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Weight, or height TABLE 2 ; . The mean pretreatment SSS score was 23.8 for the ancrod group and 24.4 for the placebo group. Although not statistically significant, milder strokes SSS scores 30-39 ; occurred more often 5% ; in the placebo group than in the ancrod group. The mean time between stroke onset and treatment initiation in the ancrod group was 2.7 SD, 0.4; range, 1.53.9 ; hours; in the placebo group, it was 2.7 SD, 0.5; range, 1.5-4.0 ; hours. Treatment began in 5.2% of ancrod and placebo group patients n 13 in both groups ; within 2 hours of stroke onset; in 77.8% n 193 ; of ancrod and 79.0% n 199 ; of placebo group patients at 2 to hours; and in 16.9% n 42 ; of ancrod and 15.9% n 40 ; of placebo group patients after 3 hours. Six patients in each group began treatment more than 3.5 hours after stroke onset.
Pharmaceutical turnover All growth rates included in the review of turnover are at constant exchange rates CER ; unless otherwise stated. The sterling growth rates may be found in the tables of pharmaceutical turnover by therapeutic area on page 81. Total pharmaceutical turnover in 2003 was 18, 181 million compared with 17, 995 million in 2002, an increase of five per cent. Approximately one per cent of this overall growth came from price increases. Growth in sterling terms of one per cent was significantly impacted by the weakness of the US dollar and other currencies. Within the Group's portfolio, turnover of new products launched in a major market within the last five years accounted for 25 per cent of total turnover and grew by 29 per cent to 4, 633 million. Turnover of the more established, franchise products amounted to 9, 888 million representing 54 per cent of total turnover and grew one per cent compared to last year. Turnover of older products, now less actively promoted, was 3, 660 million, a decline of eight per cent, representing 21 per cent of total turnover. Global pharmaceutical turnover in the fourth quarter of 2003 declined two per cent, reflecting a US turnover decline of six per cent to 2, 188 million; whereas in Europe turnover grew two per cent to 1, 363 million, and in International turnover grew four per cent to 964 million. Turnover in the US declined due to generic competition to Paxil which began in September 2003. Pharmaceutical turnover by therapeutic area GlaxoSmithKline's ability to continue to deliver pharmaceutical turnover growth, despite generic competition to several of its products, is primarily due to an exceptionally broad product portfolio of fast-growing, high-value products. These include the Respiratory product Seretide Advair 2.2 billion ; up 39 per cent, the diabetes treatment Avandia Avandamet 0.9 billion ; up 24 per cent, Wellbutrin for depression 0.9 billion ; up 18 per cent, the emesis treatment Zofran 0.8 billion ; up 16 per cent, Lamictal for epilepsy 0.6 billion ; up 31 per cent, Trizivir, for HIV 0.4 billion ; up 22 per cent, Valtrx for herpes 0.5 billion ; up 23 per cent, Coreg for heart disease 0.4 billion ; up 28 per cent and the pediatric vaccine Infanrix Pediarix 0.3 billion ; up 32 per cent. Central nervous system CNS ; CNS sales grew four per cent to 4, 455 million. Sales in the USA and Europe grew three per cent. International sales grew 15 per cent. Sales of Seroxat Paxil, GlaxoSmithKline's leading product for depression and anxiety disorders, declined four per cent to 1, 877 million. US sales declined nine per cent to 1, 179 million following the launch of a generic paroxetine in September 2003. GlaxoSmithKline's innovative new product Paxil CR, increased its share of total Paxil prescriptions branded and generic ; since the generic launch from 33 per cent to 37 per cent. Paxil CR sales in 2003 were 387 million. In Europe Seroxat sales declined eight per cent to 369 million reflecting competition and pricing pressures. International sales grew 25 per cent to 329 million led by continued strong growth in Japan and vioxx.
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Reported and very limited source, based on a total of only 288 patients in three RCTs in which acupuncture or acupuncture plus medication ; was reported as superior to medication alone, found that there is still `insufficient evidence from randomised trials to decide whether acupuncture is helpful' for Bell's palsy.15 It is important to note that this review was limited to cases treated within 14 days from onset and excluded chronic sequelae and cases involving diabetes, herpes zoster or other causes. Also excluded were TEAS, pTENS and LA. In general, clinicians and less systematic reviewers have concluded, like Zhang Hong in this journal, 22 that acupuncture, whether MA or EA, can shorten time to recovery and enhance curative effect.87, 88, 89, 90 Predictably, less good results are reported for Ramsay Hunt's syndrome, 91 while in one large Russian review facial paralysis of vascular origin had the least good prognosis of all the types treated.35 However, any intervention that improves local circulation is likely not only to help release local nerve compression but also to assist nerve regeneration.92 MA, for instance, has been found to increase facial temperature in patients with Bell's palsy, 93, 94 with temperature also increasing in response to auricular MA in one successful case.95 ; Traditional Chinese medicine TCM ; and PFP In TCM terms, PFP is usually considered to result from the invasion of wind-cold due to an underlying deficiency of qi or poor circulation in the channels and collaterals in the face, with resultant stagnation of qi and blood. The condition may also be complicated by pre-existing phlegm.19 Disharmony of Liver qi has also been proposed as a contributory factor.96 Acupoints may be selected according to a further differentiation channel blockage due to wind-cold or wind-heat, qi and blood stagnation, or qi and blood deficiency ; .29 Once PFP has become chronic, Liver and Kidney yin deficiency may complicate the picture.29 One author has suggested that PFP caused by invasion of wind-cold is most responsive to acupuncture treatment.97 It is instructive that Julius Althaus, one of the greatest European electrotherapists of the nineteenth century, attributed most cases of Bell's palsy to the influence of damp and cold.98 Bleeding at jing-well points ; , 99 and bleeding and cupping, 100 have been used in the acute phase of PFP, as well as bleeding alone for chronic PFP with blood stagnation.101 In keeping with conventional electrotherapy findings, better results have been reported with MA when higher electrical potentials are found at acupoints on the affected side than at symmetrical points on the opposite side, particularly if these potentials increase markedly with the first treatment.102 One group of researchers has also used temperature differentials between the affected and unaffected side to determine MA point selection.103 and zestril.
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