earlier stages, and even prevention of prostate cancer 24, 25 ; . The development of new therapeutic approaches that block Adiol's androgenic action, therefore, are worth investigating.
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92 -- EVIDENCE OF POSTMENOPAUSAL OSTEOPOROSIS IN SUB-SAHARAN AFRICA, ASSOCIATED WITH A LOW RATE OF FRACTURES Echouffo TJB, MD Biyem-assi District Hospital, Cameroon, Zebaze N. Bernard, Laboratory Technician Ndooh-djuttitsa Medical Centre, Cameroon, Ebah L Makoge, MD University Teaching Hospital, Yaounde, Cameroon, Banseka T. Edwin, MD Djeumen W. Charly, MD, The University of Dakar, Dakar, Senegal, Bronson B. Wendell, DO FACR, St Joseph, MO, Zebaze M. Roger, The University of Melbourne, Australia and zebeta, for example, bicalutamide. Documenting therapeutic trial and clinical failure the pharmacy and therapeutics committee has approved the requirement for a physician to show documented evidence of therapeutic trial and clinical failure of a drug or drug class before priority medicare plans will authorize the use of specific agents.

Nominations Committee, chair of the Legislative Committee, and as president of the Board of Trustees for FMCP, where he led efforts to promote the value of managed care pharmacy and pharmaceuticals. The AMCP Distinguished Service Award recognizes an AMCP member for exceptional and sustained volunteer service and commitment to the Academy. Candidates for this award must have at least five years of extraordinary volunteer service to the Academy and must have been involved in activities critical to the achievement of AMCP's mission. A selection committee made up of AMCP board members and committee chairs who are appointed by the AMCP president chooses the award recipient. In choosing Sterler for this award, the committee recognized not only his many leadership roles within AMCP, but also his continuing efforts to represent t e h Academy and the profession of pharmacy to external audiences, to educate them about the value and importance of pharmacy. Sterler has represented AMCP before the Food and Drug Administration in discussions regarding the agency's authority over health plans and pharmacy benefits management companies. He has also participated in the White House Summit and other meetings relating to Y2K planning and drug stockpiling; spearheaded talks with the Centers for Disease Control and Prevention regarding the role of pharmacists in assisting public health initiatives; and has been a frequent participant in AMCP Lobby Days, representing the Academy and its members on Capitol Hill. Sterler authored the chapter on pharmacy distribution systems and network management in the classic textbook Managed Care Pharmacy Practice; serves as AMCP's diplomat to his alma mater, South Dakota State University; and was among the first of AMCP's e-mail mentors, working with students to help them understand the complexities of managed care pharmacy practice and bupropion.

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Medical management of overactive bladder and isoptin. When the cancer has spread beyond the prostate, going to either the lymph nodes or bones, hormone therapy may be very effective at shrinking the tumour and reducing the side effects of the disease. It does not provide a cure, but will often keep the cancer in check for a number of years. This is also useful if the cancer has spread outside the confines of the prostate gland, but has not yet reached the lymph nodes or bones. The prostate gland and prostate cancer are under the influence of testosterone, the male sex hormone, which drives the tumour to grow and spread. By blocking the body's production of testosterone, or blocking its action, the growth of the tumour may be greatly reduced. The therapy prescribes the use of tablets to block the effects of testosterone anti-adrogens i.e. Casodex, Cyproterone acetate ; or implants to prevent the production of testosterone by the testicles LH-RH analogues, i.e. Prostap, Zoladex.
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Ischaemic heart disease is the major cause of mortality among diabetic patients. The risk of re-infarction is increased by 50% for diabetic patients and their risk of long term mortality from coronary disease is double that of post MI non-diabetic patients. The risk of recurrent MI in diabetic women is twice that of diabetic men. Long term insulin therapy has significant survival benefit for diabetic patients8 All patients whose blood sugar level has been found to be 10.9 mmols will have been started on insulin therapy in hospital. N.B. Elderly patients will be assessed on an individual basis. All known diabetic patients controlled by diet and tablets will have been changed to insulin therapy, for example, eulexin.
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