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Learn about HEMLIBRA® (emicizumab-kxwh), a hemophilia A treatment now approved for people with hemophilia A with factor VIII inhibitors. See BOXED WARNING. What is HEMLIBRA? HEMLIBRA is a prescription medicine used for routine prophylaxis to prevent or reduce the frequency of bleeding episodes in adults and children with hemophilia A with factor VIII inhibitors. What is the most important information I should know about HEMLIBRA? HEMLIBRA increases the potential for your blood to clot. Discontinue prophylactic use of bypassing agents the day before starting HEMLIBRA prophylaxis. Carefully follow your healthcare provider’s instructions regarding when to use an on-demand bypassing agent, and the dose and schedule you should use. HEMLIBRA may cause the following serious side effects when used with aPCC (FEIBA®), including: Thrombotic microangiopathy (TMA). This is a condition involving blood clots and injury to small blood vessels that may cause harm to your kidneys, brain, and other organs. Get medical help right away if you have any of the signs and symptoms of TMA during or after treatment with HEMLIBRA. Blood clots (thrombotic events). Blood clots may form in blood vessels in your arm, leg, lung or head. Get medical help right away if you have any of the signs or symptoms of blood clots during or after treatment with HEMLIBRA. If aPCC (FEIBA®) is needed, talk to your healthcare provider in case you feel you need more than 100 U/kg of aPCC (FEIBA®) total. How should I use Hemlibra? See the detailed “Instructions for Use” that comes with your HEMLIBRA for information on how to prepare and inject a dose of HEMLIBRA, and how to properly throw away (dispose of) used needles and syringes. HEMLIBRA may interfere with laboratory tests that measure how well your blood is clotting and may cause a false reading. Talk to your healthcare provider about how this may affect your care. What are the other possible side effects of HEMLIBRA? The most common side effects of HEMLIBRA include: redness, tenderness, warmth, or itching at the site of injection; headache; and joint pain. These are not all of the possible side effects of HEMLIBRA. You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835-2555. Please see the HEMLIBRA full Prescribing Information and Medication Guide for more important safety information including Serious Side Effects.

For around 14 years the San Juan Bay Pilots have ensured the safe and efficient movement of all type of vessels that traverse the San Juan Bay. Our services are essential to the flow of goods between the bay and the world.

This wiki contains content regarding Transportable Moisture Limit (TML) testing as outlined in Appendix 2 of the International Maritime Solid Bulk Cargoes Code (IMSBC Code). The aim of this wiki is to allow knowledgeable users to add, edit and discuss the content within so as to have a well-founded and dependable source of information, developed collaboratively, that can be referred to when determining the TML of Group A or liquefiable solid bulk cargoes.