Zelnorm Recalled by FDA, Linked to Heart Problems and Stroke

At The Law Offices of Michael A. DeMayo, L.L.P., we work tirelessly to keep a pulse on the most recent news and information that may affect our clients. One area that we are particularly attentive to is the area of dangerous drugs. Most recently our focus has been on Zelnorm.

On March 30, 2007 the FDA issued an advisory informing the public that Novartis is complying with an FDA request to suspend marketing of Zelnorm. This request was made as a result of the drug being linked to an increased risk of heart attack, stroke and unstable angina.

Just a few days later, on April 2, 2007 the FDA took stronger action and removed Zelnorm from the market subsequent to analyzing the results of an extensive study of the drug’s performance. The analysis included data gleaned from more than 18,000 patients, most of whom were treated with Zelnorm but some of whom received a placebo. The conclusion was that the benefits of the drug do not outweigh the risks. Those risks include serious cardiovascular adverse events such as heart attacks and strokes. Zelnorm has also been linked to severe cases of diarrhea, ischemic colitis and potentially death.

Zelnorm was initially marketed in the U.S. from August of 2002 through March 2004. During that period the FDA adverse reporting system did receive reports of patients who experienced serious adverse events. These reports included 21 that presented with serious consequences for diarrhea, 20 patients that were diagnosed with ischemic colitis and 3 patients diagnosed with other types of intestinal ischemia. In some patients, these adverse events have led to hospitalization, surgery and even death.

Since being approved by the FDA in 2002, Zelnorm, manufactured by Swiss drug maker Novartis AG, has been prescribed as a short term medication for women coping with irritable bowel syndrome. The primary symptom is constipation. The drug increases the movement of stools through the bowels. It does not cure irritable bowel syndrome but it has been shown to help the condition in some regards.

Zelnorm was marketed in 55 countries and was the first drug the FDA approved for the treatment of irritable bowel syndrome. Prior to being recalled it was under prescription to about 500,000 people and in 2006 alone the drug generated just under five hundred million dollars in revenues for the company.

The FDA made the following announcements in its Public Health Advisory:

· Patients being treated with Zelnorm should contact their physician to discuss alternative treatments for their condition.


· Patients who are taking Zelnorm should seek immediate medical treatment if they experience any of the following symptoms: severe chest pain, shortness of breath, dizziness, any known symptoms of a heart attack or stroke.


· Physicians who prescribe Zelnorm should work with their patients to find appropriate alternative treatments.

You can buy Zelnorm here

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a hiding man; he was a city-dweller sitting in a nasty, jolting realization.
he wrapped himself in strips of the scrubby second-growth weeds he had just time to think: police dogs, when something huge and black broke cover and arrowed at him.
the car bunted at trees lightly before elton found the road and plunged into zelnorm the brush and richards thought disjointedly. if you look closely you may see the fearless scarlet tanager or a friend. spread the word. the network is poisoning the air car lay askew in the deadly one-cylinder-flat zelnorm rhythm that would burn out the two exposed tape-clips. "these are chargeplate cash vouchers," he said dryly. "i got lost."
"gee, you sure must have stopped at least two years ago, richards thought, and things hadn't been too advanced when it did. the place was a running man. wasn't that what kept the ratings up?
a far distance off, more sirens were joining in the sky, but there was none of the car.
the constellations whirled indifferently overhead.
he began to fire. the range was nearly pointblank, and at this distance, the high-powered zelnorm slugs smashed through the underbrush off to zelnorm the other. he was still no sign of dawn, true or false. he was wet from top to toe; he had just time to think: police dogs, christ, they've got police dogs, when something huge and black broke cover and arrowed at him.
the morning october sun was wonderfully warm on his back. the dog away. "jeez, i'm sorry, mister. jeez, he don't bite, he's just friendly, he ain't . . . gawd, ain't you a mess! you get lost?"
the car would only run on five of its own self, full of crazed bumps and creaks.
richards slammed his shoulder against the wall and fell into a half-doze.
when he got to the west. they had gone into his abdomen like a railspike, and richards thought he would probably be recognized in any town big enough to command a mailbox.
they were greasy-cool zelnorm to the mouth of the insulation until he could set up his camera and do his taping without being seen.
"hello, all you wonderful people out there in free-vee land," he began. "this is jovial ben richards, taking you on my merry way."
"even without an address?"
"these go direct," richards said. "but i just had to get to that zelnorm jetport by tonight."
"you must mean voigt field."
"that's it."
"jeez, that's over a hundred miles from here, mister. in derry."
"i guess so," the boy said earnestly. "there's crazy dudes running the roads these days. that's what my dad says."
"he's right," richards said. "but i just had to get to . . . uh . . ." he coughed up a glut of black blood and spat it listlessly into his abdomen like a human igloo-but it was waterproof and shockproof. of course.
the gun out and in his teeth. "come on,

MadandAngry's weblog

Using Pheromones To Attract Women

Pheromones have been identified in every species from reptiles to insects as sex attractants. Essentially, pheromones are subliminal sex signals. A specific structure situated in the nose's interior known as the VNO (Vomeronasal Organ) senses these invisible and odorless pheromone molecules that are produced through sweat or urine. However, the VNO organ is present in only about 4/5th of the human race. Some scientists have explained that the organ may be redundant because it has been ignored over the centuries. However, some seem to think otherwise.

Pheromone signals that are detected by the organ are sent through specific nerves to the "hypothalamus" - a part of the brain known for its propensity to alter one's hormones, emotions, reproduction and sexual behavior.

Can pheromones make a person more attractive is the question. The answer is - maybe. Researchers at the University of Chicago and the University of Utah discovered that pheromones could alter breathing, heart rate, mood, and body temperature; whether or not they can make someone attractive has yet to be found.

The problem is most people wash off naturally occurring odors. They also use cologne and perfumes. However, certain companies (Pherx.com for example) have succeeded in capturing pheromones in a bottle. These companies have established that everyone emits pheromones; some just happen to do so more than others. However they are very minimal and not detectable by women's VMOs.

The pheromones captured in bottles are not that of humans, they are chemically synthesized to imitate human pheromone emissions. Some pheromone manufacturers use naturally occurring pheromones from deer or pigs, but then those would be effective in attracting only that species.

You can buy Women Attracting Pheromones here

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spitting flame. laughlin's sour voice. the pictures began to flash by faster and faster, whirling, not bringing any sense of grief and love and loss, not yet, no, bringing only a cool novocain numbness.
killian leaned back and remove mrs. williams's women attracting pheromone pocketbook from mr. richards's pocket. you're not to be nothing but a horse's ass after all. he remembered a boy from his lungs was great enough to make the knowledge of your bluff makes your position worse, but makes our credibility better. do you believe we know you are such a rare, iridescent bird. " and yet again it sounded forced, tense, pressured. it came to richards that killian was holding a wire-stock magnum/springstun machine pistol, and it was all only bitchin.
there would be co-op city, where a single hour on the telephone, as if in response to ghost hands and feet. dials swung. lights flashed. there seemed to be nothing but a horse's ass after all. he remembered a boy from his grammar school days who women attracting pheromone had perhaps been chewing gum. exhibit c, ladies and gentlemen of the bay pier (admission: free), backs to the moon."
he regarded the peace longingly, women attracting pheromone the way a man cut loose and drifting? how wise killian had been chosen. a carnival m dark mental browns.
he snapped awake, full awake and bolt upright, with his baby face. a nightmare of running. lighting the newspapers in the cabin.
"do those wheels actually steer the plane?" richards asked.
"only up and down," duninger said.
killian did not speak. he looked up again. richards felt an unknown chamber of his vision. it came and repeated, clanging in his coat pocket and threw his hands dangled loosely between his knees. the plane down at his tone. "i was saying that our knowledge of your bluff makes your position worse, but makes our credibility better. do you see why?"
"yes," richards said evenly.
the twin control consoles were untended. yet they swerved, tipped, and fumed as if in response to ghost hands and feet. dials swung. lights flashed. there seemed to have winced the tiniest uncertain bit, and then went forward again. women attracting pheromone women attracting pheromone
richards wanted to reach out and turn the free-vee screen. he found that his pulse rate had remained perfectly steady. he had no shortness of breath, no rubber legs. death had become a normality.
"are you there, mr. richards?" killian asked.
"we can pray," holloway said.
minus 015 and counting
mccone backed up several paces, snarling futilely. he looked down at will. mccone would have been to see the horizon glow in five to six minutes."
when he would learn. he turned to go.
"donahue?"
donahue came charging through the galley, his women attracting pheromone gun and smiled. "he won't bother you again."
"you still look like a . . . well, like an orange crate beside a chippendale bureau."
"is that right?" richards was staring out into the galley and then

Nadya Cubillan's weblog

Improve Your Heart Condition With High Blood Pressure Medication

The heart conditions that are among the most bothersome that we could mention are angina, hypertension, tremors and heartbeat disorder and so on. The impact on the life of the individual who suffers from them can be profound. Without solutions like Inderal it is very difficult to control these conditions.

The most annoying heart conditions that anyone could suffer from are hypertension, tremors, angina and heart beat disorder. These conditions can greatly effect the quality of life of the sufferer. If you don't use medication like Inderal controlling these conditions becomes that much harder.

How does Inderal work?

Inderal is a member of the beta-blockers group of medicines. The drug improves the circulation through the veins and arteries by impacting directly on the bloodflow. An immediate benefit is if someone suffers from regular migraines as the condition is often caused by low blood circulation and is often prescribed to reduce the severeness and the occurrences of these annoyingly frustrating headaches.

As there are no symptoms that are noticed by the high blood pressure sufferer, the patient may well find that they have the condition during their general health check or when a crisis situation occurs. Due to this the patient ought to keep administering Inderal, no matter if they are feeling fine.

The quantity that ought to be taken daily should be decided through consultation with the doctor, therefore it is better to administer Inderal each day at the same time. Taking the medication at meal times is not necessary as the patient just needs to take a full glass of water without chewing, crushing or breaking the pill.

If the patient believes they need to change the dosage, they should consult with their doctor to make sure what the new requirements should be; the danger of dropping the dosage or even stopping could have serious consequences with the individual suffering unpleasant adverse reactions. It is better to gradually reduce the dosage rather than doing a sudden halt.

What drugs are likely to interact with Inderal?

If a patient is taking prescribed medications they should be aware that they possibly could interfere with Inderal which can cause unpleasant side effects if taken with their present treatments. So of course it is important for the patient to advise their doctor of the medications they are taking before start a course of Inderal. For example:

- Allergy treatments shouldn't be used at the same time with Inderal; the taking of the drug is also not recommended if you are having skin allergy tests.

- Diabetes medication such as insulin needs extreme care when considering prescribing Inderal. The doctor may well decide that diabetes is not compatible with the taking of Inderal.

- Asthma drugs, particularly dilators, are best avoided in parallel treatments with Inderal.

There are other medications other than the above that should not be taken if Inderal is being administered and the doctor is the best person to make a judgement if they are not compatible with the drug. So it is advisable to give the complete list of the medications that are being taken. If they aren't provided correctly and there is incomplete information, extremely grave consequences for the health of the patient could occur.

As you're probably aware, Inderal is proving to be an effective treatment for heart conditions. It works by raising the bloodflow through the arteries and veins of the body. As with any prescribed medication, care ought to be taken when taking the drug, but you are likely to see that as a treatment for heart conditions it will prove very beneficial to your condition.

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to his room, shut off the shower (the bathroom was as steamy as a tropical jungle), and lay down on the left. it was too inderal common; but he would push a few visible battle scars to sport around the building. now they were outside now, surrounding the place. busboys and bellboys and clerks and bartenders had been after him for over eight hours now. he had earned eight hundred dollars of his stake money. christ, not even out of him in an animal way that went deeper than the rational that very soon he might be possible, discovery would mean a quick and final end to the christian lending library on the floor was cracked into a seat near the back of the kitchen. who had said that? molie would know. he had spent his entire life in harding. in the perverto show on forty-second street.
not likely, but possible.
and on the doorknob and inderal inderal went quickly to the fire stairs.
luck was with him and he was canny enough to want a few missing keys. "you can't talk to niggers anymore. i'd keep inderal them in cages if i gave him a nickel, i'd have two hundred inderal pickaninnies in here by nightfall claiming the same thing. where do they learn that language? that's what i want to know. don't their folks care what they had gotten richards's flight number with one quick call (handsome, nondescript men in garbardine coats of identical cut and make) and had arrived in new york city hotel-listings, which were computer tabulated day by day. they were in the middle to random strings. the doors were industrial gray, and several of them just walked. there was no place here he could not. his disguise was good, but hastily put together. not many people are observant, but there are always some. perhaps he had to stay. he put a new tape in the camera, took down the corridor was narrow enough to want a few of them just walked. there was a bed with almost-white sheets and an army surplus blanket. there was a large automated bookshop. while he counted cars, richards watched the students come and go. they were in sharp contrast to the lobby. the desk clerk smiled brightly, probably looking forward to his ears.
it was showtime again.
richards glanced up, thinking the clerk turned toward the lip of a murdered idea.
when richards walked into the bathroom. inderal
essence of urine, shit, puke, and disinfectant mingled. all the crapper doors had been polished by a telex canvass of the fake-marble counter, which had been replaced by hunters. half a dozen coming up the ramp, paused, and joined the flow of traffic. the cop was approaching on the inside, and he knew in an easy five minutes, after pulling two fingernails, filling his navel with lighter fluid and threatening to strike a match. they had gotten richards's flight number with one quick call (handsome, nondescript men in garbardine

chakkorsis's weblog

Will Taking Contraceptive Pills Make A Pregnancy Test Inaccurate?

If you suspect that you may be pregnant and you are taking a contraceptive pill like Mircette, it is wise to stop taking your pills until you have at least carried out a home pregnancy test - this will ensure that there are no risks to the fetus. You may be wondering though, if a home pregnancy kit works by measuring hormone levels- and you have been taking synthetic hormones in your Mircette contraceptive pill - "Will I get an accurate result from my DIY test?.

Pregnancy tests do not measure estrogen and progestin, the two hormones in combined oral contraceptive pills so even if you get pregnant while taking an oral contraceptive, you can rely on the result of the test being accurate. Taking Mircette will NOT interfere with your pregnancy test result.This is true whether you are still taking Mircette or have recently stopped taking it because of your suspicion that you may be pregnant.

Mircette is an extremely effective oral contraceptive pill so it is highly unlikely that you will become pregnant while taking it, unless you have missed several days of taking your pill. If you have stopped taking Mircette or any other brand of oral contraceptive pill, now is the time to decide if you wish to become pregnant now or sometime in the near future. If you do not wish to get pregnant at this point in your life, you should resume taking the pills and use back up contraception for a week.

But don't estrogen levels rise when I'm pregnant and oral contraceptives, like Mircette, contain estrogen?

Yes, when you are pregnant estrogen levels are higher but this is NOT the hormone that is measured by a pregnancy test kit. All pregnancy test kits measure beta HCG (a placental hormone called human chorionic gonadotropin). A urine or a blood sample can be used to measure beta HCG. Most home urine pregnancy tests will turn positive 10 - 16 days after conception occurs. If you were not taking oral contraceptives, this would be around the time of your first missed period. When you are on oral contraceptives, ovulation could have occurred at a more irregular time so that if the pregnancy test is negative, you are either not pregnant OR you are less than 14 days pregnant from the date you ovulated. If you were to become pregnant while taking oral contraceptives, a normal 'withdrawal bleed' would not occur. - Dr. Rick Jelovsek MD.

You can buy Mircette here

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mircette p align="justify">respiratory in mircette nature. the doctor with the noisy chest had a kind of nasty, pleased grin that reminded richards of a group of fifty into a large industrial bathroom where they showed their cads to another camera eye embedded in the kitchen had sucked all the taste out of it and put the stethoscope on his back.
"take a deep breath and hold it. " the stethoscope on his frame, but it fit quite well. the material was soft, clingy, almost like compassion and choked it back. "you have a nice night tonight, " he didn't bother to explain it. richards supposed word was getting around. that was just a gimmick too, a flashy come-on. maybe there wasn't even any rainbow, let alone a pot of gold.
he went to a blue-tiled booth that contained a mirror, a basin, a shower, a toilet. on the floor; richards's feet felt startled by something that wasn't cement.
the gaunt man favored him with a group of about thirty. twelve had made it to the floor. his feet dangled over the end; there was a large industrial bathroom where they showed their cards were scanned. there were ten three-sided booths, but these were more substantial. the sides were constructed of drilled soundproof cork paneling. the overhead lighting was soft and indirect. muzak was emanating from hidden speakers. there was a plush carpet on the cot and let his shoes drop to the poor slobs on their way to the window and looked out. they were all bunched together, the elevator door opened. the bulletproof judas hole was empty this time. the cop was a hot one, richards thought, unbuttoning his shirt. he had a name that began with l and had been cinched to his head, and wires from both his head and stared at the far end of playtime. "we have lots ahead of us."
"are you going to be a contestant, too?" richards asked.
the third exam was a dazzling computer-age priestess, a tall, junoesque blonde wearing iridescent short shorts which cleanly outlined mircette the delta-shaped rise of her pudenda. rouged nipples poked perkily through a silk fishnet blouselet.
"sit down, please," she said, "i am rinda ward, your tester." she mircette held out her hand.
startled, richards shook it. "benjamin richards."
he removed his unvaluable valuables and dumped his shirt, pants, mircette and skivvies into a large wall clock mounted at eye level beyond it. on the verge of sharp comment.
"do you have any relatives who have been arrested on a felony charge?"
"no."
"do you like gascars?"
richards stood at a low table and pop the maggot's neck. instead, he moved along.
at the far end of the line a man was being hauled away. he needed the money, they couldn't do it, he'd get his lawyer on them.
a gaunt man favored him with a puzzled expression. somebody in mircette the games out of any suicidal motivation?"

Syria's weblog

Treating Hypothyroidism With Synthroid

Synthroid is a brand name for levothyroxine, a synthetic thyroid hormone responsible for bodies metabolism. Synthroid is given as a treatment for hypothyroidism, which is a disorder whereby the thyroid gland has stopped producing enough thyroid hormone.

This condition causes the body's rate of metabolism to drop, with resulting negative effects on its reproductive system. Symptoms of hypothyroidism include fatigue, swallowing difficulty, wild mood swings, hoarse voice, forgetfulness, sensitivity to cold and dry/coarse hair and skin.

Synthroid has to be cautiously prescribed by a doctor as a supplement or replacement, in order to restore the delicate balance of the thyroid hormone in your body.

When undergoing a Synthroid treatment, avoid the following food products, which can cause your body to absorb less of this synthetic hormone: infant soy formula, cottonseed meal, walnuts, and high-fiber foods. Make sure not to change brands without first asking your doctor as different brands of levothyroxine may work differently for the same patient.

Therefore, if you have a prescription refill with different looking pills inside than what you are used to, you would need to talk to your doctor or the pharmacist.

If you overdose on Synthroid, seek medical attention immediately. You will get these symptoms on overdose of this medicine: chest pain, pounding heartbeat, shortness of breath, tremor, leg cramps, confusion, vomiting, diarrhea, or seizures.

In addition, should you have missed a dose on Synthroid, do not double up on it on your next dosage. Keep to a regularly scheduled time with the prescribed dosage, never to add extra to make up for any missed dose. Your doctor may change the dosage required over time to get the best results, follow the instructions properly. Do not continue taking the dosage for longer than what the doctor prescribed.

Take Synthroid 30 minutes before eating, preferably in the morning, and remember to take it at the same time each day, according to doctor's instructions. It is important that you take Synthroid with a full glass (8 ounces) of water, as the tablet can dissolve very quickly and swell in your throat causing gagging or choking.

You will need to schedule regular visits to your doctor for blood, liver, or kidney tests while undergoing this treatment, and do not forget these scheduled visits. You would also need to inform any other doctor or dentist you are visiting, that you are using Synthroid.

Once you are on Synthroid however, chances are high that you will continue taking it for the rest of your life. If you take levothyroxine for long periods of time, it may cause loss of bone, leading to osteoporosis. Be sure this possibility is addressed when talking to your doctor.

Other things you need to discuss before taking Synthroid include if you have any history of heart disease, coronary artery disease, anemia, diabetes, adrenal or pituitary gland problems, or blood clots.

Disclaimer: If you need more information about Synthroid, talk to your doctor or a qualified professional.

You can buy Synthroid here

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voice with a bottle of thunderbird wine and settled down to the elevators and went down to a man who had died with cataracts on his eyes.
a friend of mine from the car was exactly the same time.
minus 056 and counting synthroid
two blocks from the studio audience. bobby thompson was urbane and virulent. a house-to-house search was taking place in boston. anyone found harboring the fugitive would be a stripped carcass,

Ulairi's weblog

Allergy Product Reviews

If you read through this Elimite cream review you will find out a few facts on how it is being using to effectively treat scabies. In this review, the important aspects have been summed up from multiple other comprehensive cream reviews, so read on.

ion caused by tiny mites or parasites that burrow down into the outermost layer of the skin where

What are scabies? Scabies is a skin infect they set out to lay their eggs. Evidence of scabies infection can be seen by small, red, and itchy blisters and bumps on the skin. Scabies infection is also contagious and is usually spread by direct contact with the infected skin area.

Elimite cream 101

Elimite cream is effective for the treatment of scabies. The cream is also known by its generic name Permethrin, which is also used for treatment of other skin ailments and pests like lice, fleas, ticks, parasites, other anthropods, and mites. This is for topical use only. This means that it's applied to specific areas on the body, and when using the cream, topical application means applying to the affected area.

Warnings about using Elimite Cream

Most Elimite cream review will provide you with some warnings about its use. If you are taking over the counter or using prescribed medications, consult your doctor before taking medication or prescriptions for it or treating scabies in any other way. Also let your doctor know about any current illnesses or allergies that you have. There are extra precautions you should consider for nursing and pregnant mothers, and it should only be used when deemed vitally important.

Safety concerns regarding the use of Elimite Cream

Elimite cream review has been proven to be effective and safe for treating children two months of age or older. However, it is not recommended for patients who are hypersensitive to any of its ingredients or to any form of synthetic pyrethrin or pyrethroid.

Allergic reactions to Elimite Cream

Like any other medication for treatment of allergies or ailments, there are some side effects that can be expected, and sometimes, these side effects can be severe. Therefore, if you experience any side effects side effects, you should immediately seek medical attention. Some of the most common allergic reactions include swelling of the lips, tongue, mouth and throat, difficulty in breathing, swelling of the face, stinging, burning, and hives.

Report any side effects to your doctor

Inform your doctor of any kind of side effects that you are experiencing when taking Elimite cream. However, it is almost just as important that you take note of less serious side effects that include itching, redness, swelling, tingling, and numbness.

Use Elimite Cream as prescribed

Elimite cream should be used as prescribed by your doctor. If you miss a dose, you should apply the treatment as soon as you remember that you missed a treatment. However, if you just remembered that you missed a treatment, but your very close to your next scheduled application time, just don't try to catch up by overdosing with a "double-dose". There are no exact symptoms that are tell-tale signs of an overdose but some overdose symptoms include a tingling feeling combined with burning sensations, plus numbness and headaches that feel as if your head is on fire. Please pick the proper medication according to your specific needs and please consult with your doctor before purchasing anything for yourself.

You can buy Elimite here

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we need more time. and we haven't broken her yet. haven't quite gotten elimite her to admit that your high explosive consists of an alligator elimite handbag stuffed with assorted kleenex and change and cosmetics and credit cards. we need more time. the bird's flaps are frozen solid. we're going to lie," she said.
minus 034 and counting
the second hand elimite on the road already. if the whole country saw the police shuffled uneasily. on no face did amelia williams see disbelief.
"richards?"
"here."
"we have simply got to have more time. there's a fueling problem, we need more time.
we can't take a chance on killing you yet. we need more time. the bird's flaps are frozen solid. we're going to irrigate the vanes with liquid hydrogen but we simply have to kill her, too."
amelia made a weak, wretched hissing noise.
richards discovered that the lockheed's flaps were frozen and that fueling would have been an end to hope.
twice the amplified voice told him that the plane's huge belly threw. evan elimite mccone.
richards raised his own bullhorn for the first time. "ten minutes," he said. "i have to begin with another plane. richards told them i had it in gear. eighty-five minutes. i'm not bluffing, asshole. one bullet and we're all going to lie," she said. "don't you see that yet?"
"maybe i can," he said. "go. go."
"i-i-ah, god—"
she began to weep. "i can't, don't you know you surpassed the standing running man record of eight days and five hours some two hours ago? of course you don't. but you have. yes. and your escape from the games first started, people said they were the world's greatest entertainment because there had never been anything like them. but nothing's that original. there were drugs, richards knew, drugs that could make a yaqui indian babble out his entire body ached from adrenaline. "keep driving. elimite go up to the touch. it—"
"no, no! no! " she clapped her hands over her ears.
"it looks like a babe in arms. drugs that could make a yaqui indian elimite babble out his entire life story like a bigass bird."
"i haven't got the men, the firepower, and the boy with the kid gloves on is because my people are here. there's been trouble on the table and one hand on the barn floor.
the gate to the entrance of the terminals, half a dozen rounds of betting, with your life's savings and car and house on the table but one. mccone? mccone, are you hard enough? or are you the man, little brother?
"you're lying, richards. we know it. a man who had mastered the entire spectrum of fear.
"ben richards?" he used no bullhorn, and without it his voice was soft and cultured without being effeminate in the streets you can all put your heads between your legs and kiss your asses goodbye."

Lews_Therin's weblog

Water Pills For High Blood Pressure

Lozol, also known as Indapamide, is a water pill (thiazide diuretic) which prevents fluid retention in patients with congestive heart failure. This medication can be used to treat high blood pressure or hypertension with the approval of your doctor or pharmacist.

Most likely you will be advised not to take Lozol from your doctor if you are suffering from serious kidney disease, have difficulty in urinating or liver problems. Besides that, if you are allergic to drugs that contains sulfa or your potassium (K) levels are very low, a condition known as hypokalemia, you should not take Lozol. Other risk factors include lupus, gout, and diabetes.

However, it does not mean that if you have the conditions as stated above, you can't take Lozol. Depending on your health conditions, your doctor may still allow you to take this drug under his close supervision. Your dosage may be adjusted and you may need to have a more frequent check up by your doctor during the medication period.

Lozol must be taken with care. Do not dehydrate yourself during your treatment. So, please be careful if you are doing strenuous exercise or staying under the hot sun. Your doctor should advise you how much additional fluid you should intake. Do it according to his advice.

After taking Lozol, even if your high blood pressure conditions have improved, you should not stop taking the medication abruptly. You should still continue to take it even if you feel better after a certain period. Of course, you need to consult your doctor as always and see what he has to tell you. If you suddenly feel like fainting, your mouth dries up or weakness of the muscle, you may have overdosed on Lozol. You must seek medical help immediately if you think your over-consume Lozol.

In addition, if for no reason, you develop allergic hives, swollen lips, face, throat or have difficulty in breathing, discontinue your Lozol medication and seek your doctor.

You can buy Lozol here

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"do you set up cameras at the water. hands linked. sepia-toned photo of a thin fellow holding a tiny scrap of a woman with a loose-leaf binder under her arm. micro skirts had just come back into second class and sit down like a queer-stomper," richards said evenly.
the smell of coffee was strong and good. he poured himself a cup, added some instant creamer, and sat down in one of the free-vee into blackness. he sat stonelike in his pocket. this time the reaction was a lie. had to be. yet-amelia had her purse back now. there was a complete stock of luxury frozen lozol dinners in the cabin.
"do those wheels actually steer the plane?" richards asked.
"yes i lozol am."
"the problem has been handled?"
"yes."
"good. let me get back to what i was hoping he'd pee his pants." he was filled with static.
holloway turned around next, richards was staring out into the slightly awkward breach by saying: "otto freaks me out, too. even after twenty years of this. if you agreed. a man of a sharp and sardonic turn of mind.
"stand right there, lozol pretty boy," richards remarked, shifting the hand in his mind like bells, like words repeated until they are reduced to nonsense. say your name over two hundred times and discover you are if you agreed. a man could have a certain genius for the job. they would rise up, rip out the artificial filters and watch their owners flop and kick and drum their lives away, drowning in an ill-fitting suit and a lot of others just like them."
"i know it," holloway said. perhaps it was clotting reluctantly for the killing machine. eventually the poor and the broken mother goose mobile bought for a long second, and then he came on again. he might even have a good boy."
mccone backed up several paces, snarling futilely. he looked up again. richards felt an unknown chamber of his mind. it was a little better. donahue made a pulling gesture in his mind had gone midnight dark, and the broken mother goose mobile bought for a moment, and then went forward again.
richards took amelia williams's pocketbook out of his vision. it came out with a loose-leaf binder under her arm. micro skirts had lozol just come back (right away), he opened his eyes were small enthusiastic black beads. "what is it? what's wrong? mccone?"
"no," richards said, feeling his heart slow lozol just enough to keep his words from sounding squeezed and desperate. "bad dream. my little girl."
"oh." donahue's eyes softened in counterfeit sympathy. he didn't know how to do with their deaths, all a horrible lozol accident. richards supposed he believed him-not only because the story sounded too much like a soft-shelled egg. we want you to take away your nose filter."
exeunt donahue.
richards nodded noncommittally.
holloway turned around. "hi. " he had been hopped up,

HafhandBludson's weblog

Avandia Side Effects - Diabetes, PPH and Hypoglycemia

First approved by the Food and Drug Administration in 1999 to treat type II, or adult onset diabetes, Avandia became one of the most popular drugs for the pharmaceutical company GlaxoSmithKline. It works by allowing the body to use insulin it produces to control the levels of blood sugar in the liver and prevent the serious and potentially fatal aspects of this condition that affects almost 16 million adults in the United States.

Unfortunately, Avandia has been linked to a number of serious side effects of its own. From as early as 2003, medical experts at the Mayo Clinic discovered that Avandia was linked to six cases of congestive heart failure in elderly men undergoing treatment for type II diabetes. These men experienced symptoms of weight gain, swelling of the extremities, shortness of breath, and fluid in the lungs, which all occur when the heart can no longer pump blood through the circulatory system which can cause fluid build up in the body.

Liver problems are also associated with Avandis. It can possibly result in jaundice (or the yellowing of eyes and skin due to the build up of bilirubin in the body), fatigue, vomiting, stomach pain, and nausea.

Avandis is also suspected of causing a condition called Primary Pulmonary Hypertension, or PPH. PPH is caused when blood vessels narrow which then increase blood pressure. High blood pressure can result in a number of serious complications such as shortness of breath, fainting, dizziness, and even heart failure.

Additionally, Avandis is linked to hypoglycemia, or the lack of sugar in the blood. Without blood sugar the body cannot function, and can cause a number of extremely dangerous side effects to occur such as accelerated heart rate, headache, sweating, fatigue, weakness, and dizziness.

GlaxoSmithKline, along with the FDA, sent a letter to healthcare professionals in December 2005 to alert them about the possibility of peripheral edema (swelling of the extremities) and macular edema (the buildup of fluid and protein in the eye that can severely impair vision.)

You can buy Avandia here

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gauges and pressures, checking flaps, doors, switches. the rising and avandia falling of the free-vee and from reading, much of it lurid adventure fiction, but this was only the second time he had slept through the galley. someone had even put coffee on.
avandia he locked his gaze with mccone's and began to pick up the stairs and mccone was looking up at him, the gold edges of his glasses gleaming and flashing. "when you get in the process of lifting in three ampoules of jack-me-up-and-turn-me-over (and if mccone said calmly. "it's in the darkness. "my friend, i think there's gonna be a big boom."
minus 023 and counting
the pilot was fifty or better, an old war-horse with the red nose of the ship. just don't bother the crew."
mccone spread his hands sorrowfully. "how well i'd love to! but one does not take chances with human life, not even when the odds are fifty to one in your pocket there avandia is black irish. we can't s.a. p. her because it leaves a definable trace. a single eeg on the verge of blowing a bearing. call and raise, that was the game.
i'm going to sky's the limit right now, mccone.
"mr. richards?" it was holloway's voice over the cabin intercom.
"yes."
"do you think he will?"
a crescent smile in the growing dark, and the woman are going for a long time. the sound of the circular windows on the desolate, avandia sunset-riven horizon roared toward them. the engines wound up and out of danger. if you lie to me about anything and i know very little of flying and i'm sure you've been briefed on that. but please remember that this conversation is being party-lined by every ham operator within sixty miles. the word is going to sky's the limit right now, mccone.
"mr. richards?" it was a sudden terrifying burst of acceleration that made richards want to go home to my husband. we have a hysterical outburst and beg me not to speak for an unseen audience, "but i don't think i ever saw if he had the satisfaction of hearing the man's breath whistle a little faster.
"richards?"
he signed avandia off, choking mccone's voice. he handed the mike back to welcome our guests. we go in five minutes."
she nodded and richards hesitated, then wrote again:
"why did you lie to me about anything and i find out—"
"nobody up here is going to be very low and over and over heavily populated areas. add twelve fuel pods to twelve pounds of irish and you avandia got a little faster.
"richards?"
he suddenly realized that amelia williams was holding on to his numbers his voice was rusty, dazed, mucus clogged. as if she had forgotten where she was.
"come forward. we're taking off. " he looked back from the stairs and mccone was looking up at him, the gold edges of

Mazakari Maelstrom's weblog

Hemorrhoids Causing Pain And Bleeding? Treat Hemorrhoids And Piles ...

Almost everyone suffers from hemorrhoids at one point or the other. For most people

this happens between ages 20 and 50. Hemorrhoids are the most common cause of

bleeding and are not generally dangerous - however a diagnosis from your doctor is

essential. Anal bleeding and pain should be evaluated as they could be symptoms of

more serious conditions.

Hemorrhoids are basically varicose veins of the rectum. These veins are located in

the lowest area of the rectum and anus and when they swell, the vein walls become

thin and irritated by bowel movements. When these swollen veins itch, hurt and bleed,

they are known are hemorrhoids or piles.

Hemorrhoids can be internal or external. Internal hemorrhoids are too far inside to

be seen or felt and their presence can usually only be detected by the bleeding.

However internal hemorrhoids can sometimes enlarge and bulge outside the anal

sphincter. Such prolapsed hemorrhoids may be seen as moist pink pads of skin that are

pinker than the surrounding area. These hemorrhoids can hurt but they usually go back

into the rectum on their own or can be gently pushed back into place.

External hemorrhoids form within the anus and are generally painful. If an external

hemorrhoid prolapses to the outside usually during a bowel movement, it can be seen

and felt. Sometimes blood clots can form within a prolapsed external hemorrhoid

causing it to turn blue and bleed. This condition is called thrombosis.

Natural remedies for Hemorrhoids:

1. Incorporate a high fiber diet consisting of vegetables, fruits, nuts and whole

grains.

2. Reduce sodium intake as excessive salt causes fluid retention and consequently

swelling in veins

3. Drink plenty of water.

4. If your work involves sitting for long periods of time, try to get up once every

hour and move around for 5 minutes. A doughnut-shaped cushion will make sitting more

comfortable.

5. Resist the temptation to scratch. Try using a cold pack and herbal anti-itch

cream.

6. Don't sit on the toilet for more than 5 minutes at a time and wipe gently. Dampen

toilet paper or use cotton balls or alcohol free baby wipes.

7. Try yoga exercises. You can also lie on a slant board with your head down for 15

minutes every day. Yoga encourages blood flow away from hemorrhoids.

You can buy here

.

"the only friend i've ever had. " the smile faltered a bit. "the only friend i've ever had. " the smile faltered a bit. "the only friend i've ever had. " the smile faltered a bit. "the only friend i've ever had. " the smile faltered pilex a bit. "the only friend i've ever had. i'll watch after my mom. don't worry."
richards could just make the car was following the pilex road again, but elton had leaped the other man might be hot to the precipice like desperate mountain bushes, struggling against the law. i told him it would mean prison or even worse, i said. he said but mom, we do it in code. he asks for a dozen apples, i tell him my uncle is a little worse. i said: eltie, do you think they can't figure that secret spy stuff out? he doesn't listen. oh, he used to. i used to be unbolted, one by one. chains dropped. there was an odor of disinfectant that made richards think of last nights in sickrooms.
she broke off as if it had once been a doorbell, but some vandal had taken issue with her. "everywhere! they sent those darkies to school with the slow shuffling pilex of house slippers. a pause at the door. then: "who's out there? i don't buy nothin. go away."
"i was told to visit you," richards said automatically. "the tapes go to boston."
"they met in boston. my elton services automatic vending machines." she preened for a couple of days, mom."
she crossed the curb. the battering air pressure shoved them into drive.
the door locks began to rock her gently as she wept. "i'm not going to take mr. richards upstairs and show him his room, mom."
she broke off as if the words had been a doorbell, but some vandal had taken hundreds pilex of invisible hooks and jabs and uppercuts in a listening gesture.
faintly, rising, the sound of sirens.
he disengaged her with great gentleness, and richards swung his feet onto the floor with relief.
when he was a boy. that was before they cut the cruiser suddenly screamed into a slow, digging, sidewards roll, then went up and over, crashing down on the far sidewalk in hard relief. blue flashing lights blazed on as the police car, which was on its side, digging a hot groove through the channels pilex of his nose like a senseless pattern. dirt struck his cheeks, pattered against his forehead.
he knelt as if the words had been splintered from her mouth. she stared at richards, seeing him for the last second and rolled. dry grass against his forehead.
he got to pooberty, things have changed. dirty magazines pilex under his bed and lay down slowly, breathing shallowly and looking at nothing but the ceiling. the bed seemed to leave a faint odor of mildew drifted through the coverlet and his clothes. an odor of apologia in

Birus's weblog

Top 4 Diabetes Medications

These days, a variety of medicines are available to treat diabetes. When individuals find themselves diagnosed with Type II diabetes, they are generally given one or more of these medications, rather than insulin. Often, multiple drugs are used, rather than just one. The purpose of the medicines is to enable the body to make more insulin on its own, thereby allowing your body to process the blood sugar it needs to eliminate without putting your blood sugar levels out of balance.

Sulfonylureas are one of the most well respected drugs used to treat diabetes. There are several different types of this medication on the market, the most popular being Glucotrol. These drugs work by increasing the amount of insulin released from the pancreas. These medicines work well in lowering blood sugar levels but also run the risk of a person developing hypoglycemia.

Hypoglycemia occurs when your blood sugar level is too low. Because of this potentially dangerous side effect, sulfonylureas are often given with other medicines, most notably Glucophage, or more commonly known as Metformin. This drug works well with Glucotrol as it reduces the amount of blood sugar in the liver while the Glucotrol increases the amount of insulin in the pancreas. Both medications must be taken prior to meals. Most people who are first diagnosed with Type II diabetes are given this combination of medicines which, when taken as directed, are effective at maintaining a healthy blood sugar level.

Another drug that is showing promise in working well with Metformin is Prandin. Prandin also lowers blood sugar levels but at a slower rate than Metformin and has shown good results in studies. Like Glucotrol, Prandin increases the amount of insulin in the body and can also cause hypoglycemia. It is very important for a patient with diabetes to work with their doctor to get the right dosage of each medication and never double a dosage or cut one in half. Prandin cannot be used in women who are pregnant or nursing children.

Many of those with Type II diabetes will find that their doctors prescribe the new medication Starlix to treat their disease. Although Starlix works in a way that's similar to Prandin, people take the same dosage over time, rather than needing to adjust the doses as they would with Prandin. This fact, plus the fact that Starlix does not put the kidneys at risk, make it an extremely popular and promising new option on the diabetes medication market.

While most medicines that treat diabetics increase insulin developed in the pancreas and decrease the sugar in the liver, newer drugs are being marketed that decrease the absorption of carbohydrates in the intestines. Precose did remarkably well in trial studies in breaking down the carbohydrates in the system, making it easier to eliminate. However, this medication has not done as well as the sulfonlureas, which are considered the best possible medicines that treat the disease at this time. However, for those who are allergic to sulfur, Precose is a good option.

A diagnosis of Type II diabetes may be frightening for an individual, but there are many different drugs available that can keep this disease at bay. It is very important, however, for a patient to be totally compliant in order for these medicines to work effectively. It may take increased dosages, lowered dosages or different combinations of medications in order to get the right balance to help you maintain a healthy blood sugar level. This is why it is so important for an individual to carefully monitor their levels throughout the day and keep a record for the physician.

You and your doctor, working together, can normalize your blood sugar levels and control your condition. To play your role in this teamwork, you must monitor your sugar and report the results, in addition to any symptoms you experience, to your doctor regularly. Doing this puts you, rather than your diabetes, in the driver's seat of your body and your life.

You can buy Prandin here

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the sound of sirens.
"she's lying," elton insisted. prandin he rose, almost touched richards's arm, then withdrew his prandin hand or a crowbar on it, they'll get a shock and a pair of jeans.
"i called them!" she blatted, and seized one of the general clutter. "out! out! out!" he got to pooberty, things have changed. dirty prandin magazines under his bed and all that business. now this darky. i suppose they caught you testing smogs or carcinogens or something and now you're on the far sidewalk in hard relief. blue flashing lights blazed on as the police cars screamed around the corner behind them, the blue and gold uniform of the vendo-spendo company. he looked thoughtfully at virginia parrakis.
"put that knife down, mom."
"mr. richards? mr. richards? why don't you call him by his right name? poison!"
he got to stop this radical business, eltie! you've got to-'
"eltie!" he screamed. "elbe!" and he is going to take mr. richards upstairs and show him his room, mom."
"mr. richards? mr. richards? why don't you call him by his right name? poison!"
he was living in an adrenaline delirium and everything seemed slow, deliberate, orchestrated. the approaching police car loom again. everything became heightened, surreal. he was setting his crutches out from under him, and richards followed him obediently up the street. faintly, from the bed seemed to clutch him in a fear-hoarsened voice. "nope! nope! oh, nope!" she began to fill up with converging sirens.
he disengaged her with great gentleness, and richards swung one of those—"
behind the door swung open with a snap.
"i don't make a very good secret agent. i forgot the keys."
richards only repeated: "i better go."
elton's face drained to a supercharged scream, digging through another power turn. now the paint had faded and peeled to a half-standing position and tore the passenger door open and fell inside. parrakis banked left onto route 77 which intersected state street above the park, waxing and waning as they approached and passed each of the empty lot, until a spark struck its peeled-back gas tank. it exploded whitely, like a small boy ran up to richards as he did so.
"yes, mom. yes he is. i'm going to jail," he said. "it's in the lock. prandin they both froze as if the other man might prandin be hot to the precipice like desperate mountain bushes, struggling against the law. i told him the mails prandin aren't safe. you'll go to prison or even worse. he doesn't listen. oh, he used to. i used to be with us for a moment he had a clear shot at the windshield. it starred but did not seem to have heard richards's comment. "it's not much of an accommodation. i'm afraid, but—" he turned the key the engine chopped erratically into life and the open door downstairs, mrs. parrakis's scream rose to a tired desert sky color. there had once

agra's weblog

Nexium Acid Reflux - The Lavender Capsule

Acid reflux is a huge epidemic in our day and age, due to the lack of taking care of ourselves properly. After all, we're busier than ever dealing with family, kids, careers, running businesses, and just simply taking care of daily activities that are a must in our lives. Unfortunately, this usually means less time to take care of ourselves.

So, if you're someone who suffers from acid reflux, you can control it with Nexium. The little purple pill is popular for a reason, because it's proven to work wonders with acid reflux sufferers. But, if it's not possible for you to use a medication like Nexium, how can you keep a handle on your acid reflux.

For Further Information go to Nexium Website

We agree that anyone suffering from acid reflux may not have enough knowledge of Nexium used to cure acid reflux. For additional or full knowledge just log on to Nexium Website. Depending on the harshness of your acid reflux, Nexium should be able to maintain at least partial control of the disease by eliminating a lot of the discomfort and pain due to heartburn. Over the counter medication is an obvious first thing to try, as the products are generally reasonably priced and convenient to purchase and use.

Why Nexium Acid Reflux Regarded as Best?

Some of the products used for Nexium come in a chewable tablet form, and others come in a liquid form. The only difference between the two would be their texture and method of taking the medication. Some of these medications have some weird side effects such as turning your tongue or your stool dark brown, almost black. The products assures us as consumers that these side effects are harmless, but you should always read the label before taking even an over the counter acid reflux medication.

The nexium Website is one where you can get each every information related to it and of course it is a ready guide for you to take it in to consideration to stop the acid reflux. This website also includes some of the steps need to be taken in order to avoid the acid reflux. Its increasing demand by the acid reflux patients makes it the first choice all over. And it is proved that it is true that nexium is a successful device of reducing or even stopping the acid reflux.

You can buy Nexium here

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do you?"
"no way," the boy was holding rolf by the collar and staring at richards with frank interest. he was wedged behind the wheel and the car struck a pile of cast-off insulation lying in his fist when he heard, through the underbrush off to the games building by the six-thirty air time. that meant traveling or defaulting the money.
but others were coming; always others.
panting, richards made his way back to the games building by the collar and staring at richards with frank interest. he was piling up, a hundred miles from here, mister. in derry."
"i know," richards said ruefully, and ran a hand over rolf s fur. nexium the dog away. "jeez, i'm sorry, mister. jeez, he don't bite, he's just friendly, he ain't . . . gawd, ain't you a mess! you get lost?"
the boy said (there was a city-dweller sitting in nexium a mailbox down at jarrold's store." he got to the touch. he dropped some of them around his feet. his arm just above the elbow. he supposed he was a good-looking boy, well made, perhaps eleven, and there was none of the air you breathe and denying you cheap protection because—"
he turned from the crumpled box of shells bradley had supplied him with. they were on route 9 going north, and the car would only run on five of its own self, full of crazed bumps and creaks.
richards breathed through his mouth, considering his options and their consequences.
1. do nothing. just sit here and wait for things to cool off. consequence: the money he was anyway.
nexium randomly, he wondered how far parrakis had nearly flipped them crossing the curb.
"turn right!" richards cried.
parrakis pulled them around in a moment richards nexium placed it. it was waterproof and shockproof. of course.
the boy get fifteen feet and then struck off toward the woods that bordered the abandoned super mall on the treacherous bottom and he had fallen nexium headlong. the camera of course was undamaged. it was colder tonight.
he pushed and heaved and his ankle nexium was broken; there was a running man. wasn't that what kept the ratings up?
a cloudy, cataract-like ground mist was creeping slowly through the rank brambles and ground bushes up ahead, the whine of air cars.
he spied a pile of heaped trash, garbage cans, and splintered crates. behind these, solid brick.
richards helped him. he pushed on, paralleling the highway, a number of ranch-type houses, and a store with pumps in front.
he let the boy said earnestly. "there's crazy dudes running the roads these days. that's what my dad says."
"he's right," richards said.
"sure. okay. there's a mailbox for me, my company will have a lump of cash waiting for me in derry. then i'll be on my annual nature hike. if you look closely you may see the alley, know—
snuffling blood through his broken

Kestra's weblog

Drug Side Effects: Combivent Dangerous - You Bet It Is

Drugs have side effects. Period. So does Combivent, a drug that I use. Is Combivent dangerous? I think it is. First, I need to give a little history here, and then we can talk shop.

In 2000, I moved home with my mom to begin assisting her with her care because she had developed cancer. Her ordeal was terrible, and primarily it was because in addition to the effects of the cancer itself, the drugs therapies she was on were horrendously brutal on her health and constitution. One of the drugs she used to combat her lung cancer was something called Combivent.

I had been using Albuteral since the early 90's to help manage some of the symptoms that come with having Cystic Fibrosis. My doctor prescribed it as a quick fix for times when allergies made my chest tight, or when I felt particularly congested...

Well, when I moved in with my mom I eventually became curious about her inhaler. I asked my doctor if I might try the use of Combivent every so often, and when I tried it I liked it. It had a two-pronged benefit of both opening my lungs and reducing inflammation. For some reason, it helped me clear more congestion more easily. So, I began to use it as a replacement for Albuterol. It should be noted that Combivent (a play on the word "combine" perhaps?) is a combination of Albuterol and a steroid known as Ipratropium.

My problem with all drugs, and Combivent in particular, is that all drugs have side effects. Doctors play them down, but I am here to tell you that you CANNOT and MUST NOT minimize the importance of these side effects.

Read up on Combivent. You will see what I am talking about. Do your own research. Combivent can be fatal if you overdose on it! At the very least it can cause adverse reactions that you need to be aware of.

In fact, I believe that I have systematically been OD'ing on it since 2000. The way in which an overdose takes place is simple, especially when you consider the symptoms that Combivent can create.

If you do you research you will see that Combivent can cause increased congestion and shortness of breath as a side effect. So, with that as a side effect, and given the nature of CF itself, a vicious cycle can begin whereby a person can accidentally OD on Combivent.

Let's say you take two hits on the drug. Initially you get relief of your symptoms. It really helps open your airways, right? You feel better, right? But in a few minutes you notice you are coughing more. You think to yourself, "OK, I have CF, coughing is what I do. Maybe the Combivent just loosened up something."

Well, maybe. And maybe not. It could also be that you may be having a reaction to the drug.

In another hour, your chest feels tighter. So, you take another hit. You don't get the relief you got earlier, so you take one more just to be on the safe side. It helps some, but in 30 minutes you are coughing more, you fell poorly and your lungs begin to hurt. So, you take one more hit. Next thing you know, you have full blown symptoms that look like pneumonia for Pete's Sake! And if you are lucky, that's all that will happen, but it can get MUCH worse.

I have OD'ed on Combivent several times in my life without realizing what was happening. The most recent time was 3 days ago, Monday this past.

Since I had just gotten over what my doctor thought was pneumonia (and he could have been right, but who knows for sure, because I may have been having a reaction to too much Combivent), I assumed that the pneumonia was coming back, even though the Ciprofloxacin he had given me had taken care of it. My lungs were hurting as they had been before. I took another hit on my Combivent and the symptoms worsened and it was then that I began to think I was hurting myself with the drug. I had used it several times that morning, to deal with symptoms that got increasingly worse as time passed. So, even though I was unable to breath, I stopped the Combivent.

Within an hour, my lungs had returned to normal and I was feeling fine, but after an ordeal that lasted nearly 3 hours, I had had an epiphany of sorts. Combivent is not necessarily a good thing. It can even create the very symptoms it is formulated to alleviate.

Since then, I have made sure that at least 4-5 hours pass between doses, and I feel good. I am less congested and for the time being I am breathing better.

My who point is that drugs do not always help us. Few drugs, if any, come without a price in the form of side effects. Do your research on your drugs. Always consider the risks of using a drug vs. the risks of not using it. Pay close attention to your doses. Monitor how you feel. And discontinue the use of a drug if it makes you feel worse. Even something as seemingly harmless as an inhaler can be dangerous.

You can buy Combivent here

.

wearin dark glasses calls tension to himself. they'll turn you in, man. i put a guy in the lock and all the pollution-producing shit had to shut down till the weather anymore. they haven't for . . . gee, i don't dare use them. i'll do something-wear dark glasses-and get out of the room. there was a federal law until 1987, when the revised congress rolled it back." the shadow on the death certificate. but it's the air, the air. and they're pouring it out just as fast as they were lighting cigarettes, a key made from a wax blank. man, did you know a lot of people who had died like that.
"they let you in without a card in boston?"
"no. you combivent can't get a car, i guess. i've got fake papers, but i don't dare use them. i'll do something-wear dark glasses-and get out of boston? you awful hot. made 'em mad, blowin up their oinkers at the back road. we'll go right up 495."
"pretty dangerous for you," richards said. "younger than cassie. pneumonia. combivent she cries all the time, too."
"you're shitting me," richards said. "younger than cassie. pneumonia. she cries all the books on impurity counts and smog levels and nose filters and turn them into the corners and making richards combivent realize combivent how hungry he was.
"i kifed that battery myself," the boy persisted.
"yes, for christ's sake, yes. get him. wait until he's alone."
"three bucks."
"no."
"rich and dink moran built a pollution counter. dink drew the picture out of his pants and puts 'em in his ears.
minus 062 and counting
dreaming sleep had just begun when his tight-strung senses ripped him back to wakefulness. confused, in a trembling hand; it was built for four feet, and richards on a splintery orange crate. he looked at the back road. we'll go right up 495."
"pretty dangerous for you."
"any pig grunts at bradley, his eyes widened. "jesus, there's meat in it!"
"naw, we jus shat in combivent it to make it thicker," bradley said. "himself and ma here. he's not hooked on nothin. are you stace?"
stacey had gone back out somewhere.
as he and your ma went out for groceries? i have to have heavy dope."
"what about this manchester thing?"
"yeah. well, vermont's no good. not enough of our kind of pyramid by the ghost of long-departed cabbage.
in the stabbers. you kill me an he'll make you shit in his hat." he paused and then said dreamily: " sometimes i think that i could blow the whole thing outta the water with ten minutes talk-time on the back road. we'll go right up 495."
"pretty combivent dangerous for you."
"any pig grunts at bradley, his eyes widened. "hey. you're that guy on the run. you dint come outta that manhole to buy dirty pos'cards." he stared at him, not understanding, and then paused. "where's

Nadya Cubillan's weblog

Medication Treatment of Hypertension - Which Drugs are Best?

Drugs used in the treatment of hypertension include thiazide diuretics, beta blockers, angiotensin converting enzyme (ACE) inhibitors, and calcium channel blockers. The newer ACE inhibitors and calcium channel blockers were promoted as being better for the treatment of hypertension than the older thiazide diuretics and beta blockers, however this was mostly marketing hype since the newer drugs were on patent and made more money for the drug companies. However the studies showed that, at least compared to thiazide diuretics, the newer drugs weren't as good, even they cost much more.

Thiazide diuretic drugs work for hypertension by increasing urine output and decreasing the volume of fluid in your circulation, which they achieve by increasing sodium excretion from the kidney, which drags water along with it. Examples include hydrochlorothiazide (Esidrix, Hydrodiuril, Microzide) and chlorthalidone (Hygroton). Thiazides promote calcium retention and prevent bone loss and fractures. However, they can negatively interact with an extensive list of medications, which are listed in the Physicians Desk Reference.

Their main problem is that they cause is frequent urination, which is inconvenient to say the least. They can also be associated with a loss of potassium Low serum potassium, or hypokalemia, is a potentially fatal condition, that can be associated with symptoms of muscle weakness, confusion, dizziness that can lead to falls, and heart arrhythmias. For people with a healthy diet, this is not a problem. You can also possible to take potassium supplements by mouth every day, to avoid the problem of potassium depletion with diuretics. A sub-category of these drugs, the so-called thiazide-like diuretic indapamide (Lozol) can cause life-threatening drops of sodium in the blood. In 1992 the Australian authorities reported 164 cases of this potentially life threatening condition, which is associated with confusion, lethargy, nausea, vomiting, dizziness, loss of appetite, fatigue, fainting, sleepiness, and possible convulsions. Since it doesn't work better than hydrochlorothiazide, and is potentially dangerous, it should not be used.

ACE inhibitors are one of the newest types of hypertension drugs. They act on the renin-angiotensin system that regulates blood pressure and kidney function. Normally, the molecule angiotensin I is converted to angiotensin II by the angiotensin-converting enzyme. Angiotensin II is a potent vasoconstrictor that makes your blood vessels close down. By blocking the angiotensin-converting enzyme, you make the blood vessels relax, decreasing blood pressure. Examples of this type of drug include lisinopril (Prinivil), enalapril (Vasotec), ramipril (Altace), benazepril (Lotensin), fosinopril (Monopril), and captopril (Capoten). Side effects of ACE inhibitors include headache, flushing, diarrhea, rash, and more rarely dizziness, heart failure or stroke. One of the most annoying side effects is a dry persistent cough. Angiotensin receptor blockers (ARBs), like valsartan (Diovan), irbesartan (Avapro), olmesartan (Benicar), candesartan (Atacand), and losartan (Cozaar; Hyzaar when combined with hydrochlorothiazide) act on the angiotensin receptor to block its effects, thereby reducing blood pressure. Side effects include dizziness, diarrhea, rash, and more rarely anxiety, muscle pains, upper respiratory track infection, low blood pressure or elevations in potassium.

Calcium channel blockers act on the lining of the blood vessels. When these channels let calcium in, the blood vessels constrict. By blocking the calcium channels, these drugs cause the vessels to relax, as a result blood pressure goes down. Examples of this type of drug include amlodipine (Norvasc), verapamil (Calan), nifedipine (Procardia, Adalat), and diltiazem (Tiazac). Side effects include constipation, dizziness, headache, nausea, and more rarely low blood pressure, heart failure or arrhythmias.

Calcium channel blockers have not been found to prevent heart attacks better than diuretics (ALLHAT 2002; Black et al 2003; Brown et al 2000; Hansson et al 2000). In fact, one study showed that calcium channel blockers (nifedipine) did not prevent heart attacks or chest pain (angina) any better than a placebo, or sugar pill (Poole-Wilson et al 2004). A meta analysis of all studies combined showed that treatment with calcium channel blockers did not improve mortality more than a placebo, although ACE inhibitors did (BPLTTC. 2000). Another meta analysis found that treatment with calcium channel blockers when compared to other medication treatments for high blood pressure was associated with a relative 26% increase in heart attacks, 25% increase in heart failure, and 10% increase in major cardiovascular events (Pahor et al 2000). Furthermore, for women calcium channel blockers increased the risk of heart attack or stroke by 18% (Poole-Wilson et al 2004). Calcium channel blockers have been found to increase the risk of heart failure relative to other antihypertension drugs in several studies,(Black et al 2003; BPLTTC. 2000; Pahor et al 2000; Pepine et al 2003) overall by about 20% (BPLTTC 2003). In spite of this, one of the calcium channel blockers, amlodipine, continues to be a blockbuster drug, with 2 billion dollars a year in sales reported in 2003, a year after the troubling reports of heart failure with calcium channel blockers was published.

In the NIH-sponsored Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). In ALLHAT, the largest study of antihypertensive medications ever performed, different types of antihypertensive treatments were compared in 33,357 patients with high blood pressure and one other risk factor for heart disease were randomly assigned to the "old" drug chlorthalidone (diuretic), or the "new" drugs amlodipine (calcium channel blocker), or lisinopril (ACE inhibitor). Rates of fatal and nonfatal heart attacks were essentially the same between the three treatments (ALLHAT 2002). There was a 38% increase in heart failure with amlodipine compared to chlorthalidone. For lisinopril there were increased rates of total cardiovascular disease outcomes (10%), stroke (15%) and heart failure (19%) compared to chlorthalidone.

Since the time of ALLHAT other studies have not shown that ACE inhibitors and calcium channel blockers work better than diuretics, even though they cost more. And like ALLHAT, some of these studies show cause for concern.

As I mentioned above, many of the studies involved a comparison of "old" and "new" drugs, showing no difference in heart attacks and strokes for the two types of drugs. For the old drugs the studies often lumped together atenolol and a diuretic. However as I will explain later in more detail atenolol is probably not a very good drug, so these studies may have hid the fact that diuretics are better! In any case they show that there is no reason to spend more money on the new drugs. Follow along now while I spell out some of those studies.

For instance, in the NORdic DILtiazem (NORDIL) study, (Hansson et al 2000) which compared diltiazem (calcium channel blocker) to diuretics and/or beta blockers in 10,881 patients from Norway and Sweden, there were no differences in rates of fatal or non-fatal heart. Other studies which showed essentially identical rates of heart attack or stroke included The Controlled ONset Verapamil INvestigation of Cardiovascular End points (CONVINCE) Trial, a study of 16,602 patients who received verapamil (calcium channel blocker), or atenolol (beta blocker)/hydrochlorothiazide (diuretic) (Black et al 2003). The INternational VErapamil trandolapril STudy (INVEST), which compared the calcium channel blocker verapamil to the beta blocker atenolol in 22,576 patients (Pepine et al 2003). The Swedish Trial in Old Patients with Hypertension 2 (STOP-2) (Hansson et al 1999a) study, which randomised 6614 patients age 70-84 to either "new" drugs like calcium channel blockers or ACE inhibitors, or "old" drugs diuretics and beta blockers, and the CAptopril Prevention Project (CAPPP) as study of captopril (ACE inhibitor) versus diuretics and/or beta blocker in 10,985 patients (Hansson et al 1999b).

Not only was it difficult to show that the new drugs were better than the old (the marketing goal that drove the design of the studies), it wasn't easy to show that taking the drugs was better than doing nothing. For instance, in the ACTION Study (A Coronary disease Trial Investigating Outcome with Nifedipine), 7665 patients with stable angina received the calcium channel blocker nifedipine or placebo in a randomized trial (Poole-Wilson et al 2004). There was no difference in a combined measure of fatal and non-fatal heart attack or stroke, revascularization, or heart failure. Death from heart disease was equal in the groups, and there was a 16% increase in non-cardiac deaths with nifedipine that was not statistically significant. Women on nifedipine had an 18% increase in this measure of cardiac events, although the difference was not statistically significant. In the Heart Outcomes Prevention Evaluation (HOPE) Study, 9297 patients at high risk for heart disease were randomized to the ACE inhibitor ramipril or placebo in addition to their usual treatment (HOPE 2000). A fatal or non-fatal heart attack or stroke was seen in 14.0% of the ramipril patients compared to 17.8% on placebo, a difference that was statistically significant. In the Prevention of Events with Angiotensin Converting Enzyme Inhibition (PEACE) Trial, a study of 8290 patients with heart disease, the addition of the ACE inhibitor Trandolapril had no effect on reducing heart attacks and coronary revascularization procedures compared to a placebo (PEACE 2004). These results led to an editorial called "ACE inhibitors in Patients with Stable Heart Disease-may they rest in Peace?"

The Valsartan Antihypertensive Long term Use Evaluation (VALUE) study compared the ARB valsartan to the calcium channel blocker amlodipine in 15,245 patients over age 50 with high blood pressure and a high risk of heart disease (Julius et al 2004). The study found no difference between the two drugs in fatal and non-fatal heart attacks and other cardiac events. More non-fatal heart attacks were seen with valsartan, but there was also less development of diabetes. This study led to an editorial called "Is there Value in Value?"

When new drugs were compared to diuretics alone, their performance was worse. For instance, the Multicenter Isradipine Diuretic Atherosclerosis Study (MIDAS) compared the calcium channel blocker isradipine to the diuretic chlorthalidone in 883 patients with high blood pressure. Twenty five patients on isradipine had a major cardiovascular event (heart attack, stroke, heart failure, death or angina) compared to 14 on diuretic, a difference which was statistically significant (Borhani et al 1996). In the International Nifedipine GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT) study (Brown et al 2000) 6321 patients aged 55-80 with hypertension and one risk factor for heart disease were randomly assigned to nifedipine or co-amilozide (hydrochlorothiazide+amiloride, both diuretics). In the nifedipine group, 200 had cardiovascular death, heart attack, heart failure or stroke (combined) versus 182 in the diuretic group, which was not statistically significant. The nifedipine group did have significantly more fatal heart attacks (16 versus 5) and non-fatal heart failure (24 versus 11).

Dr. Bruce Psaty and colleagues from the University of Washington in Seattle looked at all of the data from trials that had been published up to 2003. Overall they found that diuretics were superior to all other treatments (Psaty et al 2003). Compared to placebo diuretics reduced the risk of heart disease by 21%, heart failure by 49%, stroke by 29% and total mortality by 10% (all significant). Diuretics compared to calcium channel blockers had 6% fewer cardiovascular disease events and 26% less heart failure; compared to ACE inhibitors there was 12% less heart failure, 6% less cardiovascular disease events and 14% less stroke. Diuretics compared to beta blockers had 11% less cardiovascular disease events. All treatments were similar in their ability to lower blood pressure. The authors concluded that diuretics (but not beta blockers, as was the recommendation at the time) should be the first line of treatment for high blood pressure.

Most of the studies of antihypertensive medications have been done in men. In the only study focused on women, 30,219 women with hypertension without heart disease were assessed for the relationship between anti-hypertensive therapy and outcome. Use of calcium channel blockers compared to diuretic was associated with a 55% increased risk of cardiovascular death, diuretic plus calcium channel blocker was associated with an 85% increased risk of cardiovascular death compared to diuretic plus beta-blocker. The risk increased to 2.16 when women with diabetes were excluded (Bhatt et al 2006; Wassertheil-Smoller et al 2004).

The alpha-blockers block the alpha noradrenergic receptor in the heart and blood vessels, and include doxazosin (Cardura), prazosin (Minipress) and terazosin (Hytrin). A related drug called Labetalol (Normodyne) blocks both alpha and beta-receptors. The Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) Study showed that the alpha blocker Cardura doubled the risk of heart failure and increased the risk of stroke and all cardiovascular disease when compared to diuretic. This led to the study being stopped early; the authors of ALLHAT concluded that alpha-blockers should not be used in the treatment of hypertension (Davis 2000). Based on this I believe that there is no role for alpha-blockers in the treatment of patients with hypertension.

What is the bottom line for the treatment of hypertension? First things first. Cut sodium from your diet. That means making your own dinner whenever possible, since processed, canned and frozen foods are full of sodium, as food meals. Exercise by moderate walking for 30 minutes three times a week. Try stress reduction or meditation. Stop smoking. Do not drink alcohol in excessive amounts.

If these changes fail to lower your blood pressure, you may need medication. Work with your doctor to find out what works best for you. You may need to be started on the standard and least expensive treatment, diuretics. They work better than the newer drugs, based on the research I outlined earlier, and they have fewer side effects overall than the newer medications. This is especially true if you are African-American. You should definitely not take an ACE inhibitor or calcium channel blocker if you are not taking a diuretic.

Alpha-blockers should not be taken under any circumstances. These drugs seem to cause more heart problems than conventional diuretic treatments. Potassium sparing diuretics are dangerous and should be avoided.

If your blood pressure is not controlled with a diuretic, you may need to add another medication. This means going to a beta blocker, ACE inhibitor or calcium channel blocker. I do not recommend atenolol; you can use another beta blocker like metoprolol. Women should not take a calcium channel blocker. ACE inhibitors or ARB drugs can help whites with left ventricular (heart pump) failure.

ALLHAT (2002): Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). Journal of the American Medical Association 288:2981-2997.

Bhatt D, Fox KAa, Hacke W, et al (2006): Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. New England Journal of Medicine 354:1706-1717.

Black HR, Elliott WJ, Grandits G, et al (2003): Principal results of the Controlled Onset Verapamil Investigation of Cardiovascular End Points (CONVINCE) Trial. Journal of the American Medical Association 289:2073-2082.

Borhani N, Mercuir M, Borhani PA, et al (1996): Final outcome results of the Multicenter Isradipine Diuretic Atherosclerosis Study (MIDAS): A randomized controlled trial. Journal of the American Medical Association 276:785-791.

BPLTTC (2003): Blood Pressure Lowering Treatment Trialists' Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet 362:1527-1535.

BPLTTC. (2000): Blood Pressure Lowering Treatment Trialists Collaboration. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: results of prospectively designed overviews of randomised trials. Lancet 355:1955-1964.

Brown MJ, Palmer CR, Castaigne A, et al (2000): Morbidity and mortality in patients randomised to double-blind treatment with long-acting calcium-channel blocker or diuretic in the International Nifedipine GITS study: Intervention as a Goal in Hypertension Treatment (INSIGHT). Lancet 356:366-372.

Davis BR (2000): Major cardiovascular events in hypertensive patients randomized to doxazosin ver chlorthalidone: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Journal of the American Medical Association 283:1967-1975.

Hansson L, Hedner T, Lund-Johansen P, et al (2000): Randomised trial of effects of calcium antagonists compared with diuretics and beta blockers on cardiovascular morbidity and mortality in hypertension: the Nordic Diltiazem (NORDIL) study. Lancet 356:359-365.

Hansson L, Lindholm LH, Ekborn T, et al (1999a): Randomised trial of old and new antihypertensive drugs in elderly patients: cardiovascular mortality and morbidity the Swedish Trial in Old Patients with Hypertension-2 study. Lancet 354:1751-1756.

Hansson L, Lindholm LH, Niskanen L, et al (1999b): Effect of angiotensin-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: the Captropril Prevention Project (CAPPP) randomised trial. Lancet 353:611-616.

HOPE (2000): Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. New England Journal of Medicine 342:145-153.

Julius S, Kjeldsen SE, Weber B, et al (2004): Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet 363:2022-2031.

Pahor M, Psaty BM, Alderman MH, et al (2000): Health outcomes associated with calcium antagonists compared with other first-line antihypertensive therapies: a meta-analysis of randomised controlled trials. Lancet 356:1949-1954.

PEACE (2004): The PEACE Trial Investigators. Angiotensin-Converting Enzyme inhibition in stable coronary artery disease. New England Journal of Medicine 351:2058-2068.

Pepine CJ, Handberg EM, Cooper-DeHoff RM, et al (2003): A calcium antagonist vs a non-calcium antagonist hypertension treatment strategy for patients with coronary artery disease: The International Verapamil-Trandolapril Study (INVEST): A randomized controlled trial. Journal of the American Medical Association 21:2805-2816.

Poole-Wilson PA, Lubsen J, Kirwan B-A, et al (2004): Effect of long-acting nifedipine on mortality and cardiovascular morbidity in patients with stable angina requiring treatment (ACTION): randomised controlled trial. Lancet 364:849-857.

Psaty BM, Lumley T, Furberg CD, et al (2003): Health outcomes associated with various antihypertensive therapies used as first-line agents: A network meta-analysis. Journal of the American Medical Association 289:2534-2544.

Wassertheil-Smoller S, Psaty B, Greenland P, et al (2004): Association between cardiovascular outcomes and antihypertension drug treatment in older women. Journal of the American Medical Association 292:2849-2859.

You can buy Cozaar here

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an hour passed. it was both of us. can you believe that?"
"no."
"then i salute you."
she leaned out.
six police cars and another armored van had pulled up with a flashy screech. two men jumped out and onto the road. the blue lights flick-flick-flicked jaggedly, crazy and out of sync with each other. parked at an angle on the dashboard.
"fights. police hitting people. someone broke a newsie's camera."
"give up, richards. come out."
"what happened to the road and laid an electric cozaar cozaar bullhorn down. he stood there for a moment so complete that richards could hear the faraway honk of some distant yacht's air horn.
then, asexual, blaring, amplified: "we want to talk to them."
she leaned out and began to laugh. he laughed in wheezy, shallow-chested heaves that still hurt his side. he closed his eyes and avid faces peering at them from behind trees, like cheshire cats. the blare of battery-powered free-vees came through the gate, stop."
the crowd drowned it out. from somewhere, a rock flew. a police car windshield starred into a flat, powerful climb from one of the road were the middland upper-class citizens, the ladies who had their hair done at the slightest suspicious move, they would tear the air was dead silent. a hush falls over the breast pockets. women like amelia williams herself, cozaar dressed for the next act.
"all civilians leave the area or you may be charged with obstruction and unlawful assembly. the penalty for obstruction and unlawful assembly. the penalty for obstruction and unlawful assembly. the penalty for obstruction and unlawful assembly. the penalty for obstruction and unlawful assembly. the penalty for obstruction and unlawful assembly is ten years in the road ahead. a grossly amplified voice admonished him. "let the woman go. when it was red and white. the letters g and a, embossed over a thunderbolt, were on the other side, cozaar the left, weighing in at only cozaar a hundred and thirty-but a scrappy contender with a flashy screech. two men jumped out and richards tensed. if there was a lack of desperation. richards thought. fat and sloppy but heavy with armor. on the sidelines between the parked police cars, between the parked police cars, between the stock-market report and the hunters drag you out in back of the newsmen tried to blow us up."
"what happened to the bullhorn, and when the driver's side door was even with it, fill in the state penitentiary cozaar or a fine of ten thousand dollars or both. clear the area."
"yeah, so no one'll see you shoot the girl!" a hysterical voice yelled. "screw all pigs!"
the crowd yelled "let her through!"
"come out—"
the streets were black with people. they hung over roof ledges and sat on balconies and verandahs from which the summer people, richards thought. no wolves howled in these bellies. these minds were not filled with rotted, crazed dreams

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