Partners in Health of Maine

We have all heard about the good work being done by Partners in Health, but there is another PIH, lesser known, but equally well-intentioned. It is called Partners in Health of Maine. It is a nonprofit, nondenominational organization whose mission is to provide health services, training, education and volunteer opportunities for health care providers in third world countries. Its activities have been limited to Central America, with a focus on Nicaragua and Guatemala. The organization grew around the volunteer work of Dr. Robert Bach, a general surgeon from Maine, and other health care workers who had been volunteering in Central America since 1975. The two PIHs started at about the same time, and I guess both want to keep the name!

Most of the work of PIH of Maine has centered on the Autonomous Atlantic Region (RAAN), Nicaragua’s largest province, which occupies approximately a fifth of the land area and is located on the Northeastern Caribbean coast. This area is inhabited by indigenous Miskito Indians and people of Afro-Caribe and Spanish descent.

A friend of a friend provides some of the color of the Maine organization in a recent email, written after attending a briefing in the US, complete with a story of low-cost innovation by a clever team:

I am going to Nicaragua because I was invited by old friends from Waterville. John and Mary got involved five or six years ago. The work was originally focused on providing medical care to a town on the Atlantic side of Nicaragua. John is a pathologist, and he has been instrumental in writing grants and training Nicaraguan doctors to prepare and read slides in an effort to catch some of the rampant cases of cervical cancer early enough to provide treatment.

In the States, slides are prepared with the aid of a $30,000.00 tissue processor. The machine is massive and the reagents are unavailable in Nicaragua. So the ever-resourceful John invented a way to process slides using a $69.00 microwave oven! He enlisted the aid of his brother-in-law, a retired computer chip engineer, and the two of them figured out a way to program the oven to cycle and hold the kind of temperatures required to "fix" the slides.

And, then some more!

John’s wife Mary is an artist. She was featured on one of the slides shown during the PIHOM presentation...her smiling face lit up the screen and the caption underneath read “I’m an there anything I can do to help?”

Dr. Bach admitted he groaned a bit inside when she showed up with her offer! And today she has grown into the heart and soul of the tiny grassroots group. Mary has painted colorful and uplifting murals on the online pharmacy viagra walls, she has taken over the newsletter, she writes grants, she teaches English classes. Yes, there was/is a lot she can do to help and her example was a great inspiration to the non-medical folks in the room. "Health" directly translates to "hope" in Arabic and medical care is only one leg of the stool.

This is a lovely example of people helping people. They are looking for volunteers, supplies, and cash. Go to this website for more information on how to help out.

Evidence-based Sports Medicine, 2nd ed. 2007

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Evidence-Based Sports Medicine
(Evidence-Based Medicine)
Domhnall MacAuley and Thomas Best
ISBN-10: 1405132981
ISBN-13: 978-1405132985
BMJ Books

This second edition of the popular book Evidence-based Sports Medicine builds on the features that made the first edition such a valuable text and provides a completely up-to-date tool for sports medicine physicians, family practitioners and orthopedic surgeons.
Updated to take into account new evidence from systematic reviews and controlled trials, Evidence-based Sports Medicine is a unique reference book on the optimum management of sports-related conditions. This second edition:
  • contains sections on acute injury, chronic conditions, and injuries to the upper limb, groin and knee and to the lower leg
  • pays increased attention to the important and emerging area of injury prevention
  • features thoroughly revised methodology sections within each chapter, reflecting changes in technique and application
  • MCQs and essay questions that allow readers to continually assess their knowledge and understanding of the topics covered



Boehringer Ingelheim’s lead hepatitis C compound moves into phase III – the first within

02 April 2011

FDA Fast Track designations granted for both: the protease cheap cialis BI 201335 plus standard-of-care and the interferon-free combination of BI 201335 with polymerase inhibitor, BI 207127

Not for U.S. media

INGELHEIM, Germany, 2 April 2011 – Boehringer Ingelheim today announced the study outline for the pivotal Phase III clinical trials designed to evaluate BI 201335, its investigational once-daily oral protease inhibitor, in both treatment-naïve and -experienced patients with chronic genotype-1 hepatitis C virus (HCV), the most challenging genotype to treat.

In parallel, the U.S. Food and Drug Administration (FDA) has granted Fast Track designations for BI 201335 plus standard-of care (SOC), and as part of the interferon-free combination with the polymerase inhibitor, BI 207127, in chronic genotype-1 HCV patients.

"We are delighted to receive the FDA’s Fast Track designation for both, our BI 201335 plus SOC, and interferon-free combination treatment approaches. If successful, the combination therapy carries the potential for patients to live without the burden of interferon’s side effects," said Professor Klaus Dugi, Corporate Senior Vice President Medicine at Boehringer Ingelheim.

"We are committed to bringing BI 201335 forward, with the ambition of improving cure rates for the benefit of those living with hepatitis C."

BI 201335 Phase III Trials*

BI 201335 will be evaluated in multiple randomised, double-blind, placebo-controlled trials in combination with pegylated-interferon and ribavirin (PegIFN/RBV), the current HCV SOC. The Phase III trials include two studies in treatment- naïve and one study in treatment-experienced chronic genotype-1 HCV patients. The two studies in treatment-naïve patients will be conducted in the European Union and Japan, as well as the U.S., Canada, Taiwan and Korea. The study in treatment-experienced patients will be conducted globally. BI 201335 will be dosed once-daily at either 120mg or 240mg in combination with PegIFN/RBV and treatment durations will range from 24 to 48 weeks. The primary endpoint of each trial is sustained viral response (SVR), which is considered viral cure. These studies are part of a broader Phase III trial programme expected to commence in the second quarter of 2011.

PegIFN-Free Phase II Trials of BI 201335 + BI 207127

In parallel, Boehringer Ingelheim is developing BI 207127, an oral HCV polymerase inhibitor that has completed Phase I clinical trials in combination with BI 201335. Phase II trials evaluating BI 207127 plus BI 201335 in PegIFN-free regimens, both with and without ribavirin, are currently underway. The FDA has designated this investigation as a Fast Track development programme. Fast Track is a process designed to facilitate the development and expedite the review of drugs to treat serious diseases and fill an unmet medical need. The purpose is to get important new drugs to patients earlier.

About Hepatitis C Virus (HCV)

HCV is an infectious disease of the liver and is a leading cause of chronic liver disease and liver transplant. The number of individuals chronically infected with HCV globally has been estimated at 170 million, with 3–4 million new infections occurring each year. Only about 20–45% of patients clear the virus in the acute phase. Of the remaining chronically infected patients, 20% will develop cirrhosis within a mean of 20 years. The mortality rate after cirrhosis has developed is 2-5% per year. End-stage liver disease due to HCV infection currently represents the major cause for liver transplantation in the Western world.

About Boehringer Ingelheim in Virology

Boehringer Ingelheim has more than 6,900 scientists working in cross disciplinary teams within our global R&D network in six large therapeutic areas, including virology. In addition to its ongoing research programme for HCV, Boehringer Ingelheim has a long-standing history in virology drug development, including compounds for the treatment of HIV (VIRAMUNE® (nevirapine) tablets/oral suspension, the first approved HIV non-nucleoside reverse transcriptase inhibitor (NNRTI) and Aptivus®, an HIV protease inhibitor). The company has a well established research centre in Laval, Canada, dedicated to virology research since the early 1990’s, and is committed to developing new therapies for virological diseases with a high unmet medical need.

Boehringer Ingelheim in Hepatitis C Virus (HCV)

BI 201335 is an investigational oral HCV NS3/4A protease inhibitor, discovered from Boehringer Ingelheim’s own research and development, which has completed clinical trials through Phase IIb (SILEN-C studies). This Phase II programme supports the investigation of BI 201335 in Phase III trials. Boehringer Ingelheim is also developing BI 207127, an NS5B RNA-dependent polymerase inhibitor that has completed Phase I clinical trials. Phase II trials evaluating BI 207127 with BI 201335 in interferon-sparing regimens, both with and without ribavirin, are currently underway.

Boehringer Ingelheim

The Boehringer Ingelheim group is one of the world’s 20 leading pharmaceutical companies. Headquartered in Ingelheim, Germany, it operates globally with 142 affiliates in 50 countries and more than 41,500 employees. Since it was founded in 1885, the family-owned company has been committed to researching, developing, manufacturing and marketing novel products of high therapeutic value for human and veterinary medicine.

In 2009, Boehringer Ingelheim posted net sales of 12.7 billion euro (US $17.7 billion) while spending 21% of net sales in its largest business segment, Prescription Medicines, on research and development.

For more information, please visit

*Final results of the Phase II studies SILEN-C1 and SILEN-C2 for BI 201335 were presented yesterday at the International Liver Congress TM 2011, the 46 th Annual Meeting of the European Association for the study of the liver (EASL) in Berlin.


Staring At Women's Breasts Good For Men's Health

Sin Chew Daily reported that the latest German research says that cheap cialis staring at women's breasts for 10 minutes everyday will increase his life span by 5 years.

The study published in the New England Journal of Medicine also claims that 10 minutes of ogling at women's breasts is equivalent to 30-minutes working out in the gym.

Apparently, cheap cialis who stare at women's breasts have lower blood pressure and it reduces his risk of cardiovascular diseases.

Gerontologist Dr Karen Weather explains that sexual desire improves blood circulation and this leads to better health.

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