Natalizumab (Tysabri) May Cause Significant Liver Injury

February 27, 2008 — Significant liver injury has been reported in some patients receiving treatment with natalizumab (Tysabri, Biogen Idec, Inc), the US Food and Drug Administration (FDA) announced today.

The monoclonal antibody was first approved by the FDA in November 2004 for the treatment of multiple sclerosis and was later withdrawn by the manufacturer in February 2005 after 3 patients developed progressive multifocal leukoencephalopathy (PML) during clinical trials.

After reviewing the study data to confirm the absence of additional PML cases, the reintroduction of natalizumab into the US market was accompanied by a restricted distribution program (Tysabri Outreach: Unified Commitment to Health, or TOUCH).

With the approval of natalizumab for the treatment of Crohn's disease in January 2008, the FDA added warnings to the drug's safety labeling regarding the risk for hepatotoxicity.

Signs of injury, including markedly elevated serum hepatic enzymes and elevated total bilirubin, have been observed as early as 6 days following initiation of natalizumab therapy, according to an alert issued by MedWatch, the FDA's safety information and adverse event reporting program. Other cases have occurred for the first time after multiple doses of the drug and on rechallenge.

The combination of transaminase elevations and elevated bilirubin without evidence of obstruction is an important predictor of severe hepatic injury that can lead to death or require liver transplant.

Treatment should therefore be discontinued if jaundice or other signs of significant hepatic injury occur. Patients should be advised of the risk for liver injury and instructed to call their healthcare professionals if they experience yellowing of the skin/eyes, nausea/vomiting, darkened urine, and feeling tired or weak.

Natalizumab monotherapy is indicated to delay the accumulation of physical disability and reduce the frequency of clinical exacerbations in patients with relapsing forms of multiple sclerosis; it also may be used to induce and maintain clinical response and remission in adult patients with moderately to severely active Crohn's disease who have evidence of inflammation. Use of natalizumab is generally reserved for patients who have had inadequate response to or are unable to tolerate conventional therapies.

from: Medscape.

Philippine Nursing Board Exam Result, December 2007 Exam. (Philippine Nursing Licensure Exam - December 2007)

December 2007 Exam Passers


Nurse Licensure Examination - Retakers As Per C.a. 2008 February 21

Nurse Licensure Examination - Retakers For C.g.f.n 2008 February 21

43% of 67,000 pass Philippine Nursing Board Exam ( Philippine Nursing Licensure Exam) December 2007 Exam

source: Inquirer.net

February 21, 2008 10:19:00

Veronica Uy

INQUIRER.net

MANILA, Philippines -- At least 43 percent of the 67,000 examinees who took the nursing board in December 2007 have passed, officials of the Professional Regulation Commission told INQUIRER.net.

In a text message to INQUIRER.net Thursday, Marco Antonio Sto. Tomas, member of the PRC's Board of Nursing, said that out of 67,728 examinees, 28,924 passed for a 43.45-percent passing rate.

Leonor Rosero-Tripon, PRC chairman, said that the percentage was “within the usual range.”

Tripon and Sto. Tomas said the examinees included those who took the exam for the first time, repeaters, removals, and voluntary retakers of all subjects from the June 2006 Nursing Licensure Examination.

“Ten out of the 14 retakers as per Court of Appeals decision passed and 729 out of the 1,132 special certification retakers for CGFNS passed,” he said.

PRC records show that the passing rate for the nursing board has not breached 60-percent since June 2003.

The passing rate for the past five years are as follows:

June 2003, 52.77 percent; December 2003, 43.38 percent; June 2004, 55.74 percent; December 2004, 43.06 percent; June 2005, 49.40 percent; December 2005, 53.97 percent; June 2006 (the one with the supposed leakage), 41.23 percent, December 2006, 49.10 percent; June 2007, 48.32 percent; and the latest December 2007, 43.45 percent

A nursing educator, who requested anonymity, lamented the drop in the quality of Philippine nursing education. He said these figures provide a sad contrast to the growing number of colleges producing nursing graduates -- more than 450 such colleges nationwide.

He said the economic contribution of nursing education was “superficial and artificial in the long run.”

“We have few training hospitals, we are in dearth of fully trained nursing deans and faculty-members, both public and private combined, to complement the education needs of all our nursing students enrolled all over the country,” he said.

Sto. Tomas said the top performing schools with 100 or more examinees that passed were Saint Louis University, Xavier University, and Silliman University.

He said those which had from 30 to 99 examinees that passed were Trinity University of Asia, Mindanao State University, University of the East-Ramon Magsaysay Memorial Medical Center, and Palawan State University.

PRC IDs for Philippine Nursing Licensure Exam Passers of June 2007, now available up to letter M

Professional Regulation Commission Cagayan de Oro has already received the second batch of PRC IDs from PRC-Manila, thus complementing the ID's from letter A up to letter M.You can get your PRC IDs in PRC Cagayan de Oro now, just bring your PRC Receipts and your Board Certificate for verification.

Thank You.

Oral Contraceptives Offer Long-Term Protection Against Ovarian Cancer

The use of oral contraceptives have linked it to increased risk for breast cancer

Oral contraceptives offer long-term protection against ovarian cancer, with the reduction in risk persisting for more than 30 years. This finding, from a huge analysis of 45 studies reported in the January 25 issue of The Lancet, offers "unequivocal good news" says an accompanying commentary. A hard-hitting Lancet editorial published alongside says that the finding has "important public health implications" and calls for oral contraceptives to be made available over the counter.

In the article, researchers from the Collaborative Group on Epidemiological Studies of Ovarian Cancer analyzed individual data on more than 100,000 women from 21 countries. They report that 10 years of oral contraceptive use was estimated to reduce the incidence of ovarian cancer from 1.2 to 0.8 per 100 users and reduce death from ovarian cancer from 0.7 to 0.5 per 100 users. Expressing these figures another way, the researchers, headed by Valerie Beral, MD, from Oxford University, Oxford, United Kingdom, point out that if 5000 women used oral contraceptives for 1 year, approximately 2 cases of ovarian cancer and 1 death from ovarian cancer before the age of 75 years would be prevented.

Dr. Beral and colleagues estimate that in the last 50 years during which oral contraceptives have been available, approximately 200,000 cases of ovarian cancer and 100,000 deaths have been prevented worldwide. As use of these products continues to increase, they estimate that for the next few decades, oral contraceptives could prevent 30,000 cases of ovarian cancer annually.

"These findings set a new standard in primary prevention for a deadly cancer," the editorial comments. "There are few drugs available that confer powerful and long-lasting protection against a highly lethal malignancy after such a short exposure."

However, an accompanying commentary is more cautious. Eduardo L. Franco, PhD, from McGill University in Montreal, Canada, and his wife, Eliane Duarte-Franco, MD, from the Institut National de Sante Publique du Quebec, also in Montreal, say that "women and their health-care providers are once gain at a balancing act of judging risks versus benefits."

In addition to ovarian cancer, oral contraceptives have also shown a protective effect against endometrial and colorectal cancer. However, they have also been linked with an increased risk for breast and cervical cancer, they point out, and "calculation of the next effect on women's health is fraught with uncertainties."

Source: Lancet. 2008;371:275, 277-278, 303-314. Click clinical tests.

Pharmacology in a Song. Memorize Drugs (generic names) easily.. i think

This is quite a nifty stuff to actually learn drugs, medications through a song, though I personally don't think that this funny song might actually help you memorize all that's on it, but at least, it would help you memorize some. The good thing is that, the writer actually compiled the most commonly used drugs based on their classification. Memorizing the drug's actions would be the least you could do here (well, you would still need a drug handbook or the infamous MIMS/PIMS.)

Deadline of filing for the 2008 Nurses Licensure Examination

The PROFESSIONAL REGULATION COMMISSION announces that the schedules and deadlines in filing applications for the Nurses Licensure Examinations for year 2008 are as follows:

DATES of Exam	DAYS of Exam	DEADLINE
JUNE 1 & 2, 2008	SUNDAY & MONDAY	APR18, 2008
NOVEMBER 29 & 30, 2008	SATURDAY & SUNDAY	OCT17, 2008

The PRC is now accepting applications for the June 2008 NLE at the PRC Central Office and at the PRC regional offices in the cities of Baguio, Cagayan de Oro, Cebu, Davao, Iloilo, Legaspi, Lucena, Tacloban, Tuguegarao and Zamboanga. Some 80,000 to 100,000 or more examinees are expected to take the NLE in June 2008.

Graduates of March or April 2008 will be accepted in the June 2008 examination, provided, they will be able to submit, at the time of filing applications on or before the deadline, all the documentary requirements, i.e., Transcript of Records with scanned picture, Birth Certificate in NSO security paper, Notarized/Sworn Summary of Related Learning Experience and OR/DR cases, .

The PRC enjoins early filing of applications to avoid over-crowding at the PRC filing centers.

APPLICATIONS WILL NO LONGER BE ACCEPTED AFTER THE DEADLINE.

p.s. There were some confusions regarding the filing deadline for the 2008 Nurses Licensure Exam prompting the PRC to release a circular memo, click HERE to download the Memorandum Circular No. 2008-01.

Before the year ends, Pahabol.. PRC ID's

To all Nurses who took and passed the June 2007 Nursing Licensure Exam Cagayan de Oro, your PRC IDs are now available (at the PRC Office, Cagayan De Oro City) , for passers with family names starting with the letters A & B respectively. Keep posted for updates regarding the PRC IDs and the December 2007 exam results for nursing.

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Happy New Year!