And food, instructional staff stipends, and promotional materials to carry the program's "5-2-1" message to the entire school community. At the conclusion of the three-year grant, the school staff intends to continue to offer after school programs to support students in need of nutrition and exercise. Mr. Binney, noting that Ms. Perrotta has trained eight teachers in the "Planet Health" program, says, "She's insured that the activities and philosophy embedded in the program can be sustained over time in our overall wellness initiatives." The "Jump Up & Go!" program has three goals: improving nutrition, increasing activi.
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SECTION 2 MANAGEMENT OF HEART FAILURE Heart failure is a complex syndrome that can occur from a structural or functional cardiac disorder that impairs the ability of the heart to function as a pump to support a physiological circulation. Heart failure is characterised by symptoms such as breathlessness and fatigue, and signs such as fluid retention. Diagnosis Echocardiogram should be performed to confirm diagnosis and to exclude valve disease and assess the systolic and diastolic ; function of the left ventricle. Practice based registers should be established and maintained for patients with left ventricular systolic dysfunction. Treatments Diuretics oral ; may be used to control patient symptoms of breathlessness and signs of heart failure such as fluid retention. ACE inhibitors should be considered for all patients with LVSD unless C I exists ; Beta blockers licensed for use in heart failure should be initiated after diuretic and ACEI therapy beta blockers are currently initiated and titrated to maintenance dose by the Heart Failure Clinic ; Loop diuretics Furosemide frusemide ; 20, 40 and 500mg tablets 20-40mg initial dose up to a maximum recommended daily dose of 250500mg Bumetanide 1 and 5mg tablets 0.5-1.0 mg initial dose up to a maximum daily dose of 5-10mg ACE inhibitors Enalapril tablets starting dose 2.5mg od, target dose 20mg in 1-2 daily divided doses Lixinopril tablets starting dose 2.5mg od, target dose 30-35mg daily.
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If there has been no response to a full course of SSRI treatment, check that: GPP the patient has taken the drug regularly and in the prescribed dose there is no interference from alcohol or substance use. If there has not been an adequate response to a standard SSRI dose and there are no significant side effects at 46 weeks: consider a gradual dose increase in line with the Summary of Product Characteristics. C Dose increase rate should take account of therapeutic response, adverse effects and patient preference. GPP Warn patients about and monitor for side effects during dose increases. GPP, for instance, lisinopril withdrawal.
Are 1 ; evaluation and analysis of the benefit, comparing it with national cost trends; 2 ; guiding the proposal and marketing processes; and 3 ; auditing vendors. Evaluating the Pharmacy Benefit Evaluating the pharmacy benefit requires simultaneous analysis of the financial and clinical techniques employed. Financial areas include member costsharing, the exclusion medication list, retail and mail service pricing and fees, use of generic medication, formulary analysis, and rebate discount arrangements. Despite their designation as financial, each of these areas can be addressed better if the pharmacist's inherent clinical insight adds perspective. For example, though the decision to change from a two-tier to a three-tier cost-share affects members, the impact can be mitigated if sound clinical judgment is used to determine where drugs are placed in the tiers. Research has confirmed that current cost drivers in pharmacy include increased drug.
Where HAPs supplies were available at reasonable cost, transition out of CFCs has already taken place. 2.2.2.1 Costs of retrofit There are wide variations in the cost of retrofit. The costs of converting filling facilities to hydrocarbon propellants increase dramatically if a new building, filling house or location is necessary. Thus, the decision to relocate is the largest single cost factor in conversion. In several developing countries, there are small and very small "cottage industry" aerosol fillers, which may be in residential areas or in inappropriate areas that cannot safely be converted to a flammable propellant because of their location. If there are local contract fillers available, the most economical solution is contract filling. Contract fillers do not exist everywhere, and sometimes they are unacceptable for competitive reasons. Where the owners wish to relocate to continue their own filling, it is recommended that funding be sought to assist in the installation of safety equipment and sometimes filling equipment for the new locale. In some countries the filler must also install equipment to deodorise locally available propane and butane gases of various compositions. This can also be a significant cost factor. In many cases, the filling equipment has proved inadequate for conversion. There is still some electrical equipment that cannot be used with HAPs. In all cases where the machinery is dangerous, either by design or because of its deteriorated state, the recommendation is to replace the machinery. A few small companies with ample land and relatively new equipment have been able to convert very inexpensively. In this case, total conversion costs can be less than USD $30, 000. Consultants to the implementing agencies have recommended assistance in the order of USD $50, 000 to $350, 000 for each facility to be converted, although there have been cases where large volume fillers required 1 million dollars or more in assistance and meridia.
14 Table 2. Incidence of Moderately Severe and Severe Adverse Events Reported in at Least Two Patients CTCL Trials.
Myers' infusion oncology drugs and related products to approximately 2, 300 office-based oncology practices in the United States. At the time of its acquisition by Bristol-Myers, OTN was the leading distributor of chemotherapeutic drugs and related products for the treatment of cancer. Bristol-Myers paid OTN a commission for marketing and selling its drugs. Both prior to and after Bristol-Myers acquired OTN, Bristol-Myers marketed and sold its drugs directly to medical providers across the country, and thus Bristol-Myers and OTN employed and maintained extensive marketing and sales departments. 85. Defendant Apothecon, Inc. "Apothecon" ; is a Delaware corporation with its and mesterolone, for example, lisinopril hypertension.
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LISINOPRIL Trade Names Category Regimen Prinivil, Zestril 24: 32.04 Angiotensin-Converting Enzyme Inhibitors Hypertension monotherapy in adults not receiving a diuretic: Initial dose is 5 to 10mg once daily with a maintenance dose of 20 40mg daily given as a single dose and adjusted according to the patient's blood pressure peak and trough responses and motrin.
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Calcium Mineral that is important for bone growth and body function. Calories Measure of energy value of food. Catheter Hollow tube used to transport fluids to or from the body. Cholesterol A type of fat found in most body tissues. Chronic kidney disease CKD ; Kidney function which is less than normal and will never get better. This condition might be mild and might only need to be watched by your doctor usually called Stage 1 or Stage 2 ; . Or might be slowly getting worse and will need to be watched more carefully to avoid symptoms and complications. Stage 5 CKD is also called End-stage renal disease ESRD ; , end-stage kidney disease, or end-stage kidney failure. This is when you need dialysis or a transplant to continue to live. Conservative care A treatment option which aims to provide physical and emotional comfort care, instead of extended life. Continuous ambulatory peritoneal dialysis CAPD ; Form of peritoneal dialysis in which dialysis fluid is exchanged at regular intervals throughout the 24-hour day. Creatinine Waste product of muscle activity. Cross match Blood test to measure the compatibility of a blood transfusion, or of a transplant donor and recipient. Cyclosporine Medication used to prevent rejection of a transplanted kidney. Cytotoxic antibody Substance in the blood antibody ; designed to kill the antigen; usually means that the body would reject a transplanted kidney.
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Medicalnewstoday medicalnews ? newsid 41534&nfid rssfeeds NHS 'wasting over 500m on drugs' - The BBC News, 21 04 2006 Liberal Democrat John Hemming used government figures on three drugs to show the NHS was slow to react to falls in prices once drugs lost their patent.The Birmingham Yardley MP said it showed the Department of Health was mismanaging money when many trusts were struggling to balance the books. But the government said it did not recognise the figures quoted. Mr Hemming's criticisms come as ministers are coming under increasing pressure over their management of NHS finances. The health service in England is expected to record an overspend of at least 600m for last year. Over 7, 000 job losses have been announced in recent weeks as trusts try to get out of the red. Mr Hemming used official figures on anti-cholesterol drug simvastatin, angina treatment amlodipine and lisinopril, which is used to treat heart disease. He calculated that government overspend on simvastatin alone was by 382m from 2002 to 2005. For lisinopril, it was 106m, while 26m too much was spent on amlodipine. Patents on all three drugs expired during the period, but Mr Hemming said the subsequent drop in prices was not reflected in the amount the government pays pharmacists for them. 'Slow' Mr Hemming said: "The government is slow to react to drops in drug prices once patents end. "Therefore, the money they are paying to pharmacists is way too much. At time when there are real funding problems this is mismanagement of the worst kind." He said he was writing to the National Audit Office to ask for an investigation into this. "These are only three drugs, there are no reason we won't see the same trend with others." But the government said it monitored prices to ensure it was not overpaying. A spokeswoman said: "The Department of Health does not recognise the claim that there has been a loss of 500m to the NHS in respect of these medicines. "We have monitored prices of generic medicines after patent expiry and taken action when necessary, to ensure that reimbursement prices reflect market prices." And Sue Sharpe, chief executive of the Pharmaceutical Services Negotiating Committee, added: "We do not believe the report to be accurate. "We have been CNE Health Bulletin Vol. 3, No. 5 May 2006 working with the Department of Health to establish profit levels and ensure that pharmacies are neither over or underpaid for their NHS services." : news.bbc 2 hi health 4926956 m No more room for error - The Economist, 20 04 06 Tony Blair is confident the NHS will pull through its latest crisis. Overly so AFTER all the "NHS in crisis" headlines, the image of Tony Blair perspiring heavily as he delivered a second major speech in a week defending his health reforms was irresistible. Yet far from being worth a thousand words, the pictures were seriously misleading. Under baking television lights, the prime ministerial pores have a well-established tendency to open up. And, odd though it may seem since the recent news of spiralling hospital deficits and sacked nurses has been grim, Mr Blair is in fact serenely optimistic that his health policies are about to come good. It is an optimism that is in marked contrast with his growing despondency about the prospects for his plans for secondary schools. Much of his party remains viscerally opposed to them and they are now further tarnished by the row over the honours allegedly promised to wealthy individuals in exchange for coming up with the cash to sponsor city academies. Even if his education bill survives the mauling that Labour MPs plan to give it, the trust schools that the reforms are meant to establish may suffer from the fallout. From Mr Blair's point of view, what makes health a more promising bit of his legacy is that he reckons he has not only hit on the right model to reform the NHS but won the argument for it too. He also thinks there is some understanding that the NHS is going through temporary pain on the way to big gains in efficiency and quality of care. As he said in his speech: "We have now reached crunch point where the process of transition from one system to another is taking place." Mr Blair listed four "interlocking changes" that he believes will transform the "monolithic" health service into one that is devolved and decentralised, with "far greater power in the hands of the patient". The first is practice-based commissioning, which gives incentives to general practitioners to transfer to hospitals only those patients who cannot be looked after more Page 13 of 15.
| Lisinopril walmart29 additionally, when asian americans seek treatment, they typically initiate care with eastern medicine providers eg, acupuncturists, bone setters, psychics ; and use homeopathic remedies eg, teas, soups their motivation for seeking these treatments may include a desire to preserve modesty and nexium.
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The responses suggest incomplete uptake of pharmacotherapeutic guidelines for the management of acute uncomplicated low back pain. Whilst it has been argued that a combination of paracetamol and NSAID may reduce the dose of each, there is no good reason to prefer that approach to instituting full doses of paracetamol early. The gastrointestinal morbidity of NSAIDs, including COX-2 selective NSAIDs, appears to be well known; less so are their cardiac and renal effects. Adding codeine to paracetamol or changing and phentermine.
| Released by the sample may be carried out by evaporation of the simulant and weighing of the residue. If rectified olive oil or any of its substitutes is used, the procedure given below may be followed. The sample of the material or article is weighed before and after contact with the simulant. The simulant absorbed by the sample is extracted and determined quantitatively. The quantity of simulant found is subtracted from the weight of the sample measured after contact with the simulant. The difference between the initial and corrected final weights represents the overall migration of the sample examined. Where a material or article is intended to come into repeated contact with foodstuffs and it is technically impossible to carry out the test described in paragraph 5, modifications to that test are acceptable, provided that they enable the level of migration occurring during the third test to be determined. One of these possible modifications is described below. The test is carried out on three identical samples of the material or article. One of these shall be subjected to the appropriate test and the overall migration determined M1 ; . The second and third samples shall be subjected to the same conditions of temperature but the period of contact shall be two and three times that specified and overall migration determined in each case M2 and M3, respectively ; . The material or article shall be deemed to be in compliance provided that either M1 or M3 - does not exceed the overall migration limit. 7. A material or article that exceeds the overall migration limit by an amount not greater than the analytical tolerance mentioned below should therefore be deemed to be in compliance with this Directive. The following analytical tolerances have been observed: -- 20 mg kg or 3 mg dm2 in migration tests using rectified olive oil or substitutes, -- 12 mg kg or 2 mg dm2 in migration tests using the other simulants referred to in Directives 82 711 EEC and 85 572 EEC. 8. Without prejudice to the provisions of Article 3 2 ; of Directive 82 711 EEC, migration tests using rectified olive oil or substitutes shall not be carried out to check compliance with the overall migration limit in cases where there is conclusive proof that the specified analytical method is inadequate from a technical standpoint. In any such case, for substances exempt from specific migration limits or other restrictions in the list provided in Annex II, a generic specific migration limit of 60 mg kg or 10 mg dm2, according to the case, is applied. However, the sum of all specific migrations determined shall not exceed the overall migration limit, for example, lizinopril dose.
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Because some of your immunosuppressives may cause high blood pressure, it is frequently necessary to take one or more antihypertensive following your transplant operation. Following is a list of the most commonly used antihypertensives and their side effects. Lopressor, Norvasc, Lisinopril, Atenolol Purpose: How Supplied: Dose: Lower blood pressure and prevent possible strokes. Antihypertensives come in tablets or capsules. The dosage of your antihypertensive medication is adjusted based on your blood pressure. Side Effects: Patients taking antihypertensives may experience the following side effects: Low blood pressure Weakness fatigue Headaches Dizziness Nausea vomiting and propecia.
Zestoretic hydrochlorothiazide lisinoprll ; All strengths Zithromax azithromycin ; 200mg 5ml & 1gm Susp * Zithromax azithromycin ; 250mg, ZPak Zocor simvastatin ; 5mg, 10mg, 20mg, & 80mg Tabs Zoladex goserelin ; 3.6mg & 10.8mg Inj * Zoloft sertraline ; 50mg & 100mg Tabs * Zomig solmitriptan ; 2.5mg & 5mg Tabs * Zomig ZMT orally disintegrating ; 2.5mg & 5mg Tabs Zovirax acyclovir ; 200mg Caps and 800mg Tabs Zyloprim allopurinol ; 100mg & 300mg Tabs Zymar gatifloxin ; 0.3% Ophthalmic Drops Zyprexa olanzapine ; 2.5mg, 5mg, 10mg & 15mg Tabs.
Table 4. Multivariate analysis of effects of various characteristics on percent changes in bone mineral density BMD ; of femoral neck and lumbar spine from baseline to year 3. The model was calculated as a stepwise regression using treatment assignment, age group, gender, cigarettes per day, calcium use, Vitamin D use, and multivitamin use. Significant predictors are shown with effect size expressed as % change in BMD. P values are for comparisons shown and soma.
The following symptoms are uncommon, but if you experience any of them, call your doctor immediately: swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs hoarseness difficulty breathing or swallowing fever, sore throat, chills, and other signs of infection yellowing of the skin or eyes lightheadedness fainting chest pain lieinopril may cause other side effects.
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Antihistamines , decongestants and your chronic routine medicines may be given as usual, but please ask the pharmacist about drug interactions.
For additional information see lisinopril and hydrochlorothiazide: patient drug information ; brand names prinzide; zestoretic pharmacologic category antihypertensive agent combination dosing: adults hypertension: oral: initial: lisinopril 10 mg hydrochlorothiazide 1 5 mg or lisinopril 20 mg hydrochlorothiazide 1 5 mg with further increases of either or both components could depend on clinical response.
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CCBs may be used as first-line therapy for hypertension when a thiazide diuretic cannot be used or there is a compelling reason for the use of a CCB, i.e. diabetes, high coronary disease risk. Please see hypertension guideline, page ; 1 The ALLHAT trial demonstrated no differences in fatal coronary heart disease CHD ; or non-fatal myocardial infarction MI ; between thiazide chlorthalidone ; , ACE inhibitor lisinopril ; , or dihydropyridine CCB amlodipine however, thiazide was superior in preventing certain secondary cardiovascular outcomes such as heart failure and stroke compared to CCB or ACE inhibitor.1 In African Americans, thiazides and dihydropyridine CCBs appear to have somewhat greater blood pressure lowering effects than beta blockers, ACE inhibitors, or angiotensin receptor blockers ARBs ; .1, 2 Beta-blockers are the usual first-line therapy for stable angina; however, a CCB may be used when a contraindication or intolerance to beta-blockers is present or as combination therapy when initial treatment with a beta-blocker is unsuccessful.3 CCBs are effective for prevention and treatment of Prinzmetal's variant angina. CCBs are generally selected over nitrates or beta-blockers for nocturnal vasopastic angina.3, 4 Use of immediate-release nifedipine Procardia ; for acute blood pressure reduction has resulted in adverse cardiac events, including death. Immediaterelease nifedipine should not be used for the treatment of essential hypertension.5.
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Trade in high-quality, air-freightedfresh fruit, vegetables, and cut flowers during the European winter 'off-season'. However, this trade was constrainedby the limited availability of air-cargo facilitiesout of Kenya and the limitedinvestmentsin Kenya in irrigation facilitiesand marketing infrastructure eg. storage units, refrigerated trucks ; . While the colonial govemment invested heavilyduring this period in productionand processingfacilities for such export crops as coffee, tea, and pyrethrum, public investmentsin the horticultural sub-sector were minimal. 12. Through much of the 1960s, Kenya's horticultural exports grew very moderately as.
03.03.05 perceived risks and with real or perceived side effects. In a US study of 1657 women initiating or changing to use a new contraceptive pill 32% of new starts and 16% of switchers had discontinued the method within six months. Of those who discontinued, 46% did so because of side effects most of which they did not discuss with a health professional and most of which would have resolved within weeks ; .27 In Sweden a common reason for discontinuation of the oral contraceptive pill is weight gain perceived to be caused by the pill ; and fear of health risks such as breast cancer.29 Continuation rates influence the effectiveness of contraception since women often change to a less effective method or spend some weeks or months using no method while they decide what to use next. More than four fifths of women in the US study who stopped the pill, despite being at risk of pregnancy, either failed to adopt another method or changed to a less effective one.70 Data from the US National Survey of Family Growth demonstrate high rates of method switching 61% of unmarried women will change their method over the space of two years ; .71 Switching to a less effective method is common.72 Data specific to the UK are lacking. Continuation rates of long acting methods of contraception are also fundamental to cost effectiveness. A method which costs 100 works out at 1.66 month if used for five years; discontinued after only one year of use the cost is 8.33 month.
Treatment has the same long-term health impact as in other circumstances". Indeed, evidence is mounting that thiazide-induced diabetes may be completely benign. A recently reported analysis of data from the ALLHAT study compared the effect of first-line thiazide, CCB or ACEI on fasting glucose FG ; levels and determined the cardiovascular and renal disease risks associated with elevated FG levels and incident diabetes mellitus DM ; 1. Mean FG levels increased during follow-up in all three treatment groups but was greatest with chlortalidone. At year 2 the increase was 0.47 mmol L for chlortalidone, 0.31 mmol L for amlodipine, and 0.19 mmol L for lisinopril. Overall the risk of FG level ever being higher than 6.9 mmol L was 2.9% higher for chlortalidone than amlodipine and 4.5% higher than lisinopril. However, there was no significant association of FG level change with subsequent CHD, stroke, CV disease, total mortality, or end-stage renal disease. The authors conclude that fasting glucose levels increase in older adults with hypertension regardless of treatment type. For those taking chlortalidone vs other medications, the risk of developing FG levels higher than 6.9 mmol L is moderately greater, but there is no conclusive or consistent evidence that this diuretic associated increase in DM risk increases the risk of clinical events. They comment that diuretics lead to elevated glucose levels by mechanisms different from those associated with DM. The accompanying editorial agrees that thiazide-induced DM is a different and benign disease entity compared with either de novo DM or that which develops in the context of other antihypertensives2. It concludes "viewed through the humbling and wide-angle lens of outcome research, thiazides become the cornerstone on which blood pressure-lowering treatment should be built.
SUBSTANCE 1 2 3 DU90% Estradiol Acetylsalicylic acid Lisiopril Amlodipine Diclofenac Ascorbic acid vit C ; Furosemide Diazepam Atenolol Simvastatin Isosorbide mononitrate Levothyroxine Oxazepam Glibenclamide Alprazolam Verapamil Cilazapril Loratadine Metildigoxin Chlortalidone DDD ; 2 mg 1 tabl 10 mg 5 mg 0.1 g 0.2 g 40 mg 10 mg 75 mg 15 mg 40 mg 0.15 mg 50 mg 7 mg 1 mg 0.24 g 2.5 mg 10 mg 0.2 mg 25 mg Mill. DDD 85 84 45 TOT 7.7% 4.1% Mill Euro 1.1 2.3 12.3 Euro DDD 0.01 0.03 0.27!
Table 4 Practical guidance on using ACE-I in heart failure64 Who should receive ACE-I All patients with heart failure or asymptomatic left ventricular dysfunction. Without contraindications history of angioneurotic oedema, pregnancy, bilateral renal artery stenosis ; With caution in: Significant renal dysfunction creatinine 2.5 mg dl or 221 lmol L ; Hyperkalemia K 5: 0 mmol L ; Symptomatic hypotension systolic blood pressure 90 mmHg ; Drug interactions to look out for: K supplements, K sparing diuretics including spironolactone ; , "low salt" substitutes with high K content, NSAIDS, angiotensin receptor blockers What to promise the patients The primary reason for adhering to drug therapy should be a prophylactic indication avoiding death and hospitalisations. The patient may or may not experience improved functional class and exercise tolerance. When to start As soon as possible after diagnosis and exclusion of contraindications ACE-I and dosing Captopril Enalapril Lisinorpil Ramipril Trandolapril Starting dose mg ; 6.25 t.i.d. 2.5 b.i.d. 2.5 5 daily 2.5 daily 1.0 daily Target dose mg ; 50 100 t.i.d. 10 20 daily 30 35 daily 5 b.i.d. or 10 daily 4 daily Reference 31 5456 62.
Diktators, FPU, Heinz, Felix Da Housecat, Queens Of Japan, Fisherspooner, Neon Man, Maru & Comix. VA: Neo.Pop Part Three CD 1ST 003 CD ; . $16.00 "Good music and relaxing parties are in constant demand. This is exactly why the Erfurt label, 1st Decade Records, decided to make their compilation series Neo.Pop available to a larger audience. Neo.Pop can be seen as a focus for acts and DJ's who want to set new accents in the realm of electronic music. Modern techno and electro, call it, neo.pop: meaning a synthesis of dance-orientated, fat beats paired with song structures and ideas that partially have their roots in 80's synth-pop, yet dare to step into new directions in electronic music. Northern Lite and the small, yet fine, creative record label, 1st Decade Records, are both a symbol and basis for this style of music, which has found a following not only in Germany and Europe, but which has spread as far as Japan and the USA. The third volume of this compilation series is, again, more than an insight into the most interesting and innovative part of the scene. Tested club tracks from Codec & Flexor, Kiki and Chicken Lips have their place alongside new releases and previously unreleased tracks from Monosurround, Gunjah and Warren Suicide. For the first time, `Reach the Sun' from Northern Lite premiers on a CD compilation. Further tracks from M. Mayer, Generation Aldi and Ladytron make this disc complete." NORTHERN LITE: Reach The Sun CD 1ST 007 CD ; . $18.00 "The new year is marked by a variety of things. For example, the early elimination of the German national soccer team in Portugal, which is more or less already inevitable, the likewise hot and chaotic Olympic Games in Athens and -- what so-called fortune tellers have seen in their crystal balls for years -- the ascension of the sickly Pope to heaven. On top of all this, if we're really unlucky, we'll have to put up with another 453 `popsuperstarsearchfame' shows. Fortunately, our universe is based on a balance of cosmic powers. The law of ambivalence calls for half-way good news as well. One of these is, without a doubt, the release of the new Northern Lite album. After playing their way into the hearts of clubgoers persistently for the last 3 years, and enjoying success in Spain, England and Japan, the trio from Erfurt finally found time to record their long-awaited debut. The 13 tracks successfully reflect the unbelievable atmosphere of Northern Lite's live gigs and the individuality of singer Andreas Kubat, guitarist Larry Lowe and DJ Boon. It remains to be seen, though, how much this will contribute to the stability of the universe." NORTHERN LITE: Reach The Sun LP 1ST 020 LP ; . $13.00 LP version.
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