Qbh methadone clinic. It is an alternative long-acting Studies have reported neonatal abstinence syndrome (NAS) with methadone use during the last 3 to 4 weeks of pregnancy. Qbh methadone clinic

 
 It is an alternative long-acting Studies have reported neonatal abstinence syndrome (NAS) with methadone use during the last 3 to 4 weeks of pregnancyQbh methadone clinic Opioid Treatment Programs (OTP) and Methadone Treatment

What is its legal status in the United States? Methadone is a Schedule II narcotic under the Controlled Substances Act. Methadone is used in the form of its hydrochloride salt,. 525). Constipation. dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position. , in downtown Albany. 7 out of 10 from a total of 599 ratings on Drugs. 10 While relapse is a normal step on the path to recovery, it can also be life threatening, raising the risk for a fatal overdose. Food and Drug. With your support, Ascension Brighton Center for Recovery can continue providing the tools and resources needed to live a healthy and sober life. 1. Other medicines to watch out for include diuretics, antibiotics, heart or blood pressure medication, HIV medicines and MAO inhibitors. 2. Last Updated:. The federal Modernizing Opioid Treatment Act, or MOTA, would expand methadone access to an additional 14% of census tracts in the U. Part 8. Claim this business. 2005 May;52 (5):513-23. Due to this, uneducated users may keep taking more doses, piling on to the substance that’s already in. 49 methadone clinics in Ohio accepting Medicare. Note: Multiple pictures are displayed for those medicines available in different strengths, marketed under different brand names and for medicines manufactured by different pharmaceutical companies. Community pharmacies must inform the College within seven days of starting to dispense MMT and of any changes in this information, using the. difficulty with swallowing. Each state and province has its own page with a list and map of methadone. doi: 10. Apply to Counselor, Registered Nurse, Addiction Counselor and more!Please contact us if you are the proprietor of a facility and have updates or corrections to site content. It can help to prevent the unpleasant withdrawal symptoms which can occur when you stop using drugs like these. Federal law (DEA Diversion Control Division 72-hour exception) allows a physician to administer methadone or buprenorphine, once a day, for up to a 72-hour period, in the case of an emergency, while a connection to addiction treatment is made. Concerned that this would limit availability of methadone at a time when opioid drug overdoses continue to soar, CMS adopted the payment rate from 2021, with an annual update for inflation. Maximum initial dose: 30 mg. Methadone is a medication primarily used to treat chronic pain and as a treatment for opioid use disorder. Methadone is a drug that has found widespread utility in the management of opioid addiction and pain. 11 accepting WI state insurance. Yet, these. Multi-ingredient medications may also be listed when applicable. advertisement. , 2001; Center for Substance Abuse Treatment, 2005; Lintzeris et al. Medication-Assisted Treatment (MAT), including the use of methadone, is a medically monitored therapeutic intervention designed to assist opiate dependent individuals improve their overall quality of life and begin the recovery process, that involves case management, counseling and medication management. 1a APT – Legion Ave. Dozens of men and women line up outside the mobile clinic for their daily doses of methadone, that help reduce their cravings and avoid more deadly illicit drugs such as fentanyl. Resources. Methadone is a medication used to manage and treat opioid use disorder and as an analgesic in chronic pain. The most common side effects of methadone hydrochloride include lightheadedness, dizziness, sedation, nausea, vomiting, sweating, and injection site. Treatment reduces the chances of getting HIV and other infectious diseases and decreases criminal behavior. Patients should be reviewed prior to each dose increase. Methadone can be detected in blood 15 to 45 minutes after oral administration, with peak levels occurring at 2. (810) 229-9220. This medicine is available only with your doctor's. sweating. Published reports indicate that methadone can be associated with a prolonged corrected QT (QTc) interval, especially at daily doses greater than 100 mg. Early clinical guidelines recommended patients reduce to a low methadone dose (eg, 30–40 mg or less) before transferring to buprenorphine or to discontinue methadone for several days before initiating buprenorphine dosing (Lintzeris et al. com. Your symptoms may start. A survey of 142 OTPs in June 2020 found that 127 of them had. gov. pinpoint red spots on the skin. Methadone clinic located in Brampton: methadone program, suboxone program, on-site psychiatrist, on-site pharmacy. The methadone clinics comply with, and are overseen by, government agencies, Substance Abuse and Mental Health Services Administration (SAMHSA), the Drug Enforcement Agency (DEA), the New York State Department of Health, and the New York State Office of Substance Abuse Services (OASAS). 12968/denu. Iselin. 1) Serious, life-threatening, or fatal respiratory depression may occur. com. Operator: New York City Health and Hospitals Corporation. 27 accepting MI state insurance. However, if the person taking methadone and their doctor agree to end treatment, the methadone dose is tapered down gradually over many weeks or months, easing the process of withdrawal. It was approved by FDA in 1947 as a medication for analgesic and antitussive (relieving or preventing cough) uses. restlessness. National Alliance of Methadone Advocates National Alliance of Methadone Advocates is composed of methadone maintenance patients and supporters of quality treatment. Frequently, good control of pain with methadone is PR to PO. bleeding gums. Treatment coordinators synchronize health services with identified patient needs, to facilitate the aims of the care plan. Root Center for Advanced Recovery (a trade name of The Hartford Dispensary) New Britain ClinicA panel of 15 interprofessional hospice and palliative care experts from the U. 1 day ago · Drug overdose deaths among pregnant and postpartum people soared significantly between 2018 and 2021, according to a report published Wednesday. 5 mg three times daily). Methadone is a highly controlled substance, and most of the 300 patients will need to pick up their dose at the Ryann Building daily between 6 and 11:30 a. 8 accepting Medicaid. Brick. It typically lasts seven to 14 days, but may last longer. 91. Get Help Now - 800-821-2965 Who Answers?Ngau Tau Kok Jockey Club Clinic, 60 Ting On Street, Ngau Tau Kok. Methadone belongs to a class of drugs known as opioid analgesics. The pill must be taken daily and the extended. People being treated for opioid use disorder take methadone under close supervision to ensure. doi: 10. Between 55% and 94% of babies born to mothers addicted to or treated with opioids while pregnant may develop neonatal abstinence syndrome (NAS), according to a 2016 New England Journal of Medicine article. As a result, it is much more profitable to cut a kilogram of fentanyl compared to a kilogram of heroin. . ***** SOUTH COUNTY CLINIC 90 Highland Avenue, Bldg J Phone: (408) 852-2420 San Martin, CA 95046 Nursing: (408) 852-2440 Fax: (408) 683-0697It is present in methadone hydrochloride oral concentrate as the racemic mixture. With withdrawal subdued, patients can more easily engage in counseling and therapy so that. It is slightly more popular than comparable drugs. Methods: A retrospective chart review was conducted of all clients at one methadone maintenance treatment clinic between January 2015 and May 2016 in Wayne County, Michigan. Nausea, vomiting, constipation, lightheadedness, dizziness, dry mouth, drowsiness, or sweating may occur. Douglas Gourlay. Write an article and join a growing community of more than 173,700 academics and researchers from 4,790 institutions. Methadone first became available at the end of World War II. Early clinical guidelines recommended patients reduce to a low methadone dose (eg, 30–40 mg or less) before transferring to buprenorphine or to discontinue methadone for several days before initiating buprenorphine dosing (Lintzeris et al. Methadone is an opioid, like heroin or opium. Joseph's Health Care London, London, ON, Canada. Methadone is utilized for the treatment of individuals with opiate dependence. The rate of overdose death for all age groups also increased. Methadone is a medication approved by the Food and Drug Administration (FDA) to treat OUD as well as for pain management. Pain, redness, or swelling at the injection site may occur if this medication. A typical month's supply of methadone costs about $8, while morphine will typically cost over $100. Nearly half of methadone patients were at high risk for COVID (43. Cats received either methadone (5 mg/m 2) or. and Canada convened in February 2015 to evaluate the American Pain Society methadone recommendations for applicability in the hospice and palliative care setting. 5, a partition coefficient of 117 at pH 7. Your symptoms may start off mild and become more severe over the course of a few days. decreased urine output. 34 accepting Medicaid. FindTreatment. com. Administrators of a 24/7 methadone clinic in north Phoenix were caught off guard by the volume of patients wanting. 4 [0 to 8] in the methadone group; P = 0. 10 While relapse is a normal step on the path to recovery, it can also be life threatening, raising the risk for a fatal overdose. 1 million Americans. "Methadone maintenance is a long-term treatment. m. The duration of methadone withdrawal varies from person to person but may last anywhere from two to three weeks to up to six months. Methadone binds strongly to proteins in various tissues, including the brain. Nurse Practitioner - Methadone Clinic. 449. Although not all of these side effects may occur, if they do occur they may need medical attention. Methadone belongs to the class of medicines known as narcotic analgesics. Although not all of these side effects may occur, if they do occur they may need medical attention. Strong Recovery In partnership with patients, families, and the community, we promote recovery from substance use and mental health disorders through holistic, person-centered care that values diversity. Methadone is a long-acting opioid and can last in the body for several days. 5 methadone clinics in Houston accepting Medicare. The tent city corridor in Boston known as "Methadone Mile" has been dismantled at the behest of the mayor, but some residents say disorderly conduct by its former inhabitants is getting worse. Methadone effectively treats the physical component of. Apply to Physical Therapist, Clinic Manager, Set Manager and more!23 Methadone Clinic jobs available in U. Supported by systematic and meta-analytic reviews of evidenced harm reduction effects (McArthur et al. Along with its popularity, methadone has also earned an infamous reputation for causing prolongation of the QT interval and an increased risk of torsades de pointes. Oral solution, tablets. Aims: Methadone maintenance has been an effective pharmacotherapy for the treatment of heroin dependence for nearly four decades. 96)37 Prison Nurse jobs available in Garden City, MI on Indeed. 35 clinics with payment assistance. Initial withdrawal symptoms are usually mild and may include anxiety, restlessness, a runny nose, sweating. For nearly three decades, methadone hydrochloride (6-dimethylamino-4, 4-diphenyl-3-heptanone hydrochloride) has been the primary means of treating opiate addiction. This brochure’s discussion of methadone refers exclusively to methadone used to treat opioid addiction and not to methadone used to treat pain. In this article we will give a b. Help opioid dependent individuals locate your clinic. Some people stay on methadone for life in order to stay away from opioids. S. Catharines, ON L2R 2Z3. Our clinic business hours are 8 a. reducing opioid withdrawal symptoms. Apply to Registered Nurse, Licensed Practical Nurse, Certified Registered Nurse Anesthetist and more!2 days ago · Oct. Children—Use and dose must be determined by your doctor. Learn about side effects, warnings, dosage, and. However, these guidelines will focus on methadone as it is the most widely used substitute medicine. This is a 100% grant funded position. It is a synthetic long-term opioid agonist medication. SAMHSA’s National Helpline – provides 24-hour, free, and confidential mental and substance use disorder information and treatment referral in English and Spanish. 11 Methadone Nurse jobs available in Worldwide USA on Indeed. Animals: Nine adult dogs (beagle and beagle cross breeds), four males and five females. 12 methadone clinics in Maine accepting Medicare. gov – this locator provides information on state-licensed providers who specialize in treating substance use disorders and mental illness. Extended drug panels, such as 10- or 12-panel tests do normally test for methadone. 5% in January 2019 to 3. The unadjusted median driving distance to the nearest methadone clinic accepting new patients was longer in the US compared to Canada (36. Methadone overdose can also occur if a person takes methadone with certain painkillers. Those on a methadone high process information much slower, may be drowsy and/or have droopy eyelids, a dry mouth, and muscle flaccidity. 56 (0. Olean, NY. In one small Mexican city, journalists who tried to expose cartel violence and government corruption became swept up in the murders devouring the country. 7 out of 10 from a total of 1106 ratings on Drugs. 4 accepting MS state insurance. 6% of this group reported being at high risk. 17 methadone clinics in Oregon accepting Medicare. 1. It is also a good alternative to morphine and other opiate analgesics in the treatment of severe chronic pain (Kumar, 2010[]). In general, this study showed that people in methadone treatment who struggle to be abstinent from substances may be helped by. 001) and postoperative day 3. This pdf document contains the official label information for methadone hydrochloride injection, USP, a synthetic opioid agonist indicated for the treatment of severe pain and opioid dependence. more. Metabolites. Yes. $24 to $32. QT interval screening in methadone maintenance treatment: report of a SAMHSA expert panel. Methods: Case report (n = 1). Methadone has an average rating of 8. Department: Psychology Bargaining Unit: 1199 Campus: MOSES Employment Status: Regular Part-Time Address: 2058 Jerome Avenue, Bronx. 1 This finding extends to medications used in the treatment of substance use disorders and pharmacotherapies utilized for treatment of medical or mental illnesses, as well as for abused substances—including alcohol, licit, and illicit substances. Quick Apply. Methadone is taken by mouth in a liquid form. The levomethadyl and methadone groups were significantly more likely to manifest a QTc greater than 470 or 490 milliseconds (28% for the levomethadyl group vs 23% for the methadone group vs 0% for the buprenorphine group; P < . For any opioid, symptoms can include difficulty breathing, extreme drowsiness (sleepiness), poor feeding. Berkeley. Yes, methadone can be considered as an opiate blocker. CASA-Trinity. Medicare drug coverage (Part D) also covers drugs like buprenorphine (to treat opioid use disorders) and methadone (when prescribed for pain). Methadone hydrochloride is a synthetic opioid analgesic medication used for opioid detoxification and to treat chronic and severe cancer pain or pain from nerve damage (neuropathy). Methadone treatment compliance can be effectively monitored by urine screening of methadone and its metabolite. Since methadone is lipophilic, it has been known to persist in the liver and other tissues. Methadone is a long-lasting opioid medication used in the treatment of pain and narcotic addiction. 42, p<0. Official answer. Methadone maintenance treatment has been used to treat opioid dependence since the 1950s. For patients receiving <60 mg oral morphine per day or equivalent (OME), the initial methadone dose should be no more than 7. Doctors Clinic 345 Main Street Hartford, CT 06106 860-525-2181 Intake: 860-525-9376. Methadone disposition was studied in three patients receiving chronic methadone treatment and having chronic renal disease: one oliguric patient during peritoneal dialysis, one anuric patient on hemodialysis, and one patient following renal transplantation. CMS also updated the rate for individual therapy provided in an Opioid Treatment Program (OTP), commonly referred to as a methadone clinic, to allow. Elmhurst Hospital Center – Methadone Maintenance Treatment Program. Flushing of the skin. Things at the opiate treatment program at San Francisco General Hospital look a good deal different these days from before the pandemic hit. Here are other useful contact numbers. Methadone Clinic Directory Massachusetts. Cherry Hill. Unfortunately, fentanyl’s high potency also means that even just a small amount can prove. 6 methadone clinics in Albuquerque accepting Medicare. 800-785-6890. Feedback und Hinweise auf Fehler. Methadone concentrations from 50 to 570 mcg/L were observed in assays of breast milk from. Yes, methadone can be considered as an opiate blocker. Methadone and buprenorphine are first-line therapy options for pregnant people with OUD. Summary • Methadone is not a first line agent for the treatment of chronic pain. Methadone Side Effects. There is concern over whether or not to allow the clinic to provide methadone to its clients. Methadone, an opioid, is used to treat pain and reduce withdrawal symptoms in people who are addicted to heroin or other narcotic drugs. Objective: To investigate the pharmacokinetics and effects of methadone on behaviour and plasma concentrations of cortisol and vasopressin in healthy dogs. 1 Oral Methadone Dosing Recommendations for the Treatment of Chronic Pain July 2016. 6 . (5. Obtain required references. Easily apply:18 LPN Methadone jobs available in Milton Frwtr, OR on Indeed. Once they reach peak severity, your symptoms will begin to resolve. The 15 speakers at Saturday’s gathering attacked the APT Foundation for their failure to give the community prior notice and their history of being a “bad neighbor. The billing code (also acting as the trigger code for payment) is H0020HG which will pay at $125 per week of methadone treatment. The National Council on Behavioral Health - Medication Assisted Treatmentdecision-making warrants caution. 9 overdose maternal deaths per 100,000 mothers with a live birth; in 2021, the rate was 15. "Methadone oral tablet is used to manage moderate to severe pain. The medication can be used for a brief period to get patients through acute withdrawal, or for longer periods of time as a maintenance therapy. 2 When used in larger doses, the clinical effect is terminated by systemic. If you or someone you know is experiencing a mental health or emotional crisis, please call 1-800-273-8255. Get Directions. 00 per year. 461 Dundas Street. These painkillers include oxycontin, hydrocodone (Vicodin), or morphine. While methadone is typically processed out of your system within two weeks, traces of the drug can show up for much longer, depending on the type of drug test used. However, there is a lack of. Initially, its use was limited to “detoxification treatment” or “maintenance treatment” within U. For opioid addiction: Adults—At first, 20 to 30 milligrams (mg) taken as a single dose per day. Methadone is an unusual opioid: it is long-acting with a half-life of 24 to 36 hours, so it accumulates and can cause delayed toxicity, especially with stacked doses that can cause a patient to go. By David Ovalle. Methadone maintenance treatment has been used to treat opioid dependence since the 1950s. Apply to Licensed Practical Nurse, Registered Nurse - Operating Room, Nurse and more!Continue to make naloxone widely available and encourage its use in suspected overdoses. Call 1-800-662-HELP (4357) or TTY: 1-800-487-4889 or text your zip code to 435748 (HELP4U). OUD is typically a chronic, relapsing illness, associated with. 8 clinics with payment assistance. 1093/haschl/qxad061. 505(d)(6)(iv)(B)): (1) absence of recent abuse of drugs (opiate and non-opiate), including alcohol; (2) regularity of clinic attendance; (3) absence of serious behavioral problems at the. Methadone: dental risks and preventive action. Initially, its use was limited to “detoxification treatment” or “maintenance treatment” within U. Methadone is also used together with medical supervision and counseling to treat opioid addiction (eg, heroin or other morphine-like drugs). Background: Methadone is an opioid analgesic of step 3 of the World Health Organization (WHO) analgesic ladder. Despite the rise of xylazine-fentanyl overdoses, naloxone remains the mainstay of overdose care because it reverses the effects of fentanyl, which is the primary reason that people stop breathing. S. The 1999 Federal regulations extend the treatment options of methadone-maintained opioid-dependent patients from specialized clinics to office-based opioid therapy (OBOT). Assess each patient’s risk before prescribing, and monitor regularly for development of these behaviors and conditions. 2 months as compared with those on methadone who were not at high risk (38. Methadone is a naturally long-acting analgesic with unique pharmacodynamic and pharmacokinetic properties compared to other opioids, available now in India, to treat severe pain. 2 days ago · Howard Kaminsky, president and CEO of Odan Laboratories Ltd. Each clinic listing includes contact information (address, phone number, website). In response to COVID-19, we have modified our operations but continue to provide services to our patients, including methadone dispensing. Methadone is very useful for managing complex chronic pain syndromes (combination of nociceptive and neuropathic), which are commonly seen in the top three cancers in India,[] namely, cervical, head and neck, and breast cancers. Purpose: Methadone HCl is used for the management of opioid addiction and chronic pain. Learn more. 2401 West Baltimore Street Baltimore, MD 21223. Methadone. All 18 clinics are in good standing. To get high on methadone, abnormally high doses are required. Due to the high regulation of this drug, its use is only permitted under the supervision of a practitioner, most often in clinics. mental depression. Plans for the new clinic involve the transfer of almost 400 patients to Newhallville to receive their methadone, a substitute drug used to treat morphine and heroin addiction. If you know of any methadone clinics in California that should be added to our directory, contact us. Suboxone contains two ingredients: buprenorphine and naloxone. com. 76 accepting Medicaid. 9 miles vs 14. It reduces your withdrawal symptoms, such as shaking, shivering and other flu-like symptoms. 0303. Methadone. Trends in Methadone Mortality. It can also be used for pain management. With it, you can save a life. 10. What does Methadone hydrochloride look like?MOUD is the use of one of three medications (methadone, buprenorphine, or naltrexone) approved by the Food and Drug Administration (FDA) for treatment of OUD; 11 MAT refers to treatment of OUD and certain other substance use disorders by combining counseling and behavioral therapies with the use of FDA-approved medications. 30–1. 3 . Naltrexone comes in a pill or as an injectable. numbness or tingling in the hands, feet, or lips. com. In New York State, OASAS and the Department of Health have partnered to offer a waiver for hospitals to. Isherwood, MD November 19, 2023 Isherwood is an addiction specialist and medical director of an opioid treatment program. Methadone hydrochloride (6-dimethylamino-4, 4-diphenyl-3-heptanone hydrochloride) is a synthetic opiate developed in Germany during World War II as an alternative to morphine. by Philip D. Of those on methadone treatment, 39. A sample methadone taper may look like this: The lower dosage is between 20 percent and 50 percent (as tolerated) each day until it is down to 30 mg per day. Atlanta, GA: CentersMethadone is a potent opioid analgesic that may be used to relieve severe pain unresponsive to other strong pain relievers; however, it is more commonly used to treat opioid addiction. R. Most people experience withdrawal symptoms within 2 to 4 days of their last dose. There are a variety treatment options available to Mainers struggling with substance use disorders, including programs specializing in detox and maintenance for those experiencing opioid and opiate dependence. These painkillers include oxycontin, hydrocodone (Vicodin), or. Ahora es la razón de su dolor. Methadone → 2-Ethylidene-1,5-dimethyl-3,3- diphenylpyrrolidine (EDDP) Confirmation Tests: Methadone. After 25 years of dedicated service to the SUD population in metro Detroit, QBH is opening its doors in 7 other cities. post-training) mixed analysis of variance (ANOVA) was. It is important to call 911 if a person overdoses on opioid drugs, especially a combination of methadone and heroin. Some form of ventilation assistance or breathing support if needed. There is a. 1, 2 Methadone is classified as a Schedule II controlled substance by the Drug Enforcement Administration (DEA), which means it has a high potential for. Residents of New Jersey looking for help with an addiction to opioids like heroin or prescription painkillers. pain, redness, or swelling where the medicine was injected. Methadone Clinics - New York. This pdf document contains the official label information for methadone hydrochloride injection, USP, a synthetic opioid agonist indicated for the treatment of severe pain and opioid dependence. Tell your doctor if you have or have ever had slowed breathing or asthma. , 2006). CDC compilation of benzodiazepines, muscle relaxants, stimulants, zolpidem, and opioid analgesics with oral morphine milligram equivalent conversion factors, 2017version. Methadone can also be used to manage pain. The label includes important warnings, dosage and administration, adverse reactions, drug interactions, and other information for health care professionals. Atascadero. Side effects that include pinpoint pupils, nausea, constipation, decreased respiratory rate, decreased heart rate, sweating, and mood swings (anxiety or depression) Effects associated with taking too much or an overdose that can include a decrease in blood pressure, decreased heart rate, significantly reduced breathing or. If you know of a clinic not included on this listing, contact us. Apply to Nurse Practitioner, Advanced Practice Registered Nurse, Family Nurse Practitioner and more!. Tablets are available in 5 mg and 10 mg formulations. $40 an hour. Constitutive and acquired (drug–interactions) inter- and intra-individual variability in. It is a synthetic long-term opioid agonist medication. Detoxification treatment of opioid addiction (heroin or other morphine-like drugs). Methadone for Pain Management: A Pharmacotherapeutic Review. 9 PATIENT INFORMATION BOOKLET ON METHADONE MAINTENANCE THERAPY Methadone is a long-acting, synthetic drug that was first developed to provide long lasting analgesia in thecovers opioid use disorder treatment services in opioid treatment programs. 14 clinics with payment assistance. 3 For patients who are on doses of methadone that are substantially higher than 30 mg, the required time to taper can be substantial, since it. 6 months). 9 accepting Medicaid. Full-Time. 2512 Harte Dr Brighton MI 48114. Methadone Clinic Directory This is a directory of methadone clinics in the U. Dolophine is also used used to manage. com. Atlantic City. 91. Upset stomach or vomiting. PMCID: PMC3905544. Background: Approximately 50 million US patients undergo ambulatory surgery annually. Demystify the use of methadone in hospital settings. This trueNorth Medical Clinic is located within the Queen’s Pharmacy in St. This newly revised April 2023 Guidance (hereinafter “the Guidance”) will be effective upon the expiration of the COVID-19 Public Health Emergency, and will remain in effect for the period of one. Given the potentially fatal consequences of these adverse effects, clinicians need to be alert to avoid this going unrecognised and untreated. Socialization with staff and other residents is part of the treatment, as are group therapy sessions, individualized therapy sessions, educational programs on mental health,. Find practitioners authorized to treat opioid dependency with buprenorphine by state. Of all OUD pharmacotherapies, it is used to treat the most people throughout the world and has by far the longest track record (nearly 50 years). This greater efficacy may result from greater cross-tolerance to the. 2008 Oct;35 (8):542-4, 547-8.