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Combination Approaches: Enhancing the Reach & Effectiveness of MSM-Targeted Combination HIV Prevention Interventions
HIV in Men Who Have Sex with Men in Sub-Saharan Africa
This article is a brief yet poignant comment on MSM in sub-Saharan Africa. The article states that 32 of 45 sub-Saharan African countries reported that MSM indicators were relevant to their country; however, no data were available for any of them. There are huge surveillance gaps, and of the 1 percent of governmental spending earmarked for special populations only 8 percent of those funds are budgeted for programs targeting MSM.
The Global HIV Epidemics among MSM
This 300-page monograph is one of the most comprehensive MSM-specific resources available to date focusing on MSM HIV epidemics in low- and middle-income countries. It provides an up-to-date, detailed overview of epidemic scenarios among MSM across the globe, using selected country studies to describe and explore epidemiological variance across contexts. A modified Goals Model for MSM was developed to model the effects of MSM preventive services in the countries, as well as a costing exercise to estimate their degree of cost-effectiveness. The monograph also contains detailed information on combination HIV prevention interventions, graded using a novel adaptation of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system for public health interventions, with recommendations for priority areas. There is a chapter on epidemic modeling of prevalence, incidence, and cost in MSM populations, as well as a chapter focused on policy and human rights.
The Global Epidemics of HIV among MSM in 2010: Epidemiology, Responses, and Human Rights
This presentation, given at the Global Forum on MSM and HIV Preconference in Vienna in 2010, contains these key findings related to HIV prevention among MSM: (1) MSM-specific prevention interventions can have an impact on the rate of new infections in the general population but must include access to antiretrovirals for MSM; (2) where people who inject drugs play a major role in the epidemic, needle-exchange programs and substitution therapy programs can have a major impact on the rate of new infections in the general population; and (3) human rights–based approaches and science are in agreement. The presentation provides a detailed overview of four distinct epidemic scenarios, recognizing that HIV epidemics among populations of MSM occur together with those affecting other exposed groups (i.e., people who inject drugs, heterosexuals).
The Effectiveness of Individual-, Group-, and Community-Level HIV Behavioral Risk-Reduction Interventions for Adult Men Who Have Sex with Men—A Systematic Review
This article presents the results of a systematic review of the effectiveness and cost-effectiveness of individual-, group-, and community-level HIV behavioral prevention interventions for MSM. Of 664 titles screened, the article presents 31 candidate studies as a body of evidence, with each evaluated according to a series of parameters, including intervention effectiveness, applicability, economic efficiency, and barriers to implementation. The review shows that individual-level, group-level, and community-level HIV behavioral interventions can reduce the odds of unprotected anal intercourse (by 27 to 43 percent) and increase the odds of condom use for the group-level approach (by 81 percent). Group- and community-level interventions were found not only to be cost-effective, but also to result in cost savings. The review can be used as a tool in HIV policy and program work to help secure resources and commitment for implementing interventions among MSM. v
Behavioral Interventions to Reduce Risk for Sexual Transmission of HIV among Men Who Have Sex with Men
This review considers behavioral interventions as a means for reducing risk for sexual transmission of HIV among MSM. It analyzes 44 studies evaluating 58 interventions, including small group-, individual-, and community-level approaches. Interventions reviewed include individual counseling, peer education, group counseling, and interventions in community areas, among others. The review found that behavioral interventions can lead to significant reduction in risk for HIV transmission among MSM; however, it highlights the need for further analysis to understand in greater detail which interventions are most effective for which groups. One interesting finding is that interventions that included greater than 25 percent non–gay-identifying MSM were more effective than those that did not. This suggests that, when they can be reached, these men may be more responsive to risk reduction efforts.
Mental Health and HIV Risk in Men Who Have Sex with Men
Using the early monotherapeutic AZT HIV treatment as a metaphor, this article makes the point that current behavioral approaches to HIV risk reduction among MSM have shown short-term effects but have not shown effectiveness in the long term. Looking at recent articles that have explored the effect of diverse psychosocial factors interacting to produce elevated risk behavior among MSM—called a syndemic—the authors hypothesize that psychosocial and mental problems may moderate the ability of existing interventions to reduce risk. Addressing co-occurring psychosocial risk factors may improve the effect sizes of current HIV prevention interventions, allowing for more effective intervention uptake by MSM. The authors advocate for combination approaches to prevention.
Elevated Risk for HIV Infection among Men Who Have Sex with Men in Low- and Middle-Income Countries 2000–2006: A Systematic Review
MSM in low- and middle-income countries in Asia, Africa, Latin America, and the former Soviet Union experience high levels of HIV transmission. The authors examined the relationship between HIV prevalence among MSM to that of the general population in countries with low to high HIV prevalence overall. After conducting a meta-analysis of studies in low- and middle-income countries, the authors found that HIV prevalence among MSM was 58 times as high as the general population in nations with very low prevalence. In medium-high prevalence settings, HIV prevalence among MSM remained high, at nine times that of the general population. MSM from low- and middle-income countries are in urgent need of prevention and care, and appear to be both understudied and underserved, due in part, say the authors, to the criminalization of sex between consenting adult men in 85 countries as of 2007.
Review of Sampling Hard-to-Reach and Hidden Populations for HIV Surveillance
Surveillance is crucial to containing HIV epidemics, including groups that are "hidden" and difficult to reach with conventional methods such as snowball, time-location sampling, and facility- and survey-based sampling methods. This article critically reviews alternative sampling strategies for undertaking research among such difficult-to-reach subpopulations. Many of the preexisting methods carry challenges, limiting their applicability. The article concludes that respondent driven sampling shows promise for research among MSM subpopulations; however, further evaluation is required regarding its applicability in resource-poor settings.
HIV Prevalence, Risks for HIV Infection, and Human Rights among Men Who Have Sex with Men (MSM) in Malawi, Namibia, and Botswana
This study of 537 men is the first cross-sectional study establishing MSM as a high-risk group for HIV infection and human rights abuses in the countries of Malawi, Namibia, and Botswana. In these contexts, a significant proportion of men identified as either heterosexual or bisexual, and were married or had at least one female partner in the previous six months. An important finding of the study establishes the Internet as the predominant tool used by MSM to find male sexual partners. This is especially true in contexts like Malawi, Namibia, and Botswana, where homosexuality is criminalized and there is no safe, legal space for MSM to congregate. The authors suggest the Internet may represent a powerful tool for efficiently reaching and delivering prevention messages to MSM.
Recruiting Hard-to-Reach Drug-Using Men Who Have Sex with Men into an Intervention Study: Lessons Learned and Implications for Applied Research
This study presents a unique, effective, and cost-effective, two-stage recruitment strategy for enrolling high-risk MSM in research studies. It analyzes data from two years of recruiting injection-drug-using gay and bisexual men into a research study. It presents and contrasts the results of the two prongs of the study recruitment process. One used a strategy of marketing the research study itself to men; the other followed a two-stage recruitment strategy that began with an initial low-commitment survey, followed by a subsequent invitation into the trial upon completion of the first visit.
Discordance between Sexual Behavior and Self-Reported Sexual Identity: A Population-Based Survey of New York City Men
The researchers describe discordance between self-described sexual identity and behavior among MSM and the relationship between self-described sexual identity and risk behaviors. Of New York City men reporting a sexual identity, 12 percent reported sex with other men. MSM who self-identified as heterosexual were more likely than their gay-identified counterparts to belong to minority racial or ethnic groups, to be foreign-born, to have lower education and income levels, and to be married. Heterosexual or "straight-identified" MSM were more likely to report having only one sexual partner in the previous year than gay-identified MSM, but were less likely to have been tested for HIV and were less likely to have used condoms during their last sexual encounter. The authors conclude that medical providers cannot rely on patients' self-reported identities and that public health messages should target risky sexual activities rather than a person's sexual identity.
They See You as a Different Thing: The Experiences of Men Who Have Sex with Men with Healthcare Workers in South African Township Communities
This qualitative study describes interactions between MSM and health care workers (HCWs) in South Africa and found that many MSM felt their options for non-stigmatizing sexual health care services were limited by homophobic verbal harassment by HCWs. Gay-identified men sought out clinics with reputations for employing workers who respected their privacy and sexuality, and some challenged workers who mistreated them. Non-gay-identified MSM presented masculine, heterosexual identities and avoided discussing their sexuality with HCWs. The strategies MSM employ to confront or avoid homophobia from HCWs may not be conducive to health promotion. Initiatives to improve appropriate care from public sector HCWs are urgently needed.
Reaching African-American Men on the Down Low: Sampling Hidden Populations: Implications for HIV Prevention
Studies of the impact of the HIV epidemic among African-American MSM have largely neglected men who self-identify as heterosexual but who engage in same-sex behavior. These men, commonly referred to as "men on the down low," pose formidable challenges to researchers conducting prevention studies. The authors discuss the benefits and drawbacks of various sampling methods to identify these hard-to-reach MSM and describe a novel approach to reaching these men. Instead of relying on self-identified gay men or gay establishments, the researchers successfully used three recruiters who frequented known cruising areas (a park and the Internet) to find men who would meet the general classification of men on the down low.
Accessing Men Who Have Sex with Men through Long-Chain Referral Recruitment
The authors compared MSM identified by two methods: convenience sampling and long-chain referral. Long-chain referral relies on study participants to recruit their acquaintances to the study, who in turn recruit their acquaintances. Long-chain referral identified more MSM who were migrants, young, from lower-income groups, and at higher risk for HIV than those identified by a convenience sample (such as all men attending a certain clinic). The authors state that long-chain referral can reach subgroups better than convenience samples. The authors report behavioral-risk outcomes associated with various subpopulations.
Reaching Men Who Have Sex with Men (MSM) in the Global HIV & AIDS Epidemic: A Policy Brief
This policy brief succinctly argues that MSM shoulder a disproportionate burden of HIV globally, and therefore countries need to increase their commitment to and coverage of MSM populations. It identifies the following strategic areas for increased work, with specific action recommendations for each: (1) increased investment in effective HIV treatment, care, and support for MSM; (2) expanded coverage of quality services for MSM; (3) increased MSM-related knowledge through research; (4) decreased violence, stigma, and discrimination against MSM; and (5) strong MSM networks linked to MSMGF. Quotes from MSM activists throughout the world are included.
A Novel Approach to Prevention for At-Risk HIV-Negative Men Who Have Sex With Men: Creating a Teachable Moment to Promote Informed Sexual Decision-Making
Serosorting provides an alternative to condom use and thus addresses the problem of safer-sex "fatigue." However, there are challenges to this approach, which is reliant on informed decision making regarding selection of lower-risk partners. This study tested a brief, one-on-one, peer counselor–delivered intervention based on informed decision making to address the limitations of serosorting. The intervention was based on conflict theory, which prepares people for informed decision making and creates a "teachable moment," wherein participants are more open to change. The results showed that men in the serosorting intervention reported fewer sexual interventions at follow-up.
Comparisons of Disparities and Risks of HIV Infection in Black and Other Men Who Have Sex with Men in Canada, UK, and USA: A Meta-Analysis
This article is a meta-analysis that assesses factors associated with disparities in HIV infection in black MSM in Canada, the United Kingdom, and the United States from 1981 to 2011. The authors base their findings on aggregated data from racial comparative studies with outcomes associated with HIV risk or infection from seven studies from Canada, 13 from the United Kingdom, and 174 from the United States. It looks at data related to a number of factors, including seropositivity, drug use, structural barriers, and access to prevention services, among others. The study finds that there are similar racial disparities in terms of HIV status, STIs, and ART initiation among MSM in the United Kingdom and the United States. The study concludes that elimination of these disparities cannot be accomplished unless structural barriers to clinical care access are addressed.
Coming to Terms with Complexity: A Call to Action for HIV Prevention
This article is a well-articulated, evidence-based argument for combination approaches to HIV prevention. The authors recognize the complexity of the HIV epidemic, and discuss the importance of not becoming overwhelmed by this complexity. They cover key epidemic elements in a step-by-step manner, elucidating each with concrete examples. The article ends with an extensive call to action, listing detailed action steps for each element.
Understanding and Integrating the Structural and Biomedical Determinants of HIV Infection: A Way Forward for Prevention
This article makes the important argument that the successful integration of structural and biomedical approaches to HIV prevention depends on biomedical and social scientists working together. It compares successful and unsuccessful prevention interventions/programs, and highlights the importance of structural factors in determining HIV risk. For HIV prevention programs to be effective, the focus must include both behavioral and structural factors. The article concludes that multidisciplinary teams provide a good starting place for the development of effective prevention programs that take combination approaches.
Rights Matter: Structural Interventions and Vulnerable Communities
This is an edited version of the Jonathan Mann Memorial Lecture given at the XV International AIDS Conference in Bangkok, Thailand, on July 14, 2004, and makes a strong case for addressing the structural drivers of HIV.
Technical Guidance: Prevention for Men Who Have Sex with Men
As part of the President's Emergency Plan for AIDS Relief's (PEPFAR's) second five-year strategy, this technical document provides specific information to assist country teams in the development of HIV prevention programs for MSM that respond comprehensively and effectively to specific epidemic scenarios. The document highlights the importance of combination prevention, which combines structural, biomedical, and behavioral approaches, and provides in-depth information on community-based outreach; condom distribution; HIV counseling and testing; active linkages to health care and antiretroviral therapy; targeted information, education, and communication; and sexually transmitted infection prevention, screening, and treatment. The guidance document also recommends a set of best program practices to ensure the effectiveness of HIV prevention programs among MSM (i.e., MSM involvement; confidentiality; staff training; strategic information; linking, integrating, and collocating services; and incorporating research advances and new technologies).
Human Rights Considerations in Addressing HIV among Men who Have Sex with Men
This technical brief provides a systematic global review and synthesis of practical approaches, program examples, and resources to support human rights as a core element of HIV programming for MSM. This document gives an overview of U.S. policies on and commitments to MSM and human rights, and outlines recommended approaches, including program examples in various countries, for linking health and human rights to address HIV among MSM. It also offers a compilation of questions for developing and monitoring HIV programs for MSM, as well as a list of program resources.
Achieving an AIDS-Free Generation for Gay Men and Other MSM: Financing and Implementation of HIV Programs Targeting MSM
The goal of this comprehensive report is to evaluate the impact of legislation that criminalizes same-sex sexual practices on two key outcomes: (1) the efficiency of multilateral funding sources for HIV programming and (2) the effectiveness of programming for MSM. It also analyzes the evidence for the positive impact decriminalizing same-sex sexual practices can have on the delivery of comprehensive HIV programs for MSM. It is comprised of analysis of country case studies; in-country consultations with a wide range of stakeholders; and data from the UN General Assembly Special Session on AIDS (UNGASS), PEPFAR, and the Global Fund. Countries of focus include China, Ethiopia, Guyana, India, Mozambique, Nigeria, Ukraine, and Vietnam.
Prevention and Treatment of HIV and Other Sexually Transmitted Infections among Men Who Have Sex with Men and Transgender People—Recommendations for a Public Health Approach
These WHO-published guidelines are intended to enhance the ability of countries to provide comprehensive HIV responses to MSM and transgender (TG) populations, and comprises a thorough set of technical recommendations for STI and HIV treatment among MSM and TG populations. This document provides six "good practice recommendations," focused on the following: (1) prevention of sexual transmission; (2) HIV testing and counseling; (3) IEC; (4) HIV prevention focused on substance use; (5) MSM and TG people living with HIV; and (6) prevention and treatment of STIs. It is geared toward national public health officials, nongovernmental organizations (NGOs), and health workers.
UNAIDS Action Framework: Universal Access for MSM and Transgender People
This action framework seeks to go beyond "business as usual" approaches to articulate UNAIDS' specific commitments to MSM and transgender (TG) communities worldwide. It provides direction for enhanced action by the UNAIDS Secretariat and UNAIDS Cosponsors. The framework is intended to serve as a foundation for articulating specific workplans and recommendations for better-coordinated action. It focuses on these key objectives: (1) improving human rights for MSM and TG populations; (2) strengthening and promoting the evidence base related to MSM, TG, and HIV; (3) promoting partnerships and ensuring better, broader responses for MSM and TG populations; (4) outlining roles, responsibilities, and partnerships within the UN related to MSM and TG groups; and (5) developing a monitoring, evaluation, and review plan.
Priority HIV and Sexual Health Interventions in the Health Sector for Men Who Have Sex with Men and Transgender People in the Asia-Pacific Region
This 128-page Asia-Pacific-focused document articulates a set of priority health sector interventions needed to achieve universal access to HIV prevention, care, and support for MSM; summarizes WHO recommendations; guides the selection and prioritization of HIV prevention, care, and support interventions for MSM; and directs readers to more resources. The target audience is wide, including national public health officials, NGOs, community-based organizations (CBOs), and health care providers. Chapters cover prevention; sexual health; care, support, and treatment; strategic information; and strengthening health systems.
Advancing the Sexual and Reproductive Health and Human Rights of Men Who Have Sex with Men Living With HIV
This policy briefing was developed as an elaboration of Advancing the Sexual and Reproductive Health and Human Rights of People Living with HIV: A Guidance Package, published jointly by the GNP+, the International Community of Women with AIDS, EngenderHealth, the International Planned Parenthood Federation, and UNAIDS in 2009. It is a set of principles, based on the original guidelines, specific to the needs and priorities of MSM living with HIV. The recommendations are intended for program managers and policy makers, sexual health advocates and health care workers, and community and civil society organizations.
Men Who Have Sex with Men (MSM), HIV, and the Road to Universal Access—How Far Have We Come?
This 56-page report provides the results of data submitted to the United Nations by 128 countries. Nearly half of the countries failed to provide any data on MSM. Despite a unanimous commitment by all UN member countries in 2001 to monitor HIV among high-risk groups, the report found that 71 percent of countries had no information on the percentage of MSM reached by HIV prevention programs. The report attributes this failure to a lack of leadership both from national governments and the institutions charged with leading the global response to HIV. The report cites the criminalization of male-male sexual activity as a major driver of the epidemic among MSM in many countries. Seven of the ten countries with the highest reported HIV prevalence among MSM criminalize homosexuality. Institutionalized stigma and discrimination frequently prevent MSM from accessing even basic HIV services.
MSM and HIV/AIDS Risk in Asia
This 82-page report discusses the vulnerability to HIV of MSM in Asia. Many Asian countries focus on such high-risk groups as female sex workers and injecting drug users, while ignoring MSM despite increasing HIV prevalence in the region. MSM may be overlooked because many are married and do not self- identify as gay or bisexual. Studies found HIV prevalence as high as 28 percent among MSM in Bangkok, Thailand; 14 percent in Phnom Penh, Cambodia; and 16 percent in Andhra Pradesh, India. MSM in Asia are often not organized, are hidden from society, and are persecuted by police. Sex between men is illegal in 11 of the countries examined. Many MSM have multiple partners, have sex with women, fail to use condoms, and have high rates of sexually transmitted diseases. This in-depth report provides research findings, country profiles, recommendations for politicians and non-governmental organizations, a directory of organizations, and extensive appendices for reference.
Off the Map: How HIV/AIDS Programming Is Failing Same-Sex Practicing People in Africa
This 125-page report with a seven-page executive summary explores the ways in which governments, donors, and nongovernmental organizations have failed to incorporate basic human rights protections for same-sex practicing Africans and how that failure affects efforts to combat the HIV epidemic. The authors recommend that access to prevention, care, and treatment must be equal for all. Gaps in available research are discussed, including the need to better understand hidden male-male sexual behavior.
Reaching Men Who Have Sex With Men for HIV Prevention Messaging with New Media: Recommendations from an Expert Consultation
The Internet and other technologies are increasingly used by MSM for a variety of purposes, including meeting sexual partners. This article reports the results of an expert consultation led by the U.S. Centers for Disease Control and Prevention (CDC) on the potential role of the Internet in delivering HIV prevention messaging to MSM. The report summarizes group discussion around how use of specific channels, technologies, and websites differed between groups; characterizes the strengths and weaknesses of those channels in terms of their potential for delivering HIV prevention messages; and discusses how online tools might be developed to help reduce HIV risk and promote overall health for MSM.
HIV Prevention with MSM: Balancing Evidence with Rights-Based Principles of Practice
This brief challenges the silence at the global level about the disproportionate impact that HIV has on MSM and calls for ethically implemented and methodologically sound surveillance, along with epidemiological and social science research that can sensitively inform HIV prevention and advocacy responses around the world. It highlights contemporary approaches to HIV prevention among MSM, new HIV prevention strategies and key issues, and UNAIDS-recommended components for comprehensive HIV prevention programs with MSM.
Global Epidemiology of HIV Infection in Men Who Have Sex with Men
This article looks at the epidemiological drivers of the global epidemic in MSM and why it continues unchecked. It is based on a review of available data for HIV prevalence, incidence, risk factors, and the molecular epidemiology of HIV in MSM from 2007 to 2011, and on an agent-based simulation that is used to model the dynamics of HIV transmission. The article shows that unprotected anal intercourse plays a central role in explaining the disproportionate disease burden in MSM, that HIV can be transmitted through MSM networks with speed and efficiency, and that prevention strategies that lower biological risks, such as ART, offer promise for controlling the expanding epidemic in MSM. It also finds that the potential effectiveness of ART is limited by structural factors that contribute to low levels of health-seeking behavior in populations of MSM.
Comprehensive Clinical Care for Men Who Have Sex with Men: An Integrated Approach
This article highlights the importance of developing culturally sensitive and respectful clinical care programs that address health disparities in MSM communities, such as depression, anxiety, and substance abuse. The authors carefully detail structural and biomedical drivers of HIV risk, including mental health and substance abuse, making a case for culturally competent care. They also make the point that research is required to understand more clearly how MSM can live positively in the face of societal discrimination and other structural factors that negatively impact health outcomes.
Successes and Challenges of HIV Prevention in Men Who Have Sex with Men
This article suggests a detailed conceptual framework for packaging HIV prevention interventions for MSM and modeling the potential effect of scale-up. It contains a review of MSM-focused HIV prevention interventions, and makes a strong case for combination interventions. It underscores the importance of innovative study designs, increased resources for scale-up, and bringing more focus to low- and middle-income countries.
From Personal Survival to Public Health: Community Leadership by Men Who Have Sex with Men in the Response to HIV
This article reviews the key role that community leadership has played in HIV responses since the beginning of the epidemic. It outlines a history of gay and MSM participation, as well as new opportunities for community leadership and participation in HIV programming, research, and advocacy.
Common Roots: A Contextual Review of HIV Epidemics in Black Men Who Have Sex with Men across the African Diaspora
This article examines HIV infection in black MSM across the African diaspora and the extent to which these men report access to HIV prevention and care services, assesses whether these findings are associated with increased susceptibility to HIV infection, examines genetic and biological explanations for disproportionate rates of HIV infection in black communities compared with other populations, and uses meta-analytic methods to assess differences in the prevalence of HIV infection between black MSM and general populations. The authors present recommendations based on study findings.
A Call to Action for Comprehensive HIV Services for Men Who Have Sex with Men
This article is a call to action for comprehensive HIV services for MSM based on the articles in the special MSM edition Lancet from July 2012. The call is directed specifically governments, health ministries, donors, providers, researchers, and community members, and covers the following issues in some detail: prevention, clinical resources, youth, health disparities, mental health, health care provision, community, resilience, and structural changes. The authors conclude with a detailed strategy for action with a timeline for action from 2012 to 2014.


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I've been eating peanut butter on toast, lunch and dinner, for the past two days. To be more precise, peanut butter on baguette, fresh or toasted, but that's just semantics. Fastidious. Under the circumstances. I've been eating a lot of peanut butter on toast. Peanut butter on toast is my ultimate comfort food. I eat it when I am sick and I eat it when I am sad. I woke up Tuesday morning, logged onto Facebook, as is my habit first thing after coffee, and discovered the death of a friend. A man just a year older than I, killed in an automobile accident in Orlando, Florida.
It's funny how the death of someone can stop us in our tracks. Everything is going all hunky dory, the days flowing more or less smoothly one into the next, one son preparing his final architecture project, other son searching for his third-year internship, husband off to meetings for his project, Ilva and I compromising on how much time we take off from Plated Stories while we are each away on summer vacation and suddenly in one status update my world is flipped on its head. We are so caught up focusing on the little details of our lives and then BOOM we read about an old, old friend our own age who lost his life in a flash just gone and we stop, shocked, unable to move although we must. Standing still, the world spinning relentlessly around us, and all of those little selfish details seem almost irrelevant, at least for the moment. A friend, a brother and we at once want to live harder, hold on tighter, laugh louder and cry, pause, slow down, both at once how can we decide, pulled every which way as we are, our head spinning.
Incomprehension intertwines with the pain; we look at their life and think of all they had yet to accomplish, the years and road ahead of them, the promise their life held, and we wonder if the tears are for them or for ourselves. Their death brings us closer to our own destiny and, truth be told, we just aren't ready, we have such a long time ahead of us, there is still so much to do, so how is this possible? The loss is so close, too close; with each death, we feel that much more orphaned, left alone in the world to battle it out, to overcome each hurdle alone. Without that person to share it with. It is as if we have lost a limb or part of ourselves. And now we return to our family our home our job and must move ahead.
Sometimes only when they are gone, do we begin to understand the impact they had on our life, the importance of the memories of the time spent together. We dig out big brown paper envelopes stuffed with letters (handwritten!), postcards and photographs and read through each one carefully. We allow ourselves to be carried away deep into memory on a wave of laughter and wonder at the tears streaming down our cheeks.
A friend of mine once spoke to me of the importance of grieving: "The death of a loved one is something that we all experience at some point in our lives and I think it is important to talk about it instead of tidily brushing it under the carpet. When my grandfather died, I was so unprepared and had no idea how to deal with my emotions." Another friend of mine sent me a fascinating book about reincarnation. Her philosophy? Spirits are all around us but aren't there to do harm but rather to watch over us, help us understand what we don't understand and we should simply give a friendly Hello from time to time and let them know we appreciate the visit and the care. Talking with her is so comforting, no black thoughts, no fear of the unknown, rather the joy of life, the dream of an afterlife and never losing touch with those who have passed on.
Yet for just a few minutes, a few hours we have to focus on the pain and the heartbreak. Again. Before tucking it back away out of sight. And getting on with life without them.
RIP Rhett, my friend. You were much loved.


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Allison Imber is a Registered Patent Attorney who practices Intellectual Property Litigation as well as handles various patent, copyright, trade secret and trademark transactional matters. She has prosecuted numerous trademark and patent applications from availability searches to registration, and counsels business owners regarding intellectual property protection strategies. Her litigation experience spans from the Southern to the Northern District of Florida, and includes inter partes proceedings before the Trademark Trial and Appeal Board. Allison graduated from the University of Florida Levin College of Law cum laude in May of 2007, and from Florida State University cum laude with a B.S. in Biological Sciences and a minor in Chemistry in August of 2003.
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Browse Used Cars in Boston at MetroWest Subaru | Used Car & Pre-Owned Subaru Dealership in Natick MA
At MetroWest Subaru we carry a huge inventory of used vehicles in Natick from a variety of manufacturers. We put all our pre-owned vehicles through an extensive inspection before hitting the lot in order to ensure that they are of the highest quality. Whether you are looking for a used truck, car, van, or SUV in the Natick, Belmont or Norwood areas, we're confident that we have what you are looking for. Give us a ring or visit our dealership for a test drive today. We invite you to experience why we are one of the most trusted used car dealerships in Boston.


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NewsBrand New Master Recycler ClassSave the FoodRecycled Art Calendar Contest Waste Matters: On the Air hits the airwaves! Master Recycler NewsEarthWISE Bulletin
Mixed recycling makes it convenient to divert valuable materials from the garbage, but it's important to make sure only the right stuff goes in. One of the challenges to single-stream recycling is the increase in contamination. Folks tend to get a little recycling happy, tossing additional items into the bin. But sending non-recyclable materials can get tangled in machinery, makes recycling harder, and sometimes even hazardous.Please help make single-stream recycling a success by keeping these materials out of the recycling bin.1. Plastic Film and BagsKeep the pesky plastic films and bags out of your mixed recycling cart. They get tangled in machinery and stop the important work of sorting. Instead, drop them off at your local transfer station or grocery store. For a complete list of drop off locations visit: PlasticFilmRecycling.org2. TextilesOld clothes can be donated to your favorite charities, or if they are beyond repair, look for textile drop off sheds around the area. You can also use warn out clothes for rags or material for your next sewing project, but please keep them out of the recycle bin. 3. FoodDid you know that almost 20% of our garbage is food? So what can you do? Food or food contaminated paper or cardboard should not be added to your mixed recycling bin. If you live in Salem or Keizer, you can add all solid food discards and food contaminated cardboard or paper in the yard debris bin. If you live outside of Salem or Keizer and have a yard debris roll cart available, you can add fruits or vegetables to the yard debris bin. 4. Styrofoam - Please don't add stryofoam to your mixed recycling cart. Instead drop off your styrofoam any Monday – Friday from 7:00 a.m. to 5:00 p.m at the Fresh Start Market. They accept clean (no stickers or tape) styrofoam that snaps when folded. Colored foam is ok too, but not if it bends without snapping. Construction related foam & foam that bends without snapping is not able to be recycled. Meat trays, egg cartons, coffee cups & takeout containers are not able to be recycled. The Fresh Start Market does not accept styrofoam peanuts, but most mailing stores accept them for free if they are clean and dry. For a complete list, type in the word "peanuts" in our recycling guide.
5. Household Hazardous Waste- Did you know that most cleaners, solvents, pesticides, and fertilizers you may have around the house are actually considered hazardous waste when they're not longer needed? Don't put household hazardous waste in your mixed recycling bin. Instead, drop them off for free Thursdays, and 1st and 3rd Saturdays of the month. 8am to 3:30pm at the Houshold Hazardous Waste Disposal located at the Salem/Keizer Transfer Station at 3250 Deer Park Dr. SE, Salem. Please bring your household hazardous waste in the original containers, if possible with good fitting lids. Please place the material into a box to keep it from tipping over and spilling in transit. Small businesses can use the facility, however they will be charged $2.50 per pound of hazardous waste ($100 minimum). Businesses using the facility must make an appointment by calling the appointment hotline (1-800-444-4244). And as always, if you have an item that you're not sure how to dispose of, visit the online Recycling Guide to find out how and where to dispose of the item. Thanks for your help to keep contaminates out of the recycling stream!
Green Community Calendar


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Eligibility & Application Process
Honors Program Eligibility
Incoming Freshmen Students
- 3.3 cumulative high school GPA
(3.5 or higher for scholarship consideration)
- ACT composite of 25
(27 or higher for scholarship consideration)
- Strong reading and writing skills
Current Kent State Stark Students
- 3.25 cumulative college GPA
- Strong reading and writing skills
How to Apply
- Incoming Freshmen
New incoming freshmen students who meet the above criteria will receive an invitation to the Honors Program upon acceptance to Kent State University at Stark. An application for admission is not necessary.
- Current Students
Current Kent State Stark students and any motivated learner expressing a strong interest in the Honors Program is welcome to complete an application for admission. Contact the Honors admissions counselor with questions.
Admissions Contact:
Amanda Paulus
Admissions Counselor
Office of Admissions
110 Main Hall
Curriculum & Advising Contacts:
Dr. Leslie Heaphy
Honors Program Coordinator
310D Main Hall
Ryan Bucher
Academic Advisor
Office of Student Services
132 Main Hall


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An Aiken teen has been jailed and charged after he was caught with a rifle allegedly stolen from a vehicle, according to the Aiken Department of Public Safety.
Deandre Gaiters, 17, has been charged with four counts of breaking into motor vehicles and one count of possession of stolen goods.
The incident began when officers responded to Churchill Commons after receiving a call that two suspects on bicycles were looking into car windows, the report stated.
A Public Safety officer saw a subject on a bicycle on East Pinelog Road, and when the bicyclist saw the officer, he began to cut across residents' yards to get away, the report stated.
When the officer blocked the bicycle with his vehicle, Gaiters ran from the officer on foot, but was having trouble running, the report said.
The officer commanded Gaiters to stop several times, and then observed Gaiters begin to pull a rifle from the leg of his sweatpants, the report said. Gaiters refused to comply with the officer's orders to drop the rifle, but the officer was able to get close enough to him to knock him down and obtain the rifle, police said.
Gaiters told police he had stolen the gun from a unlocked truck on Robinwood Drive, the report stated, and police confirmed with the truck's owner that the rifle did indeed belong to him.
Police found three other vehicles that were broken into on Robinwood Drive, and Gaiters confirmed to police that he did indeed break into those vehicles as well, police said.
Gaiters insisted that he acted alone, despite the initial report that two people were spotted on bicycles looking into vehicles, police said.
Gaiters is currently being held in the Aiken County detention center.
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Aiken Standard is pleased to offer readers the enhanced ability to comment on stories. Some of the comments may be reprinted elsewhere in the site or in the newspaper. We ask that you refrain from profanity, hate speech, personal comments and remarks that are off point.
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Benefits for Veterans
Veterans/Reservists enrolling at Kent and planning to apply for Veterans Administration (VA) educational benefits must submit a copy of their DD214 Form, Certificate of Release or Discharge from active duty, or DD2384, Notice of Basic Eligibility, to the Veterans Certifying Official at the campus where they will be attending. All veterans/reservists are required to complete the necessary Veterans Administration forms to obtain educational benefits and must complete an enrollment certification at the beginning of each semester. Veterans must be enrolled in a degree program in order to receive benefits. Some students who have a parent who is disabled or deceased from a service-connected incident may also be eligible for educational benefits. Contact the Geauga Campus Certifying Official, Dave Chappell at 440-834-3730 or email@example.com.


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PIRSA:10040072 ( Flash Presentation , Windows Presentation , Windows Video File , MP3 , PDF) Which Format?
Explorations in Theoretical Astrophysics (PHYS 7890) - Lecture 15
Speaker(s): Parampreet Singh, Neil Turok
Abstract: Gauge Invariant Cosmological Perturbation theory from 3+1 formulation of General Relativity. This course will aim to study in detail the 3+1 decomposition in General Relativity and use the formalism to derive Gauge invariant perturbation theory at the linear order. Some applications will be studied.
Date: 23/04/2010 - 9:30 am
Collection: 09/10 PSI - Explorations in Cosmology 2
URL: http://pirsa.org/10040072/ Share:


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Treat someone special to a gourmet gift full of mouthwatering fruit and delectable snacks. The food experts at The Fruit Tree™ have paired fresh-from-the-tree fruits like seasonal pears and crisp apples, with complementing camembert-flavored cheese spread, sweet hazelnut cookies, nut crunch and flatbread crackers. All beautifully presented in a decorative wood basket. Measures 8 3/4"Hx9"Wx14"L
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Explore the Entrepreneurship.org Resource Center to find resources. Designed with entrepreneurs in mind, our resource center allows you to find materials to grow great ideas.
I recently wrote about the tremendous backlog of patent applications at the U.S. Patent and Trademark Office (PTO). Indeed, with a backlog of over 700,000 patent applications, investors have become frustrated with long processing times. Yet, as I was writing about the PTO budget, the U.S. Senate was considering a major reform of the patenting process. On March 8, the Senate passed the America Invests Act (S. 23) with an overwhelming vote of 95-5. Debate over this bill, which was introduced by Sen. Patrick Leahy (D-VT), will now shift to the U.S. House. While the bill does many things (including increasing agency resources), it has become mostly known for establishing a first-to-file rule in the U.S., replacing the existing system of first-to-invent. This is a dramatic change bringing this country's patent filing system in line with the rest of the world.
The debate over first-to-file has been heated at times. Some business leaders, for instance, have said that the first-to-invent system benefits larger entities. As Henry R. Nothhaft, the chairman and CEO of Tessera, recently wrote in an op-ed for The Hill, "A `first to file' system may prove beneficial to established corporations like my own, which are financially better situated to quickly file patent applications and thereby beat smaller, less sophisticated inventors and startups." With this in mind, a number of organizations which represent innovative entrepreneurs sent a letter on February 23, 2011, to Sen. Harry Reid (D-NV), the Majority Leader, urging him to oppose passage of the America Invests Act. They wrote that the bill would have "unique adverse effects on small business, startup entrepreneurs, independent inventors, and U.S.-based technology professionals. It disrupts the unique American start-up ecosystem that has led to America's standing as the global innovation leader – the ecosystem that is vital to our businesses, but with which large firms have less expertise." It was for that reason that both California Sens. Barbara Boxer and Dianne Feinstein, which represent Silicon Valley, voted against the bill.
On the other side, businesses say that the first-to-invent system produces greater uncertainty, especially for global firms wishing to defend their inventions overseas. The biotechnology industry, for instance, says, "This bill would remove these uncertainties, while providing adequate protections against misappropriation of an invention by someone other than the true inventor." For his part, Sen. Leahy argues that the switch to first-to-file will ultimately benefit the patent community. He says, "It will simplify the patent application system and provide increased certainty to businesses that they can commercialize a patent that has been granted. Once a patent is granted, an inventor can rely on its filing date on the face of the patent. This certainty is necessary to raise capital, grow businesses, and create jobs."
From here, Rep. Lamar Smith (R-TX), who chairs the House Judiciary Committee, has said that he will introduce a bill similar to S. 23 later this month. After Senate passage, he issued a press release praising the bill, saying:
"Adopting a first-inventor-to-file standard creates certainty about patent ownership and makes it easier for American innovators to apply for patents around the world. The post-grant review process helps to reduce frivolous lawsuits filed by holders of weak or overbroad patents. And allowing for the third party submission of prior art helps prevent bad patents from being granted in the first place. These are just a few of the many provisions for which there is widespread support. Today's vote is an important development in our efforts toward meaningful patent reform. I look forward to achieving much-needed patent reform for American innovators and job creators."
President Obama has also voiced his support for the bill. Therefore, assuming the House passes a similar bill, the U.S. could soon make its largest patent reform in decades by adopting a first-to-file system. The switch to this new patent "ecosystem" should help to improve certainty to the marketplace for ideas. It should also help to encourage filers, both large and small, to file sooner in the process. So, despite some of the criticisms and possible hiccups in making this switch, the adoption of a first-to-file patent process should provide pragmatic benefits overall, especially for firms that intend to commercialize their intellectual property in foreign markets.
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Cocoon yourself within the comforts of the Travis reclining collection. Three over three seating has chaise pad leg rest for extra support along with the lumbar tufting accents. Padded arm rest are wrapped with welted detail. A lever release activator makes it simple for anyone to lean back.
The Klaussner Living Room Travis Reclining Sofa is available from Klaussner Home Furnishings.
Prices subject to home office audit & correction.
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Search and Book FedRooms® Properties Here! As always, please check your agency's policy before going to FedRooms.com (a nongovernment website) to book your hotel accommodations for official travel. You will be redirected to a nongovernment website.
FedRooms provides Federal Travel Regulation (FTR)-compliant hotel rooms for federal government travelers while on official business. Some of the benefits of the program include:
Best price/value at or below per diem rates;
- No add-on fees;
Policy compliant hotels that are fire safe/FEMA-certified and ADA-compliant;
Flexibility with cancellation deadline of 4:00 p.m. or later (in the U.S.) on date of arrival and no early departure fees. Many hotels offer last standard room available rates;
- Simple reservations made through CGE, DTS, E2, FedTraveler, GovTrip, your agency's travel agent, and www.fedrooms.com when considered acceptable by the employing agency's travel policy;
- FedRooms rate code of XVU, which must be reserved to get the program's rates and benefits;
Dynamic hotel auditing to ensure the integrity of the programs' rates and benefits; and
Quality lodging worldwide where you need it, when you need it.
The FedRooms booking site includes enhancements that were requested by frequent government travelers! Federal travelers can:
- Store profile information;
- Modify and cancel reservations; and
- Reserve up to three rooms in one booking.
FedRooms also offers market research services for those planning a conference or meeting. The service is free and simple. Check out FedRooms® Groups & Meetings, or view Groups & Meetings Information Sheet (PDF, 38K) for more details.
FedRooms is an easier way to a better stay! Contact the Help Desk at 1(800) 226-1741 for assistance.
FedRooms invites you to sign up for email notifications about the program.
To ensure that these messages do not enter your spam account, please add "firstname.lastname@example.com" to your contacts.
The shortcut for this page is www.gsa.gov/fedrooms.


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Rockets begin Training CampWritten by Zach Davis | | email@example.com
The UT football team began preparations for another season with lofty expectations as it opened up the 2012 training camp on Aug. 3.
"We split our team into two and it's great to be back out here with these guys," Toledo head coach Matt Campbell said. "It's kind of fun to see the strides that a lot of these guys have made from the end of spring to the start of fall camp. I know our kids are really excited and from an attitude standpoint it was outstanding. Now we get a chance to really grow as a football team."
The Rockets held two half-squad practices to begin the camp. The first started at 8:30 a.m. before the rest of the team took the field at 4. The players will continue with this practice format through the weekend until they begin full-squad practices on Aug. 6.
Campbell, who will be entering his first full season at the helm of the UT program, separated the two teams to make them "as even as possible" to attempt to make the players "feel like starters."
In 2012, Toledo has been projected as the preseason favorite to win the Mid-American Conference West Division by a vote of the 17 members of the league's media contingent. They still have some major holes to fill, especially on offense, but Campbell thinks those replacements may already exist on their young roster.
The Rockets lost playmakers Eric Page and Adonis Thomas from last year's squad but appear to have experienced replacements in David Fluellen at running back and Bernard Reedy at wide receiver. The offensive line, however, lost three members from last season's unit, which finished sixth in the nation, allowing only 10 sacks on the year.
The team still returns talent up front, however, in Rimington candidate Zac Kerin in the middle alongside second-year guard Greg Mancz, who was named to the Freshman All-American Team for Yahoo! Sports in 2011.
"It's a situation right now where we have some youth in some key spots and some guys that will be challenging for some spots on offense," Campbell said. "Of course, our offensive line, we have to replace a couple veteran football players, and I'm really proud of what those guys looked like."
Toledo's already suspect secondary, which ranked 105th in the country in pass defense last year, giving up over 268 yards per game, took a big blow as well at the cornerback position losing its two most solid starters in Desmond Marrow and Taikwon Paige. Among the candidates to replace them this season are senior Byron Best, sophomores Keith Suggs, Kishon Wilcher and Jordan Haden and redshirt freshman Chris Dukes.
"We lost two guys who played a lot at corner," Campbell said. "We have a lot of talent there and we have got three or four guys that will come into the football game and play consistently for us."
Toledo returns 12 starters from last season's unit, which went 9-4 with a 7-1 record in conference play. Among those returning are three All-MAC performers including Reedy and quarterback duo of senior Austin Dantin and junior Terrance Owens.
Tags: Austin Dantin, Bernard Reedy, Byron Best, Chris Dukes, David Fluellen, Greg Mancz, Jordan Haden, Keith Suggs, Kishon Wilcher, Matt Campbell, Mid-American Conference, Rocket football, Terrance Owens, Zac Kerin, Zach Davis


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Rx drug information, pharmaceutical research, clinical trials, news, and more
To reduce the development of drug-resistant bacteria and maintain the effectiveness of ERYC® and other antibacterial drugs, ERYC should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.
ERYC capsules contain enteric-coated pellets of erythromycin base for oral administration. Each ERYC capsule contains 250 mg of erythromycin base.
Erythromycin is indicated in the treatment of infections caused by susceptible strains of the designated organisms in the diseases listed below:
Upper respiratory tract infections of mild to moderate degree caused by Streptococcus pyogenes, Streptococcus pneumoniae, or Haemophilus influenzae (when used concomitantly with adequate doses of sulfonamides, since many strains of H. influenzae are not susceptible to the erythromycin concentrations ordinarily achieved). (See appropriate sulfonamide labeling for prescribing information).
Lower respiratory tract infections of mild to moderate severity caused by Streptococcus pneumoniae or Streptococcus pyogenes.
Listeriosis caused by Listeria monocytogenes.
Pertussis (whooping cough) caused by Bordetella pertussis. Erythromycin is effective in eliminating the organism from the nasopharynx of infected individuals rendering them noninfectious. Some clinical studies suggest that erythromycin may be helpful in the pro-phylaxis of pertussis in exposed susceptible individuals. Respiratory tract infections due to Mycoplasma pneumoniae.
Skin and skin structure infections of mild to moderate severity caused by Streptococcus pyogenes or Staphylococcus aureus (resistant staphylococci may emerge during treatment).
Diphtheria: Infections due to Corynebacterium diphtheria e, as an adjunct to antitoxin, to prevent establishment of carriers and to eradicate the organism in carriers.
Erythrasma: In the treatment of infections due to Corynebacterium minutissimu m.
Syphilis caused by Treponema pallidu m: Erythromycin is an alternate choice of treatment for primary syphilis in penicillin-allergic patients. In primary syphilis, spinal fluid examinations should be done before treatment and as part of follow-up after therapy.
Intestinal amebiasis caused by Entamoeba histolytica (oral erythromycins only). Extraenteric amebiasis requires treatment with other agents.
Acute pelvic inflammatory disease caused by Neisseria gonorrhoea e: Erythromycin lactobionate for injection, USP followed by erythromycin base orally, as an alternative drug in treatment of acute pelvic inflammatory disease caused by N. gonorrhoeae in female patients with a history of sensitivity to penicillin. Patients should have a serologic test for syphilis before receiving erythromycin as treatment of gonorrhea and a follow-up serologic test for syphilis after 3 months.
Erythromycins are indicated for the treatment of the following infections caused by Chlamydia trachomati s: conjunctivitis of the newborn, pneumonia of infancy, and urogenital infections during pregnancy. When tetracyclines are contraindicated or not tolerated, erythromycin is indicated for the treatment of uncomplicated urethral, endocervical, or rectal infections in adults due to Chlamydia trachomati s.
When tetracyclines are contraindicated or not tolerated, erythromycin is indicated for the treatment of nongono-coccal urethritis caused by Ureaplasma urealyticu m.
Legionnaires Disease caused by Legionella pneumophil a. Although no controlled clinical efficacy studies have been conducted, in vitro and limited preliminary clinical data suggest that erythromycin may be effective in treating Legionnaires Disease.
Prevention of Initial Attacks of Rheumatic Fever: Penicillin is considered by the American Heart Association to be the drug of choice in the prevention of initial attacks of rheumatic fever (treatment of Streptococcus pyogenes infections of the upper respiratory tract, e.g., tonsillitis or pharyngitis). Erythromycin is indicated for the treatment of penicillin-allergic patients.3 The therapeutic dose should be administered for ten days.
Prevention of Recurrent Attacks of Rheumatic Fever: Penicillin or sulfonamides are considered by the American Heart Association to be the drugs of choice in the prevention of recurrent attacks of rheumatic fever. In patients who are allergic to penicillin and sulfonamides, oral erythromycin is recommended by the American Heart Association in the long-term prophylaxis of streptococcal pharyngitis (for the prevention of recurrent attacks of rheumatic fever).3
To reduce the development of drug-resistant bacteria and maintain the effectiveness of ERYC and other antibacterial drugs, ERYC should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
Effect of long-term, low-dose erythromycin on pulmonary exacerbations among
patients with non-cystic fibrosis bronchiectasis: the BLESS randomized controlled
trial. [2013]IMPORTANCE: Macrolide antibiotics such as erythromycin may improve clinical
outcomes in non-cystic fibrosis (CF) bronchiectasis, although associated risks of
macrolide resistance are poorly defined. OBJECTIVE: To evaluate the clinical efficacy and antimicrobial resistance cost of
low-dose erythromycin given for 12 months to patients with non-CF bronchiectasis
with a history of frequent pulmonary exacerbations...
Randomized double-blind crossover study to determine the effects of erythromycin
on small intestinal nutrient absorption and transit in the critically ill. [2012]on small intestinal nutrient absorption and transit in the critically ill... CONCLUSIONS: Acute administration of erythromycin increases small intestinal
A comparison between the effectiveness of erythromycin, single-dose clarithromycin and topical fusidic acid in the treatment of erythrasma. [2011.09.18]Abstract Although erythrasma is a superficial skin infection, there is no consensus on the treatment model of erythrasma... Conclusion: Topical fusidic acid proved to be the most effective treatment; however, clarithromycin therapy may be an alternative regimen in the treatment of erythrasma because of its efficiency and better patient's compliance.
[Comparison of maternal and perinatal outcomes in the conservative treatment preterm premature membrane rupture between the use of erythromycin and clindamycin]. [2011.07]BACKGROUND: premature rupture of membranes occurs between 5 and 15% of pregnancies, of these, 10% occurs at term and preterm 2 to 3.5%. OBJECTIVE: To compare maternal and perinatal outcomes from the use of erythromycin or clindamycin in women with preterm premature rupture of membranes with conservative treatment at the Regional General Hospital No. 36... CONCLUSIONS: comparing the maternal and perinatal outcomes with conservative management of premature rupture of membranes, results were better in the group treated with erythromycin. It is not possible to prove it statistically because of the sample size.
Erythromycin infusion or gastric lavage for upper gastrointestinal bleeding: a multicenter randomized controlled trial. [2011.06]STUDY OBJECTIVE: The quality of endoscopy depends on the quality of upper gastrointestinal tract preparation. We determine whether in acute upper gastrointestinal bleeding the frequency of satisfactory stomach visualization was different after intravenous erythromycin, a nasogastric tube with gastric lavage, or both... CONCLUSION: In acute upper gastrointestinal bleeding, administration of intravenous erythromycin provides satisfactory endoscopic conditions, without the need for a nasogastric tube and gastric lavage. Copyright (c) 2011 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.
The Effect of Concomitant Administration of Erythromycin and Diltiazem on CYP3A Activity in Healthy Volunteers [Completed]
We, the researchers at the Indiana University School of Medicine, are doing this study to
better understand how the effects of certain medications are altered when taken
simultaneously, or in combination with each other. We will also look at how each volunteer's
genes (DNA) may affect the way these medications are metabolized.
We will test the hypothesis that the extent of drug-drug interaction caused by the
combination of erythromycin and diltiazem is not predictable from the extent of interaction
produced by each inhibitor alone. Specifically we will test the hypothesis that the
combination of erythromycin and diltiazem will cause a greater decrease in midazolam
intravenous and oral clearance than the sum of the decreases caused by each inhibitor alone.
Comparison of Two Macrolides, Azithromycin and Erythromycin, for Symptomatic Treatment of Gastroparesis [Recruiting]
Erythromycin is effectively used in the treatment of Gastroparesis (GP) patients. In
susceptible patients however, it has been associated with sudden cardiac death due to
prolongation of QT intervals and subsequent cardiac risks through its interaction some other
drugs. Azithromycin (AZI) is a macrolide antibiotic but does not have the mentioned druf
interactions , has fewer gastrointestinal side effects, and fewer risks of QT prolongation
and cardiac arrhythmias. Consequently, AZI avoids drawbacks of dosing with erythromycin and
may be preferred as a prokinetic agent in patients on other concomitant medications.
We hope to demonstrate the effectiveness of Azithromycin (AZI) as compared to Erythromycin
in the treatment of Gastroparesis (GP), and later, form the framework for larger
randomized-controlled parallel studies to investigate use of AZI for treatment of GP.
Our novel hypothesis is to determine whether AZI can be used to treat GP.
A Study of Erythromycin and Rivaroxaban in Study Participants With Normal and Reduced Kidney Function [Recruiting]
The purpose of this study is to evaluate the pharmacokinetics and pharmacodynamics of
rivaroxaban when administered with erythromycin to study participants with mild or moderate
renal impairment compared to the pharmacokinetics and pharmacodynamics of rivaroxaban
administered to study participants with normal renal function.
Methylnaltrexone vs Erythromycin for Facilitating Gastric Emptying Time in Critically Ill Patients [Recruiting]
42 patients admitted in ICU with intolerance to enteral feeding (GRV more than 250 ml) are
recruited. All patients enter a primary acetaminophen absorption test study as baseline.
Serum levels of acetaminophen will be measured by florescence polarization method at
15,30,45,60,90,120,180,240,480 minutes after enteral administration of 975 mg acetaminophen.
Then the patients will be randomized to methylnaltrexone or erythromycin group. Another
acetaminophen absorption test with the same schedule will be done after the last dose of
each drug. The area under the curve for acetaminophen blood level will be used to compare the
effect of two studied drugs on gastric emptying time.
Effect of Erythromycin Before Endoscopy of Patients With Subtotal Gastrectomy (STG), High Risk of Gastric Stasis [Recruiting]
Erythromycin has a prokinetic effect through Motilin receptor. It evokes migrating motor
complex with longer and stronger contraction.
In patients with upper gastrointestinal bleeding, It has been shown that erythromycin could
clear the stomach of blood, so visual examination could be improved.
Frequent food stasis is encounted when we examine patients with subtotal gastrectomy. It is
postulated that erythromycin reduce food stasis and help to improve endoscopy in these
All Rights reserved - Copyright DrugLib.com, 2006-2015


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Chris Buescher will make his third start overall in the NASCAR Nationwide Series (NNS) and his first start at Bristol Motor Speedway (BMS) on Saturday! The No. 16 team brings brand new chassis RK-735 to BMS this weekend. Buescher's two previous NNS starts came in 2011 at Richmond and Darlington, finishing 17th in both events. In 2012, the 20-year-old driver participated in the full ARCA schedule, earning the ARCA Championship with four wins, 12 top-fives and 16 top-10s in the 19 race season. Overall, in five seasons of ARCA Racing, Buescher has made 54 starts, with one Championship, nine wins, 32 top-fives and 42 top-10s. Be sure to check out all of Chris' statistics and thoughts on racing at Bristol Motor Speedway in the full preview!
NASCAR Nationwide Series:
Saturday March 16th, 2013
Grit Chips 300
Bristol Motor Speedway
2:00 pm ET on ESPN