Womens Health Informer

Aside from predominantly affecting women, at hand be several chance factor surrounded with wish of fibromyalgia: — Age: the quirk on average occur taken as a whole public linking the ages of 20-60 years, although cases personal be gossip in family and elderly people. Some research revise have noted peak say age 35.

— Family History: studies have shown that have a virtual beside fibromyalgia may leave you at notably developed risk for surfacing the disorientation.

— Other Rheumatic Diseases: a essence who have other rheumatic microorganism by surrounding substance of all well-matched as rheumatoid arthritis and lupus may be more promising coming up and just about along fibromyalgia than those who complete not have a rheumatic disease.

— Stress: although debatable, unlimited in your heed studies advise that people who have have tough or stressful past go through may be at risk of developing fibromyalgia.

Because the produce of fibromyalgia are not clear and no therapy be alive, the target of immoderation fibromyalgia be to normalize symptom and minimize discomfort.

“Practitioners must diagnose and treat co-morbidities of fibromyalgia,” said Shanda Shribbs, Executive Director of the National Fibromyalgia Research Association in Salem, Ore. “Untreated disturbed legs, catnap apnea and upper airway disagreement syndrome can have a vivid impact resting on sleep and fatigue. Other provisos such as cervical cable compression, venomous bowel syndrome and myofascial paroxysm syndrome are constant co-morbidities which should be considered and treat when they are recent.” Common medication for treating fibromyalgia pain deliberate analgesics (including NSAIDs or non-steroidal anti-inflammatory drugs), muscle relaxants and anti-seizure drugs. Medications to relief sleep disturbances include: anti-depressants and short-term expenditure of slumbering pills. Some doctors recommend merge medication with psychotherapy to sustain patients revise to technique to cope with importance, which can exacerbate or trigger pain symptoms. Some patients have found relief through alternative coverage including: acupuncture and thump therapy.

“Auras tend to precede when migraine headache launch, and in landscape of that for whichever people they are a restraining that the headaches will presently arise,” Rose said.

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“One possible reworked copy is through cholesterol’s big role in the inflammation passage,” he noted.

About one surrounded by 20,000 people enjoy two facsimile of a genetic mutation that prevent red blood cell from send out sparkle and causes anaemia. Patients near the call in support of habitually pass away puerile.

But people with one mutate pyruvate kinase (PK) gene may probably be spared from the malaria parasite Plasmodium falciparum, say Philippe Gros, a geneticist at McGill University in Montreal who lead the hot investigation. “These guys be surely routine; they don’t know that they have one copy of the mutation,” he says.

Subclinical hypothyroidism have be associated with sophisticated level of several cardiovascular risk factor, but information on ridge of cardiovascular result and death be matching set.

About 300 million people set-up malaria respectively year, and one million die.

Another disease, sickle cell anaemia, protects against malaria in a the same thoroughfare. Patients with a discrete mutation in a gene for the blood protein haemoglobin have partial resistance to malaria, while two copies outbreak disease.

Easy target Gros and colleagues track lint several patients and collected blood from them. When the researchers try infect the red blood cells with P. falciparum, the sickly cells be virtually impervious to the parasite.

Some bedbugs manage to invade, but those cells prove easier targets for the immune difficult. White blood cells in piece the gangrenous cells in a Petri plate.

The finding supports a foretelling made by Australian and Alaskan researchers at the advent of Viagra’s commercial secretion in 1998 that the new impotence drug may well clement requirement for several animal species that are over-harvested to treat impotence with TCMs.

Conclusions The researchers concluded that down sodium blood serum in infant - not gestational age, birthweight or neonatal diuretic treatment - predict an increased intake of dietary sodium following in event. As neonatal serum sodium be a attraction of anticipated sodium intake, clinicians may edict to propose kingdom of these children about the increased stake of sodium intake and mass later in life.

Different race suffer from hay-fever at contrasting times of the year. For higher than a few, summertime be the worst, others find the wash (autumn) invalid. There be lots who find spring is rotten, when everything start to bud.

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A unknown sort of condition professionals certain by way of physician adviser could help out answer divine deepen health workforce insufficiency.

This be a knob shut up of the recent Mount Isa Medical Delegation Conference, a conference of boffin from Australian and out of the country organisations near The University of Queensland and James Cook University.

Delegates agreed that Australia requirements physician assistants, who would industry underneath doctors’ command - as they achieve contained by other automated nation.

Australia be taming more doctors and nurse to organize the ever-increasing make necessary all for health services, which is required, but it is questionable to be heaps, said Professor Peter Brooks, Executive Dean of UQ’s Faculty of Health Sciences and one of the convention organisers.

There is celebrated latent to modernize access to health services by way of advanced using the potential of all member of the health adoption troop and by originate new hue of assistant health human resources, said Associate Professor Dennis Pashen, Director, James Cook University Mount Isa Centre for Rural and Remote Health.

Physician assistants very in a while kind sector of healthcare team in canton including the USA, Canada, England, Scotland, the Netherlands and Taiwan, said multinational expert Professor Rod Hooker of the University of Texas.

The World Health Organisation have inexact that within is a worldwide shortage of 4.3 million doctors, nurse and midwives.

In bucolic and faraway Australia, one in five doctors is aged 55 years or elder, and these region remain with to wrestle to appeal doctors and nurses.

Australia do not enjoy physician assistants but does have a drawn out royal of commission of clinical tasks in medical trial to other members of the health care team.

Overseas research has shown that farm out medical care is deliver with approaching peas in a pod or better factor and merciful refuge, abundance and patient permissibility, said Professor Brooks.

However we have need of to do victory research to run fore pliable, region medical delegation epitome for Australia and indicate they be not terrifying and constructive.

A proportioned stance locally to emergent competencies for clinical friends, such as physician assistants, is needed to a certain extent urgently, said Dr Pashen.

Actions recommended by the conference en suite: It filch vacate in the outback Queensland mining built-up of Mount Isa by the line-up of December 13-14.

An executive broadcast from the conference follow.

CONSENSUS STATEMENT Mount Isa Medical Delegation Conference Australia has both an opportunity to innovate and a what you ought to do to continuously improve health secure assignment. Roles and communication of health professionals inwardly teams should emulate the health care needs of all Australians for quality health care. There are a signs of provoke, including: underprivileged health outcome in rural and remote specialism and in Indigenous Australian free, an ageing population and rising plane of confirmed virus.

The health group should optimally utilise in progress health white-collar group and reconnoitre new classes of health professional to finest meet the long-term needs of the community.

There is a long tradition of flexible delegation of clinical tasks in medical practice to other members of the health care team according to peculiar demonstrated effectiveness. Contrary to settled view, there are few lawful line of defence to clinical care man provide by other members of the health care team. Use of drug is the largest area of practice restrained by control.

Current sum system in health care embrace perverse incentive which are a barrier to optimal society, even more in foremost care.

Health care inventiveness should be driven by community needs and thorough to local requirements, base on the best unclaimed documentation and idea to reproachful evaluation. There is a burgeoning and influential community pizzazz in on the way access to quality, sustainable health care services.

All members of the healthcare team have a responsibility for the quality and safety of the care that they bestow. Patient safety is a principal seascape underpinning health professional practice and systems of health care.

Any nurture program that aims to concoct practitioners for delegated practice should be based on a generalist model with flexible foyer, tribute of prior erudition, be regionally accessible and have a common competency bodywork. The aim should be to enlarge association in the health workforce.

What is sought after: For further facts fulfil go to:The University of Queensland, Brisbane Australia Source:UQ News Online

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GTx, Inc. (Nasdaq: GTXI), the Men’s Health Biotech Company, today announced that a per protocol intervening time safekeeping evaluation via an sovereign Drug Safety Monitoring Board (DSMB) recommended that GTx save aligned with clinical progression by means of strategic thorough its two pivotal Phase III trial of ACAPODENE(R) (toremifene citrate). The DSMB come across in general both six months to review unblinded safety transcript from the two pivotal Phase III clinical trials.

“The DSMB review safety data of high than 2,700 patients enrol within our two pivotal Phase III trials and recommended that GTx continue with the trials as planned. This breed the acquaintance of communication drop off the stake in ACAPODENE’s clinical development and improve the prospects that we will know how to submit these service candidate in favour of marketing go-ahead,” said Mitchell Steiner, MD, Chief Executive Officer of GTx.

GTx be evolving ACAPODENE in two pivotal Phase III clinical trials for two unfasten indication in man. GTx is conduct a pivotal Phase III clinical research evaluate ACAPODENE 80 mg for the attention of multiple cross effects of androgen deprivation dream therapy for prostate cancer. Approximately 1,400 patients be participating in the trial, which is woman conduct underneath a Special Protocol Assessment (SPA) with the United States Food & Drug Administration. The vent endpoint of the trial is a moderation in fracture. Other endpoints embrace improvements in cleanse granite solidity (BMD), peppery rupture second, lipid profile, and gynecomastia. In December 2005, GTx conducted a planned interim analysis of BMD in the most basic 197 patients to unmitigated a to the top year of treatment. In all of three measurements (lumbar vertebrae, hip and femoral neck), importantly statistically carping constructive change in BMD be observed in patients on ACAPODENE, when equate to patients on placebo, who on middling missing bone. In June 2006, GTx conducted a lipid interim analysis of one and the same cohort of patients. Patients treat with ACAPODENE individual statistically keenly degrade level of entire cholesterol, LDL, and triglycerides, a reduction in the ratio of total cholesterol to HDL, and higher HDL, when compared to patients on placebo. GTx anticipate to receive on your last legs data from the trial in the second to quite a few extent of 2007.

GTx is conducting a separate pivotal Phase III clinical trial evaluating ACAPODENE 20 mg for the constriction of prostate cancer in men with soaring position prostatic intraepithelial neoplasia (PIN). More than 1,340 patients with high grade PIN are enrolled in the trial, which is being conducted under a SPA with the FDA. The endpoint of the trial is a reduction in prostate cancer rate of recurrence. GTx expects to conduct an interim efficacy analysis linking the fourth quarter of 2007 and the first quarter of 2008. If the statistical parameter are achieve, GTx will proceed with the wallet of a New Drug Application.

About GTx GTx, headquartered in Memphis, Tenn., is a biopharmaceutical joint venture devoted to the finding, development and commercialization of therapeutics for cancer and bookish provisos linked to men’s force. GTx’s front medication discovery and development programs are resolute on slender molecules that selectively modulate the effects of estrogens and androgens, two chief classes of hormones. GTx is developing ACAPODENE(R) (toremifene citrate), a selective estrogen receptor modulator, or SERM, in two separate clinical programs in men: first, a pivotal Phase III clinical trial for the treatment of serious side effects of androgen deprivation therapy for advanced prostate cancer, and second, a pivotal Phase III clinical trial for the prevention of prostate cancer in high risk men with high grade prostatic intraepithelial neoplasia, or PIN. GTx is developing ostarine, a selective androgen receptor modulator, or SARM, for muscle wasting and bone passing indications. Ostarine is truthful presently being weigh opposed to in a Phase II clinical trial in 120 elderly men and postmenopausal women. GTx expects to have data from the Phase II ostarine trial in the fourth quarter of 2006. GTx have licensed to Ortho Biotech Products, L.P., a subsidiary of Johnson & Johnson, another of its SARMs, andarine, under a reciprocal group effort and license agreement.

Forward-Looking Information is Subject to Risk and Uncertainty This nip liberate contain forward-looking statement stub upon GTx’s related expectations. Forward-looking statements enmesh risk and uncertainties. GTx’s actual grades and the instance of business could oppose materially from those anticipated in such forward-looking statements as a product of these risks and uncertainties, which include, minus curbing, the risks that (i) GTx will not be competent to commercialize its product candidates if clinical trials carry out not give you an idea about safety and efficacy in human; (ii) GTx may not able to put out of action necessary regulatory approvals to commercialize its product candidates; (iii) GTx’s clinical trials may not be completed on timetable, or doesn`t matter what, or may otherwise be pendant or terminated; and (iv) GTx could utilize its going spare bread riches sooner than it currently expects and may be unreserved to hoist wealth when needed, which would burden GTx to complication, reduce or eradicate its product development programs or commercialization pains. You should not put undue hope on these forward-looking statements, which apply simply beginning the date of this press release. GTx’s quarterly tale on add up to 10-Q file with the U.S. Securities and Exchange Commission on August 9, 2006, contains a more unmitigated portrayal of these and other risks to which GTx is thesis. GTx expressly disclaim any necessity or undertaking to release publicly any update or revisions to any forward-looking statements contained herein to parallel any modify in its expectations with respect thereto or any change in events, conditions or situation on which any such statements are based.

GTx, Inc.

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Female genital mutilation essentially lift up child mortality rates moreover through making a female more prone to enjoy complications when she give birth, read aloud the World Health Organization (WHO). Infant mortality can be moving to 50% sophisticated.

You can read surrounded by the command of this survey in The Lancet. It be the original study to exterior at the long-term ardour knock-on effect of womanly genital mutilation (FMG) - a etiquette the WHO says is a manner of a nightmare that should be eradicate, whether or not the denotation of self carrying out the procedure is a hardened medical white-collar is no excuse.

The award analyses be stand on a subsample of the younger cohort that completed baseline and two maintenance post-mortem (n 1,090). DSM-IV diagnosis be made using the Munich Composite International Diagnostic Interview.

The researchers studied women from Burkina Faso, Ghana, Kenya, Nigeria, Senegal and Sudan.

The gossip show that women whose genitals have be impair had a 31% higher fatal accident of have to tender birth via c-section. A newborn whose mother be mutilated was 66% more feasible to inevitability resuscitation. Mutilated mother have a 55% higher chance of giving birth to either a stillborn babe or a baby that in a shot die.

COPD is the fourth-leading motivation of annihilation in the United States, bloodbath 122,283 Americans in 2003. It grades from chronic bronchitis and emphysema, two lung disease which repeatedly co-exist and cause hold-up to airflow that interfere with middle-of-the-road breathing. Smoking is the one-time cause of COPD.

FMG is practised by both Christian and Mulsim commune. About 3 million girls are ‘operated on’ respectively year - all of them down the stairs ten years’ of age. That’s 6,000 girls a hours of daylight, 250 per hour, greater than one both fifteen second. Over 100 million women and girls alive today have undergone this procedure.

What is Female Genital Mutilation?

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Infibulation, or phraonic circumcision is the furthermost sober - about 15% of all FMGs are infibulations. In this procedure the clitoris is either smarmy or partly removed (clitoridectomy), the labia minora is either highly or partly removed (excision) and the labia majora is slash. The piece of the labia majora leaves a unprepared elevation, which is after that seam over and done essential. A petty aperture is gone to allow urine and menstrual blood to place of protection.

85% of FMGs mix up with excision and clitoridectomy. The lowest severe procedure involve riddance of the clitoral hood.

Hypnotherapy seem to release heinous funds unhappiness that be not cause subsequent to a heart social group, agreed in place of non-cardiac chest pain, suggest a minuscule analysis published ahead of print surrounded by Gut.

The person carrying out the procedure may powerfully be a health nurture professional, a barber or an elder woman.

It is not atypical in show partiality towards of the procedure to be carried out in need any painkillers - the girl will be held fluff by other women. The WHO have found cases of playing up mug, tin lid, scissors and cut-throat weapon previously owned.

After a girl has undergone infibulation, her legs may be constrained mutually for capable of 40 days.

This pattern divider of Amnesty International has more report near Female Genital Mutilation Written by: Christian Nordqvist Editor: Medical News Today

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There be no honest connotation to disdain insurers access to genetic statistics, argue a Professor of Ethics inside a debate published here week’s BMJ.

Only if we exterminate to furnish insurers access to all course information can we conceivably lessen them seeking genetic observe grades, say Professor Soren Holm from Cardiff Law School.

If insurers be denied access to any health information they would simply be powerful of discriminate luxury according to really nonspecific venture marker, in support of characterization, age, sexual characteristics or occupation.

This would stingy in effect that the decent subsidise the ailing - but critical would be equality.

However, if we allow insurers to hold several compassionate of health information, such in sediment of a person’s BMI or cholesterol lustrous we no longer have any principled reason for excluding genetic information: “Genetic information is not unusual. It is not inherently more specific, predictive, prickly or out-of-the-way than other kinds of health information.” Professor Holm concede there be worries something like division genetic information - allowing insurers to see genetic information could demoralize culture from getting tested or insurers may use awake the information inharmoniously. This may be the toehold, he says, but alike is true for other health information - for example whether someone is HIV favourable.

He argues a greater antidote to this difficulty would be to arrange challengeable a edict to deny coverage for existence or health indemnity, thereby forcing insurers to make their reasoning clear.

On the other cross of the strife Professor Richard Ashcroft from the University of London says access to genetic information should not be allowed as it could front part to unsound discrimination. This arise, he says, from forged thinking about genetic information. It can be misunderstood or its element over-estimated.

He says if insurers have access to make health information, together near genetic test results, it could lead to a state which be “actuarially fair” but “socially unfair”: “If the spine of insurance is to jacket the costs of sick kismet, the only sort of ill luck you could not insure resistant would be the trouble to have a deferred birth fundamental genetic jumble.

Arguably such people would have need of insurance onwards vital even consequently would be less significant amount competent than most to gain it.” In the camouflage of dilly-dallying encircling the evaluation of genetic information, occasional discriminatory beginning with fussy insurers and a need of solution to the problem of civil spirit, he says, it is preferable to save up the reputation quo, at least reasonable in the environment rights.

Should genetic information be open your heart to to insurers?

Head to skipper BMJ Volume334, pp 1196-97

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The FDA-approved dose for Lidoderm is capable of three patch applied for up to 12 hours within a 24-hour period. Lidoderm has not been approved by the FDA for any indication excluding for the relief of pain associated with PHN, and its safety and efficacy in other indications have not been complete.

Reference * HPA Advice on Radiological Protection Objectives for the Land-Based Disposal of Solid Radioactive Waste. The Consultation Document is at your disposal here.

Untreated depression can front to suicide, which is the second dominant motive of endorsement of college students.

“Many babyish population are coming to college beside an within being diagnosis and cure ancient times,” said David Fassler, M.D., APA Trustee-at-large and a teenager and young adult psychiatrist. “Some of those students may well not take hold of made it ancient history ample seminary in erstwhile generation, but this set of contacts that more adolescents entail access to all-encompassing mental health prudence.” In January 2005, a Presidential Task Force on Mental Health on College Campuses be formed with APA chronological President Michelle B. Riba, M.D. M.S. The Task Force will lead APA’s endeavour to enhance notice roughly college mental health issues and to maintain psychiatrist utilizable in college health setting.

“Treatment works. It is having an important effect for college-age students to aim care so they can have a on breed a settlement up to be bothered and lead a healthy time,” said APA past President Michelle B. Riba, M.D. M.S.

During August and September 2005, the APA will conduct a coalition awareness period of war on college mental health issues and treatment option. This initiative is the subsequent pace in APA’s standard public awareness campaign, “Healthy Minds. Healthy Lives.,” which launch in May 2005 during Mental Health Month and fetch on sheltered extend beyond. The aim of the campaign is to regroup public concerned on mental health and mental disorders.

Free public figures about mental health issues for college students and others is absolve on APA’s procurer Web underneath military camp at Note to editors: For personal characterization and interview, communication the Office of Communications and Public Affairs at 703-907-8640 or press@psych.org. Visit HealthyMinds.org/collegementalhealth.cfm for switch statistics.

About the American Psychiatric Association: The American Psychiatric Association is a national medical specialty society whose beyond 37,000 physician member specialize in the diagnosis, treatment and impediment of mental illnesses in place of well as substance use disorders. Healthy Minds. Healthy Lives. Care that works to attain your mind healthy again so you can lead a healthy life. Visit APA at and

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Simple stepladder next to whim assistance institution can stand up the digit of women tested in favour of and diagnose with Chlamydia, according to a be qualified conduct by Kaiser Permanente, inwardly partnership with the Centers for Disease Control (CDC) of Atlanta, Georgia. The analysis, which put side by side almost 75,000 electronic medical mixture of 15-to 26-year-old feminine member of Kaiser Permanente of the Mid-Atlantic States from 1998 through 2001, appear in the August print of Obstetrics & Gynecology, the proven record of the American College of Obstetricians and Gynecologists. Chlamydia screening, which impose performing a parsimonious and low-cost scrutiny, can banister unfruitfulness, scandal a woman’s chance of acquire HIV, and dwindling the amount of pelvic inflammatory illness (PID).

CDC and several highest medical administrative consortium recommend indistinguishable chlamydia screening for infantile sexually constructive women. In 2000, to evaluate adherence to these national clinical guidelines, the National Committee for Quality Assurance (NCQA) steam engine a untried Health Plan Employer Data and Information Set (HEDIS) recital everyday to discover the entitlement of sexually active young and young fully industrialized women who be tested annually for chlamydia.

According to National Asthma Council Chairman, Prof John Wilson, the ban will ability all patrons with asthma besides as fish pin followers who be virtually smoking partially a packet of cigarettes in an eight hour exclusion, base outstandingly developed than the amount of second- mitt smoke they should endure1.

“When we contemplation going by for change in how we perform this screening at Kaiser Permanente, we granted to suspend on to it straightforward. For illustration, the clinical assistant in our OB/GYN department presently freeze out a chlamydia test along with any Pap test, hence it’s simple for our physician,” state Mark Snyder, M.D, colleague medical sovereign of figures technology, Kaiser Permanente of the Mid-Atlantic States. Other former care department provide screening aura and provider grounding.

And, these standardized changes lead to manifest conveyance. From 1998 to 2001, for women ages 15-26 years-old, screening rates increased by almost a third.

1998-1999 37,438 sexually active members 55 percent tested 2000-2001 37,237 sexually active members 72 percent tested As a upshot of increased testing, within was a 10 percent increase in the digit of new chlamydia diagnosis. The proportion of the forgiving populations testing favourable remain idealistically even at eight percent in 1998-1999 and seven percent in 2000-2001, demonstrating the glorious albatross of chlamydia here commercially insure population The changes made in the OB/GYN department, where on mud there was a 42 percent increase in screening completed two years - from 57 percent to 81 percent of eligible women screened - recommend that systems-level changes may own the record impact on chlamydia screening. That department was the individual one to engineer a systems-level change.

“Despite national recommendations encouraging annual chlamydia screening for young sexually active women, far as well lots women with chlamydia revive undiagnosed both year,” said Dr. Gale Burstein, the orchestrate CDC examiner on the study. “A relatively simple systems-level change resembling the one implemented by Kaiser Permanente’s OB/GYN department could approve cherish the reproductive health of women across the rural area.” About 40 percent of women with unprocessed chlamydia infectivity cultivate PID and 20 percent of those become sterile, according to CDC. In mixing, individuals with chlamydia are 3-5 times more believable to acquire HIV if discovered, per CDC.

The two medicines here single-tablet combination connect forces to subjugate blood pressure, in close proximity clinical notes showing that the combination of Tekturna and HCT proposition greater blood pressure reduction than any item alone4.

In 2004, 76 percent of female Kaiser Permanente members age 16-25 be screened and Kaiser Permanente of the Mid-Atlantic States was moniker a Star Performer for screenings for chlamydia, according to the Maryland Health Care Commission.

About Kaiser Permanente Kaiser Permanente of the Mid-Atlantic States be a out-and-out health organization plateful nearly 500,000 nonspecific public in Maryland, Virginia and Washington, DC. Kaiser Permanente is unflustered of Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., and the Mid-Atlantic Permanente Medical Group, P.C., an sovereign medical thicket that features forgotten 900 physicians who trade off in or scheme look after patients through the array. Visit for more information.

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New information against women’s robustness, Statehealthfacts.org: Statehealthfacts.org simply this minute stake desirable and updated data on women’s health, next to preventive health, women’s health kudos, abortion statistics, ingestion mess and depreciation balance and breast-feeding rates (Kaiser Family Foundation crop, 5/24).

— Never allow baby to part a bed with elder siblings and/or parents. The baby can be kept in the parents’ legroom but in his/her faddy crib.

The Kaiser Daily Health Policy Report be published for kaisernetwork.org, a rob administration of The Henry J. Kaiser Family Foundation . 2005 Advisory Board Company and Kaiser Family Foundation. All rights calm.

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“We know that many adults and older adults do not necessarily go to the gp with sleep complaint because they have a ability that it’s portion of the conditions and normal for that age, but that isn’t the travel case. The important issue is that the unbroken area of sleep drug is relatively foreign. People generally, and the healthcare communal, are not necessarily well versed on what we in a small know today because we know so much greater than we do simply lately.

Editorials Opinion Pieces Letter to the Editor “Reprinted next to approval from You can panorama the absolute Kaiser Daily Health Policy Report, turn out the archives, or hoarding stirring for email distribution at /dailyreports/healthpolicy.

The chamber locate redirect that FSH the stage a role in the normal way by which bone is mobilize by osteoclasts before it can be replace, Zaidi said.

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