Objective To investigate the eBcacy and safety of toltero-of incontinence and pad use were reduced by 20%, 46% and 29%, respectively, while the volume at first dine, a new antimuscarinic agent, and define the optimum dosage in patients with symptoms of detrusor contraction increased by 89 mL. The 4 mg dosage was associated with a large increase in residual urinary instability (urgency, increased frequency of micturition and/or urge incontinence).volume and an increased incidence of dry mouth. The incidence of adverse events (mainly mild or moderate Patients and methods A double-blind, placebocontrolled, multicentre study was carried out; after a antimuscarinic eCects) was comparable with placebo at tolterodine dosages of∏2 mg. No serious adverse 1-week run-in period to establish baseline values, 81 patients were randomized to receive placebo or toltero-events were observed and tolterodine had no clinically significant impact on electrocardiographic or labora-dine 0.5, 1, 2 or 4 mg twice daily for 2 weeks. Micturition (diary) variables, urodynamics and subjec-tory findings. Conclusion The results indicate that tolterodine oCers tive urinary symptoms were assessed after 2 weeks' treatment.an eCective treatment for the symptoms of detrusor instability. The optimum dosage appears to be 1-2 mg Results A per-protocol analysis of eBcacy in 64 patients showed dose-related improvements in recorded mictur-twice daily. Keywords Tolterodine, antimuscarinic agents, detrusor ition and urodynamic variables, e.g. at a dosage of 2 mg twice daily, the frequency of micturition, episodes instability, dose-ranging study of urge incontinence and other symptoms of an over-

Annual or triennial FOBT, double contrast barium enema (DCBE) 3 and 5 and colonoscopy 5 and 10 are all cost-effective. There is less value in combining FOBT and flexible sigmoidoscopy, or flexible sigmoidoscopy alone. Physicians therefore have the option of offering individuals a range of cost-effective screening strategies, including colonoscopy.

The model described in this paper takes into consideration two key findings: (a) In a given year, the vast majority (90-95%) of active substance abusers do not enter treatment or self-help groups, and (b) substance abusers have frequent contact with their families (60-80% either live with a parent or are in daily contact). This paper presents a method for mobilizing and collaborating with families and extended the support system toward working with resistance and getting the substance abuser into treatment. Principles and techniques are provided for convening and structuring intervention network meetings toward that end. This intervention network approach can be used either alone or as part of an overall model, ARISE (A Relational Intervention Sequence for Engagement). The ARISE model addresses both clinical and programmatic issues in treatment engagement for substance abusers.

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