failed to mention that i made several errors on the f.a. really stupid errors. for instance i said that the trapezius does not take part in the abduction of the arm. gawd, this is embarrassing. i don't know what went through my mind, all i saw was this image of the scapula and the arrow showing the action of the serratius anterior, but no arrow for the trapezius. -sigh-


some shocking news:

NEW YORK (Reuters) -- The arthritis drug Vioxx, used by millions of people around the world, is being pulled off the market after a study confirmed long-standing concerns that it raises the risk of heart attack and stroke, the manufacturer, Merck & Co., said today.

"Patients who are currently taking Vioxx should contact their health care providers to discuss discontinuing use of Vioxx and possible alternative treatments," Merck said.

The company said it was withdrawing the drug following a review of data from a three-year colon cancer trial.

"In this study, there was an increased relative risk for confirmed cardiovascular events, such as heart attack and stroke, beginning after 18 months of treatment in the patients taking Vioxx compared to those taking placebo," Merck said in a press release.

Worldwide sales of Vioxx totaled $2.55 billion last year. Since the introduction of the drug in 1999, 91 million Vioxx prescriptions have been written in the United States alone. The drug is sold in some countries under the name Ceoxx.

Merck shares plunged 15 percent in pre-market trading after the announcement. Shares of Pfizer Inc., which sells two rival arthritis drugs, rose 5 percent.

"It's a major blow for Merck," said Sena Lund, an analyst at Cathay Financial. "It was one of their five key drivers for future growth."

Vioxx sales have been flat in recent years amid safety concerns. Clinical trial data have shown the drug increased the incidence of blood clots tied to strokes and heart attacks.

A recent study by the U.S. Food and Drug Administration suggested patients taking Vioxx faced a 50 percent greater risk of heart attacks and sudden cardiac death than those taking Pfizer's Celebrex arthritis treatment.

Sales of the Pfizer arthritis drugs Celebrex and Bextra have steadily grown as doctors have turned to those drugs, which have not been linked to heart attack and stroke.

The colon cancer trial was designed to evaluate the effectiveness of the standard 25-milligram Vioxx dose in preventing recurrence of colon polyps. Such polyps sometimes become cancerous.

Vioxx was used in the colon cancer trial because some researchers theorize that inflammation, present in arthritis, may be linked to colon cancer.

Merck said the heart attacks and strokes were not spotted during the first 18 months of the trial but became apparent later.

"Given the availability of alternative therapies, and the questions raised by the data, we concluded that a voluntary withdrawal (of Vioxx) is the responsible course to take," Merck Chief Executive Officer Raymond Gilmartin said.

Vioxx and the two Pfizer drugs are designed to block inflammation and pain as effectively as standard nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen, while causing far fewer ulcers and gastrointestinal problems than the older treatments.

The newer medicines block a protein called Cox-2 that has been linked to inflammation.

Merck said it would continue to market Arcoxia, its newer Cox-2 treatment that is sold in 47 countries. Approval of Arcoxia in the United States has been delayed by concerns among U.S. regulators about whether it poses the same risk of heart attack and stroke as Vioxx.

it's scary cuz my dad used to be on vioxx.