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The information in this publication is meant to complement the advice of your health-care providers, not to replace it. Before making any major changes in your medications, diet, or exercise, talk to your doctor. Articles written by outside contributors have not been reviewed by the Hope Health Medical Advisory Board. If the hypothesis that GO is related to orbital autoimmune reactions directed toward antigen s ; shared by the thyroid and the orbit 1 ; is correct, the complete ablation of thyroid tissue might be important for the removal of both the thyroid-orbit cross-reacting autoantigens antigen deprivation ; and thyroid-autoreactive T lymphocytes 199 ; . The importance of total thyroid ablation on the decrease of thyroid autoimmune phenomena finds support in the observation that after thyroidectomy and radioiodine therapy in autoantibody-positive patients with thyroid cancers, serum antithyroglobulin and anti-thyroid peroxidase autoantibodies become undetectable or decrease in patients with no evidence of residual or metastatic ; thyroid tissue, but they do not change or increase in patients with persistent neoplastic disease 231 ; . On the other hand, if orbital autoantigens are not cross-reactive with the thyroid, total thyroid ablation would have a limited relevance for the course of the ophthalmopathy 232 ; . In addition, if ophthalmopathy is well established and or long lasting, it is conceivable that orbital autoimmunity might proceed independently of the persistence or removal of thyroid tissue. Therefore, also in this case, total thyroid ablation might not influence favorably the course of eye disease even in the presence of a real link between thyroid and orbital autoimmunity. Treatment of hyperthyroidism by radioiodine therapy or thyroidectomy is rarely followed by the complete ablation of thyroid tissue, even in patients who develop hypothyroidism and require l-T4 replacement. DeGroot 233 ; reported that most of 40 patients, treated with radioiodine therapy followed by replacement therapy for hypothyroidism, still had nonsuppressible thyroid radioiodine uptakes of 224% when therapy was discontinued for 2 days. In an uncontrolled study, DeGroot and Benjasuratwong 234 ; described 15 patients, 14 of whom were hypothyroid after either radioiodine therapy n 13 ; or thyroidectomy n 1 ; . These patients were treated with further radioiodine doses to obtain thyroid ablation, defined as a thyroid radioiodine uptake less than 1%. 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Of MAOI prior to elective cardiac surgery.97 There is no literature specifically concerning MAOI and ambulatory anesthesia. MAOI-related drug interactions are possible and have been reported; however, patients continuing to take either classic or selective MAOI remain suitable candidates for ambulatory anesthesia if meperidine, cocaine and indirect-acting catecholamines are avoided. Summary To date much of the research in ambulatory anesthesia has focused on selection of anesthetic techniques to minimize side effects in the healthy outpatient. This series of brief evidence-based reviews highlights what is known and what is yet to be learned regarding selected high-risk patients undergoing ambulatory surgery. For many patient conditions the clinician must base his her practice on case reports or extrapolate conclusions from more invasive inpatient procedures. This need not be so. Level 1 evidence characterizes the incidence and risk factors predicting postoperative apnea in the expremature infant undergoing herniorrhaphy. The clinician can call on randomized controlled trials to inform the choice of regional or general anesthesia and systematic review to summarize the prophylactic use of caffeine. Compare this to our knowledge of outcomes in adult patients with sleep apnea. A single retrospective study of patients with sleep apnea and matched controls undergoing ambulatory surgery is available to guide the clinician. Anesthesiologists should have better answers to these and other questions they are faced with in their ambulatory practice. Research in ambulatory anesthesia should now focus on identifying the risks and benefits of this model of care. Events following discharge in higher risk subgroups of patients should be sought and characterized. Prospective trials to characterize the patient at risk for complications and strategies to reduce these events are required. Ambulatory surgery has moved well beyond the "ASA I and II" patient that is represented in much of our prospective literature. Research in ambulatory anesthesia must follow. Acknowledgements The Canadian Ambulatory Anesthesia Research and Education CAARE ; Group would like to thank Dr. Ramiro Arellano, Dr. Peter Duncan, Dr. Angela Fitzmaurice, Dr. Ken LeDez, Dr. Stuart McCluskey, Dr. Barbara Pask, Dr. Donald Wilson, and Dr. Suntheralingam Yogendran for their participation. Special thanks to Alexandra Davis for her assistance with the literature searches. 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This might be done, for example, where the applicant is seeking approval for a new use for a drug that has already been approved for a different use or for a different formulation of the same drug that is already approved for the same use. 11 GOVERNMENT BILLS AND PRIVATE MEMBERS' PUBLIC BILLS PROJETS DE LOI MANANT DU GOUVERNEMENT ET PROJETS DE LOI D'INTRT PUBLIC MANANT DES DPUTS Bill 1, An Act to perpetuate an Ancient Parliamentary Right Loi visant perptuer un ancien droit parlementaire. Hon. Mr. Eves Premier ; . First Reading April 19, 2001. Bill 2, Ministerial Travel Accountability Act, 2002 Loi de 2002 sur l'obligation de rendre compte des voyages ministriels. Mr. Bartolucci L. Sudbury ; . First Reading April 23, 2001. Second Reading carried on division April 26. Ordered referred to Committee of the Whole House. Bill 3, Safe Drinking Water Act, 2002 Loi de 2002 sur l'eau potable saine. Ms. Churley N.D. TorontoDanforth ; . First Reading April 23, 2001. Second Reading debated and carried on division October 11. Ordered referred to the Standing Committee on General Government. Bill 4, Saving for Our Children's Future Act Income Tax Amendment ; , 2002 Loi de 2002 sur l'pargne en prvision de l'avenir de nos enfants modification de la Loi de l'impt sur le revenu ; . Mr. Hastings P.C. Etobicoke North ; . First Reading April 23, 2001. Second Reading carried on division April 26. Ordered referred to the Standing Committee on General Government. Considered June 6. Reported as amended June 7. Bill 5, Audit Amendment Act, 2002 Loi de 2002 modifiant la Loi sur la vrification des comptes publics. Mr. Gerretsen L. Kingston and the Islands ; . First Reading April 23, 2001. Bill 6, Protection of Minors from Sexually Explicit Goods and Services Act, 2002 Loi de 2002 sur la protection des mineurs contre les biens et services sexuellement explicites. Mr. Wood P.C. London West ; . First Reading April 23, 2001. Bill 7, Public Sector Salary Disclosure Amendment Act Friends on the Take ; , 2002 Loi de 2002 modifiant la Loi sur la divulgation des traitements dans le secteur public favoritisme ; . Mr. Bartolucci L. Sudbury ; . First Reading April 23, 2001. Bill 8, Canadian National Anthem Act, 2002 Loi de 2002 sur l'hymne national du Canada. Mr. Colle L. EglintonLawrence ; . First Reading April 23, 2001. Bill 9, Student Health and Safety Programs Act, 2002 Loi de 2002 sur les programmes de sant et de scurit pour tudiants. Mr. Gravelle L. Thunder BaySuperior North ; . First Reading April 25, 2001. Bill 10, Limitations Act, 2002 Loi de 2002 sur la prescription des actions. Hon. Mr. Young Attorney General ; . First Reading April 25, 2001. Bill 11, Remembrance Day Observance Amendment Act, 2002 Loi de 2002 modifiant la Loi sur l'observation du jour du Souvenir. Mr. Wood P.C. London West ; . First Reading April 25, 2001. 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Bill 15, Greater Judicial Appointments Accountability Act, 2002 Loi de 2002 sur une obligation accrue de rendre compte en ce qui concerne les nominations la magistrature. Mr. Wood P.C. London West ; . First Reading April 25, 2001 and ketorolac. Agreements were useful tools when new work practices are being implemented. Specifically on telework, the conference drew up a good practices list, including a recommendation that telework should be voluntary, with the right for individuals to return to company offices. The need to protect teleworkers' employment and representational rights was also stressed. The conference explored the occupational safety and health implications of new technology at work, particularly in respect of such new workplace concerns as ergonomics, stress, mixing of work and leisure, and intensity of work. Delegates called for better professional advice from labour inspectors, occupational safety and health institutions, hardware and software manufacturers, and others on acceptable working environments and conditions of work. There are important gender implications of the changes taking place in employment. In the digital economy, men still tend to hold the higher skilled and better paid jobs, whilst women are concentrated in the lower skilled, lower paid, less promising jobs with more repetitive and less creative work. Therefore, existing gender inequalities in the labour market will probably be reinforced unless active gender policy measures are implemented concerning pay, working hours, job opportunities, and education in the ICT field. With all European Union candidate countries from Central and Eastern Europe represented, the conference provided a valuable opportunity for delegates to take stock of the potential that ICTs offer for employment creation and for decent work in their own countries. It was agreed that further opportunities for sharing experience in this way through similar regional initiatives should be encouraged. A full report of the conference has been published, and will be made available on the ILO-CEET website in January 2003. In the meantime, the conclusions of the conference can be found on: : ilo-ceet.hu latest events Tallin 2002 Conclusions or on request from ILOCEET CEE participants and resource persons at the ICT and decent work conference, Tallinn, Estonia, 2526 April AR of work; and ways to increase the capacity of governments, employers and unions in this regard. The conference concluded that Central and Eastern European countries are well equipped for the information society, but that the benefits will be secured only if appropriate policies and efficient social dialogue are put in place. Participants agreed that ICTs should lie at the very core of employment strat-egy, especially with respect to the quality of work. Amid fears that the expansion of the European Union could potentially mean a "brain drain" to Western Europe, the conference urged governments and social partners to combine incentives for qualified professionals to remain in their home countries and to encourage those who had already left to return. Continuous training of young people and indeed older workers in appropriate skills was also considered an important strategy. The conference discussed new forms of work organization, including telework, which are emerging through the use of ICTs. 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