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Children's Hospital Boston, in conjunction with MetroWest Medical Center, presents the following Pediatric Health Care Summit. The summit is a free, community-based continuing medical education seminar designed to inform primary pediatric providers of trends in the management of common pediatric health concerns.
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2. HEART ATTACKS AND STROKES Oral contraceptives may increase the tendency to develop strokes stoppage or rupture of blood vessels in the brain ; and angina pectoris and heart attacks blockage of blood vessels in the heart ; . Any of these conditions can cause death or serious disability. Smoking greatly increases the possibility of suffering heart attacks and strokes. Furthermore, smoking and the use of oral contraceptives greatly increase the chances of developing and dying of heart disease. 3. GALLBLADDER DISEASE Oral contraceptive users probably have a greater risk than nonusers of having gallbladder disease, although this risk may be related to pills containing high doses of estrogens. 4. LIVER TUMORS ln rare cases, oral contraceptives can cause benign but dangerous liver tumors. These benign liver tumors can rupture and cause fatal internal bleeding. ln addition, a possible but not definite association has been found with the pill and liver cancers in two studies, in which a few women who developed these very rare cancers were found to have used oral contraceptives for long periods. However, liver cancers are extremely rare. The chance of developing liver cancer from using the pill is thus even rarer. 5. CANCER OF THE REPRODUCTIVE ORGANS AND BREASTS Various studies give conflicting reports on the relationship between breast cancer and oral contraceptive use. Oral contraceptive use may slightly increase your chance of having breast cancer diagnosed, particularly after using hormonal contraceptives at a younger age. After you stop using hormonal contraceptives, the chances of getting breast cancer begin to go back down. You should have regular breast examinations by a healthcare provider and examine your own breasts monthly. Tell your healthcare provider if you have a family history of breast cancer or if you have had breast nodules or an abnormal mammogram. Women who currently have or have had breast cancer should not use oral contraceptives because breast cancer is a hormone-sensitive tumor. Some studies have found an increase in the incidence of cancer of the cervix in women who use oral contraceptives. However, this finding may be related to factors other than the use of oral contraceptives, for example, plavix tablets.

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Rationale: Per health plan, to ensure appropriate use of Actiq for breakthrough pain relief, in combination with a long-acting opioid medication regimen in patients with chronic pain secondary to cancer. Actiq is not to be used as a first-line opioid pain relieving agent and should be reserved for use when other agents are ineffective, contraindicated, or not tolerated per guidelines. Actiq should never be used without a concomitant long acting opioid medication. FDA Approved Indication: Actiq is indicated only for the management of breakthrough cancer pain in patients with malignancies who are already receiving and who are tolerant to opioid therapy for their underlying persistent cancer pain. References: 1. Actiq Product Information, Cephalon, Inc. 2004. 2. Fentanyl citrate Product Information, Barr Labs, 2006. 3. Fentora Product Information, Cephalon, Inc 2006. 4. Healthcare Guidelines: Assessment and Management of Acute Pain. ICSI March 2006. ICSI accessed 8 21 2006. Healthcare Guidelines: Assessment and Management of Chronic Pain. ICSI May 2006. ICSI accessed 8 21 2006. Healthcare Guidelines: Headache Diagnosis and Treatment. ICSI Jan 2006. ICSI accessed 8 21 2006 and plendil.

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Hanna JP, Frank JI, Furlan AJ, Sila CA, Secic M. Prediction of Worsening Consciousness From Edema After Hemispheric Infarction. Journal of Stroke and Cerebrovascular Diseases, 1996. 6 1 ; : 25-29. Lavertu P, Guay ME, Meeker SS, Kmiecick JR, Secic M, Wanamaker JR, Eliachar I, Wood BG. Secondary Tracheoesophageal Puncture: Factors Predictive of Voice Quality and Prosthesis Use. Head and Neck, 1996. 393-398. Weinstock-Guttman B, Secic M, Kinkel RP. A composite outcome measure to monitor clinical response to M.S. treatment protocols. Journal of Neuroimmunology, 1996. 971 ; : 56-63. Hirakawa K, Bauer TW, Stulberg BN, Wilde AH, Secic M. Characterization and Comparison of Wear Debris From Failed Total Hip Implants of Different Types. Journal of Bone and Joint Surgery, 1996. 78-A 8 ; : 1235-1243. Lonzer MD, Imrie R, Roger D, Worley D, Licata A, Secic M. Effects of Heredity, Age, Weight, Puberty, Activity and Calcium Intake on Bone Mineral Density in Children. Clinical Pediatrics, 1996. April: 185-189. Lowder CY, Secic M, Butler CP, Dodds EM, Recillas-Gispert C. CD8 + T lymphocytes and cytomegalovirus retinitis in patients with the acquired immunodeficiency syndrome - Reply. American Journal of Ophthalmology, 1996. 121 4 ; : 455-456. Bloomfield EL, Porembka DT, Ebrahim ZY, Grimes-Rice M, Secic M, Little JR, Lockrem JD, Analysis of Catecholamine and Vasoactive Peptide Release in Intracranial Arterial Venous Malformations. Journal of Neurosurgical Anesthesiology, 1996. April; 8 2 ; . Secic M. Discussion of the Comparison of GLM and MIXED Procedures for a Repeated Measures Design: One Within and One Between Subjects Factor. Mid-West SAS User's Group Proceedings, 1995 October. Goodkin DE, Jacobsen DW, Galvez N, Daughtry M, Secic M, Green R. Serum Cobalamin Deficiency is Uncommon in Multiple Sclerosis. Archives of Neurology, 1995. 51: 11, Rom ME, Keller WB, Meyer CJ, Meisler DM, Chern KC, Lowder CY, Secic M. Relationship Between Corneal Edema and Topography. Contact Lens Association of Ophthalmologists Journal, 1995. 21 3 ; : 191-194. Lowder CY, Butler CP, Dodds EM, Secic M, Recillas-Gispert C. CD8 + T Lymphocytes and Cytomegalovirus Retinitis in Patients with Acquired Immunodeficiency Syndrome. American Journal of Ophthalmology, 1995. 120 3 ; : 283-290. Jacobsen DW, Gatautis VJ, Green R, Robinson K, Savon SR, Secic M, Ji J, Otto J, Taylor LM Jr. Rapid HPLC Determination of Total Homocysteine and Other Thiols in Serum and Plasma: Sex Differences and Correlations with Cobalamin and Folate Levels in Normal Subjects. Clinical Chemistry, 1994. 40: 873-881. Broughan TA, Valenzuela R, Escorcia E, Secic M, Vogt DP. Mouse Antibody-coated Lymphocytes During OKT-3 Therapy in Liver Transplantation. Clinical Transplantation, 1994. 8: 488-491. Vanek EP, Carey W, Secic M, Jackman D, Fleshler B. Value of Needs Assessment Surveys. Journal of Continuing Education in the Health Professions, 1994. 14 4 ; : 224-231. Gupta MK, McBride N, Secic M, Sheeler L, Kohse L, Licata A, Hoogwerf B. TSH Receptor Antibodies in Graves' Ophthalmopathy: High Association and Predictive Role of Thyroid Stimulating but not TSH Binding Inhibitory Antibodies. Endocrine Journal, 1994. 2: 305-310. Wood DA, Hughes GB, Secic M, Good TL. Objective Measurement of Normal Facial Movement with Video Microscaling. The American Journal of Otology, 1994. 15 1 ; : 61-65.
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Under this alliance, we are required to purchase minimum levels of DEPOCYT finished goods equal to $5.0 million in net sales for each calendar year Minimum Annual Purchases ; through the remaining term of the agreement. SkyePharma is also entitled to a milestone payment of $5.0 million if our sales of the product exceed a $17.5 million annual run rate for four consecutive quarters and an additional milestone payment of $5.0 million if our sales exceed an annualized run rate of $25.0 million for four consecutive quarters. We are also responsible for a $10.0 million milestone payment if the product receives approval for all neoplastic meningitis prior to December 31, 2006. This milestone payment will be incrementally reduced if the approval is received subsequent to December 31, 2006 to a minimum payment of $5.0 million for an approval after December 31, 2007. Our license is for an initial term of ten years and is automatically renewable for successive two-year terms thereafter. Either party may terminate the agreement early upon a material breach by the other party, which breach the other party fails to cure within 60 days after receiving notice thereof. Further, SkyePharma will be entitled to terminate the agreement early if we fail to satisfy our Minimum Annual Purchases. In addition, we will be entitled to terminate the agreement early if a court or government agency renders a decision or issues an order that prohibits the manufacture, use or sale of the product in the U.S. If a therapeutically equivalent generic product enters our markets and DEPOCYT's market share decreases, we will enter into good faith discussions in an attempt to agree on a reduction in our payment obligations to SkyePharma and a fair allocation of the economic burdens resulting from the market entry of the generic product. If we are unable to reach an agreement within 30 days, then either party may terminate the agreement, which termination will be effective 180 days after giving notice thereof. After termination of the agreement, we will have no further obligation to each other, except the fulfillment of obligations that accrued prior thereto e.g., deliveries, payments, etc. ; . In addition, for six months after any such termination, we will have the right to distribute any quantity of product we purchased from SkyePharma prior to termination. Zeneus Manufacturing Agreement Zeneus Pharma, Ltd. Zeneus ; owns the right to market ABELCET in any markets outside of the U.S., Canada and Japan. Our supply agreement with Zeneus requires that we supply Zeneus with ABELCET and MYOCET through November 21, 2011. For the period from November 22, 2002 until June 30, 2004, we supplied ABELCET and MYOCET at fixed transfer prices that would subsequently be adjusted to Enzon's actual manufacturing cost. Beginning on July 1, 2004 through the termination of the agreement, we supply these products at our manufacturing cost plus fifteen percent for ABELCET and plus twenty percent for MYOCET. In December 2005, Zeneus became a wholly owned subsidiary of Cephalon, Inc. Patents and Intellectual Property Rights Patents are very important to us in establishing the proprietary rights to the products we have developed or licensed. Our new executive management team has been reinforcing our organizational commitment to intellectual property. The patent position of pharmaceutical or biotechnology companies can be uncertain and involve complex legal, scientific and factual questions. If our intellectual property positions are challenged, invalidated or circumvented, or if we fail to prevail in potential future intellectual property litigation, our business could be adversely affected. We currently hold 129 issued U.S. patents many of which have foreign counterparts. These patents, without extensions, are expected to expire beginning in 2006 through 2022. We have also filed and currently have pending 30 patent applications in the U.S. Under our license agreements, we have access to large portions of Micromet's and Nektar's patent estates, as well as a small number of individually licensed patents. Of the patents owned or licensed by us, 7 relate to PEG-INTRON, 17 relate to ABELCET, and 3 relate to DEPOCYT. Although we believe that our patents provide adequate protection for the conduct of our business, we cannot assure you that such patents: s will be of substantial protection or commercial benefit to us, s will afford us adequate protection from competing products, or s will not be challenged or declared invalid and pravachol.

Other antecedents, such as cognitive resources, accessibility of motives, and persuasion expertise cf. Campbell and Kirmani 2006 ; . The notion that prevention focused individuals may try to avoid being unduly persuaded by an ad suggests that a prevention focus may lead to greate r use of sentry coping strategies Kirmani and Campbell 2004 ; . In a study of consumers' persuasion coping behaviors, Kirmani and Campbell described two general approaches by consumer targets for dealing with interpersonal persuasion agents: targets behaving as goal seekers attempted to use the persuasion agent to achieve their own purchase-related goals, while targets behaving as persuasion sentries attempted to achieve their purchase-related goals by guarding against unwanted persuasion. Sentry strategies, reflecting the desire to avoid being unduly persuaded, included forestalling, deception, assertive resistance, confrontation, punishment, withdrawal, preparation, and enlisting a companion. Our research suggests that sentry strategies may be more likely to be used in a prevention focus, while seeker strategies may be more likely to be used in a promotion focus. This would extend our findings beyond the advertising context to interpersonal persuasion. Future research may examine the link between regulatory focus and persuasion coping strategies. Another contribution of the paper is to demonstrate that general suspicion of companies can affect processing of advertising. Darke and Ritchie forthcoming ; show that when people learn that they have been personally deceived by an ad, their distrust spills over to ads from other advertisers. Our paper describes a much more general phenomenon. Our suspicion manipulation was different from theirs in two important ways: 1 ; people were not personally deceived by the susp icion -arousing stimulus; and 2. The ambulance took Logan to an emergency room. He was later transferred to the Pediatric Intensive Care Unit at Gillette. "We knew immediately that we were in good hands, " says Crawford. "Gillette had the most reassuring and professional medical staff I'd ever seen." Doctors explained that Logan had sustained a traumatic brain injury, was comatose and needed a ventilator to help him breathe. He didn't begin to regain consciousness for three weeks. "Until that day, we didn't know if he would live, " Crawford recalls. Gillette patients move from intensive care to our Center for Pediatric Rehabilitation as soon as they're medically stable. Some, like Logan, are admitted while they're unconscious or breathing with ventilators. By working with children early in their recovery, our therapists can help prevent muscle contractions and other complications. Once Logan regained consciousness, he continued with physical therapy. He also began occupational and speech therapy. "Logan stayed in the hospital a day shy of three months, " says Crawford. "I was with him the entire time. Gillette was so accommodating. They really understood the situation and encouraged me to be with my son. We couldn't have asked for a better facility." After returning home, Logan continued an exercise regimen to rebuild strength and improve his balance. "He still receives therapy twice a month at Gillette, " says Crawford. "When he walks down the halls, staff members greet him. They all love seeing how well he's doing and prednisone.
Information available to the members of the Board : The Board of your Company is presented with all information under the following heads whenever applicable and materially significant. These are submitted either as a part of the agenda papers well in advance or are tabled in the course of the Board meetings. The information regularly supplied to the Board includes: Review of annual operating plans of business, capex budget and updates, if any. Quarterly results of the Company. Minutes of the meeting of the Audit Committee and other committees. Information on the recruitment and remuneration of senior officers just below the Board level including the appointment and removal of the Chief Financial Officer and the Company Secretary. Materially important show causes, demands, prosecutions and penalty notices. Fatal or serious accidents or dangerous occurrences. Any material effluent or pollution issues. Any material default in financial obligations to and by the Company or any substantial non-payment for goods sold by the Company. Any issue which involves possible public or product liability claims of a substantial nature. Details of joint ventures or collaboration agreements. Transactions that involve substantial payments towards goodwill, brand equity and intellectual property, if any. Significant labour problems and development in human resources industrial relations. Material sale of investments, investments in subsidiaries and assets not in the normal course of business. Quarterly details of foreign exchange exposure and the steps taken by the management to manage the exchange risk of adverse exchange rate movement. Non compliance of any regulatory or statutory provision or listing requirements as well as shareholder service such as the non-payment of dividends, delays in share transfers, etc!


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