The Tennessee House Health and Human Resources Committee on Tuesday passed the Senate version of a resolution (S.J.R. 127) supporting an amendment to the state constitution stating that "nothing in the Constitution of Tennessee secures or protects the right to abortion or requires the funding of an abortion," the Memphis Commercial Appeal reports. The committee had rejected prior attempts to pass a similar amendment, according to the Commercial Appeal. Approval of the amendment marks a key step in the long-running effort by abortion-rights opponents to overturn a 2000 Tennessee Supreme Court ruling that declared that the state constitution provides stronger protections than the U.S. Constitution for abortion rights and struck down several state restrictions on the procedure, the Commercial Appeal reports. The amendment would need approval by two-thirds majorities in the House and Senate during the next two-year term of the General Assembly for the measure to proceed to a statewide vote in 2014.
Committee members also voted 16-11 to table House Democratic Leader Rep. Gary Odom's proposal to include language in the resolution that would allow future legislatures to ban abortion "except in cases involving rape or incest or when the life of the pregnant woman is threatened." Odom's proposal also would have banned public funding of abortion and prohibited so-called "partial-birth" abortion (Locker, Memphis Commercial Appeal, 4/8).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
вторник, 28 июня 2011 г.
воскресенье, 26 июня 2011 г.
Opening Dialogue On Incontinence At San Francisco Forum
UCSF and the National Association For Continence (NAFC) are holding a public workshop on October 3 to help women understand how they can control and treat incontinence. Even though urinary incontinence can be improved in eight out of 10 cases, fewer than half of those with bladder problems ever talk about the condition with their health care professionals, according to the Agency for Healthcare Quality and Research.
Urinary incontinence, or the unintentional loss of urine, is a problem for more than 25 million Americans. Of this group, about 16 million are women with stress urinary incontinence, or leakage with sneezing, laughing, or coughing, the NAFC notes.
"Incontinence is common yet rarely discussed. Consequently, many women needlessly suffer in silence and don't seek treatment," said Nancy Muller, executive director of the NAFC. "And contrary to popular belief, incontinence is not normal or an inevitable part of aging. Most cases of urinary incontinence can be treated non-surgically with lifestyle or behavioral changes, physical therapy or medication."
The public workshop, titled "A Woman's Guide to Pelvic and Bladder Health", will be held from 8 a.m. to 1 p.m. at San Francisco's Hotel Kabuki. Registration is $10. To sign up, visit nafc/. The half day event features presentations from recognized experts on pelvic and bladder health followed by a question and answer session. Topics include the bladder's function, the role of pelvic support, types of incontinence, the impact of aging, and bowel health. Surgical and non-surgical treatments also will be discussed.
"We want to create an environment at this forum that encourages women to learn the facts about incontinence and motivates them to take actions to improve their quality of life," said Nancy Milliken, MD, vice dean, UCSF School of Medicine and director, UCSF National Center of Excellence in Women's Health. "It is particularly important to erase the discomfort around this issue now, since the incidence of incontinence - along with associated costs - has the potential to grow as the baby boomer population ages and obesity rises."
Incontinence is a condition that can be triggered by surgery, childbirth, diseases such as multiple sclerosis, and degenerative changes associated with aging, among other causes. Studies also have indicated that obesity is a strong risk factor for urinary incontinence. A recent study led by UCSF researchers demonstrated that behavioral weight-loss programs can be an effective way to reduce urinary incontinence in women who are overweight or obese.
The clinical planning leads for the forum are Jeanette S. Brown, MD, director of the UCSF Women's Continence Center and a professor in the UCSF Department of Obstetrics, Gynecology, and Reproductive Sciences, and Donna Deng, MD, a professor in the UCSF Department of Urology.
The UCSF Women's Continence Center was established in 1991 and in 2004, the UCSF Center for Pelvic Physiology was established for women and men with a variety of bowel and bladder problems.
According to the NAFC, anyone experiencing the following warning signs of bladder control problems should talk to a health care professional:
Leakage of urine which impacts one's activities
Leakage of urine causing embarrassment
Leakage of urine after an operation, such as a hysterectomy or Caesarean section
An urgent need to rush to the bathroom and/or loss of urine if you do not arrive in time
Frequent bladder infections
Urinating more frequently than usual without a bladder infection
Pain related to filling the bladder and/or during urination in the absence of a bladder infection
Changes in urination related to a neurological condition such as stroke, spinal cord injury, or multiple sclerosis
Urinary incontinence, or the unintentional loss of urine, is a problem for more than 25 million Americans. Of this group, about 16 million are women with stress urinary incontinence, or leakage with sneezing, laughing, or coughing, the NAFC notes.
"Incontinence is common yet rarely discussed. Consequently, many women needlessly suffer in silence and don't seek treatment," said Nancy Muller, executive director of the NAFC. "And contrary to popular belief, incontinence is not normal or an inevitable part of aging. Most cases of urinary incontinence can be treated non-surgically with lifestyle or behavioral changes, physical therapy or medication."
The public workshop, titled "A Woman's Guide to Pelvic and Bladder Health", will be held from 8 a.m. to 1 p.m. at San Francisco's Hotel Kabuki. Registration is $10. To sign up, visit nafc/. The half day event features presentations from recognized experts on pelvic and bladder health followed by a question and answer session. Topics include the bladder's function, the role of pelvic support, types of incontinence, the impact of aging, and bowel health. Surgical and non-surgical treatments also will be discussed.
"We want to create an environment at this forum that encourages women to learn the facts about incontinence and motivates them to take actions to improve their quality of life," said Nancy Milliken, MD, vice dean, UCSF School of Medicine and director, UCSF National Center of Excellence in Women's Health. "It is particularly important to erase the discomfort around this issue now, since the incidence of incontinence - along with associated costs - has the potential to grow as the baby boomer population ages and obesity rises."
Incontinence is a condition that can be triggered by surgery, childbirth, diseases such as multiple sclerosis, and degenerative changes associated with aging, among other causes. Studies also have indicated that obesity is a strong risk factor for urinary incontinence. A recent study led by UCSF researchers demonstrated that behavioral weight-loss programs can be an effective way to reduce urinary incontinence in women who are overweight or obese.
The clinical planning leads for the forum are Jeanette S. Brown, MD, director of the UCSF Women's Continence Center and a professor in the UCSF Department of Obstetrics, Gynecology, and Reproductive Sciences, and Donna Deng, MD, a professor in the UCSF Department of Urology.
The UCSF Women's Continence Center was established in 1991 and in 2004, the UCSF Center for Pelvic Physiology was established for women and men with a variety of bowel and bladder problems.
According to the NAFC, anyone experiencing the following warning signs of bladder control problems should talk to a health care professional:
Leakage of urine which impacts one's activities
Leakage of urine causing embarrassment
Leakage of urine after an operation, such as a hysterectomy or Caesarean section
An urgent need to rush to the bathroom and/or loss of urine if you do not arrive in time
Frequent bladder infections
Urinating more frequently than usual without a bladder infection
Pain related to filling the bladder and/or during urination in the absence of a bladder infection
Changes in urination related to a neurological condition such as stroke, spinal cord injury, or multiple sclerosis
суббота, 25 июня 2011 г.
Social Pressure, Affordable Access Prompt Older Women In India To Seek IVF Services
Intense social pressure to bear children and access to relatively affordable reproductive technology has spawned hundreds of infertility clinics across India, where a significant number of clients are women older than age 50, the Washington Post reports. In India, "giving birth to many children defines a woman's worth" in society and is "considered parents' best chance for financial security," according to the Post. Little is being done to curb the nation's rapidly growing population of 1.2 billion, and planning advocates argue that the unchecked expansion is stalling India's economic growth and straining its infrastructure.
As in the U.S., the majority of Indian IVF clients are upper-middle class couples in their 30s and early 40s who have delayed childbearing to focus on careers. However, about 20% of India's clients are older women looking to "shed the stigma of being unable to conceive," the Post reports. For example, the private National Fertility Center in the northern state of Haryana has helped 100 women older than age 50 conceive in the past 18 months, including a 66-year-old woman who gave birth to triplets. About 60 of the women were able to carry their pregnancies to term.
A single IVF attempt in India costs about $2,500, compared with up to $15,000 in the U.S., and many patients take out loans or borrow money from relatives to pay for the procedure. Some of the women used eggs donated by younger relatives that were fertilized with their husbands' sperm.
Fertility experts who oppose the use of IVF in older women note that it carries several risks for the mother, including stress on the heart, high blood pressure and uterine rupture. In addition, older women's infants are more likely to be born prematurely and face health problems. Although the U.S. has no age limit on IVF, doctors discourage it after age 45 and can refuse to provide it in situations they consider too risky.
The Indian government does not regulate IVF clinics. Hrishikesh Pai, a leading IVF expert in India and president of the 900-member Indian Society of Assisted Reproductive Technology, said there are more than 550 in-vitro fertilization centers in India, with an average of one new clinic opening every 15 days. Pai said that some health experts expect as many as 600,000 IVF cycles to be performed in India in the next three years, exceeding the number of IVF cycles performed in the U.S. -- 150,000 -- and China -- 80,000 -- in 2009. Doctors in India will often attempt up to four rounds of IVF on a patient (Wax, Washington Post, 8/13).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families.
© 2010 National Partnership for Women & Families. All rights reserved.
Individual Counseling, Religious Support Increase Contraceptive Use In Afghanistan, WHO Study Finds
Birth control use in three rural areas of Afghanistan increased over an eight-month period after health workers explained the benefits of contraception in individual counseling sessions, according to a report published Monday in the World Health Organization's journal Bulletin, the AP/Yahoo! News reports. Afghanistan has one of the highest fertility rates in the world, with an average of more than six infants per woman. Awareness and use of contraception remains low among many Afghans, with about 10% of women using some form of birth control, according to UNICEF estimates. The country has a maternal mortality rate of 1,800 maternal deaths per 100,000 live births, making it second only to Sierra Leone worldwide, according to UNICEF. The U.S. maternal mortality rate is 11 maternal deaths per 100,000 live births.
For the study, the Afghanistan Health Ministry from 2005 to 2006 worked with not-for-profit organizations to reach out to 3,700 families. The families covered three rural areas with different ethnic groups, including both Sunni and Shia Muslims. The health workers told participants that using birth control was 300 times safer than giving birth in Afghanistan and tried to dispel beliefs that contraception can have negative side effects, such as infertility. They also used quotes from the Quran to encourage women to breastfeed for at least two years and to promote longer breaks between births. The discussions included husbands and local religious leaders called mullahs. According to the AP/Yahoo! News, Islam does not fundamentally oppose birth control, and various parts of the Muslim world support "[e]verything from vasectomies to abortions."
According to the study, contraceptive use increased to 27% in all three areas, reaching up to 50% of women in one area. Thirty-seven mullahs endorsed contraceptive use as a way to increase time between births, with some offering the message during Friday prayers. Douglas Huber -- lead author of the study, conducted for the U.S.-based Management Sciences for Health -- said, "The main take-home point is that for women who do not want to be pregnant now, it can be a double tragedy for her to die from a pregnancy she did not want especially when we could have helped her." He added that the "fastest, cheapest, easiest way to reduce maternal deaths in Afghanistan is with contraception."
According to Huber, the Health Ministry plans to expand the program with help from USAID, the European Union and the World Bank. Matthews Mathai, a maternal health expert at WHO, said, "It's good to see there are results coming out of Afghanistan," adding, "Clearly, it takes the religious leaders and the men to get some change." However, he cautioned that the program's costs, combined with continuing conflict in the region, could make it difficult to expand nationally (Mason, AP/Yahoo! News, 3/2).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2010 The Advisory Board Company. All rights reserved.
Teen Pregnancy Rate Rose In 2006, Marking First Increase Since 1990, Study Finds
The pregnancy rate among U.S. teens ages 15 through 19 rose 3% from 2005 to 2006, marking the first increase since 1990, according to a new analysis by the Guttmacher Institute, the Washington Post reports (Stein, Washington Post, 1/26). The increase spanned racial demographics and coincided with an increase in teen birth rates and a 1% rise in abortion rates (Jayson, USA Today, 1/26). Lawrence Finer, director of domestic research at Guttmacher, said, "The decline in teen pregnancy has stopped -- and in fact has turned around," adding that the statistics "are certainly cause for concern."
Increases in the teen birth rate, which has been declining for years, first appeared in 2005 data, but it had not been clear whether the change was because of more pregnancies or fewer abortions and miscarriages, the Post reports. For the new analysis, Guttmacher researchers examined data on teenage sex and births compiled by the Centers for Disease Control and Prevention's National Center for Health Statistics and abortion data gathered by CDC and Guttmacher. While fluctuations in birth rates can be caused by changes in abortion rates, the Guttmacher analysis shows that the shift represents "a true rise in pregnancies," John Santelli, a professor of population and family health at Columbia University, said. Researchers determined that 71.5 teenage girls per 1,000 -- roughly 743,000 pregnancies in total, or 7% of women younger than age 20 -- became pregnant in 2006. In 2005, 69.5 teenagers per 1,000 became pregnant, which represented the leveling off of a decline in teen sexual activity that began in 1991.
Broken down by race, the pregnancy rate increased from 124.9 pregnancies per 1,000 Hispanic teenagers in 2005 to 126.6 in 2006. Among white teens, the rate rose from 43.3 per 1,000 in 2005 to 44 per 1,000 in 2006, while among black teens it rose from 122.7 per 1,000 to 126.3 per 1,000 (Washington Post, 1/26). Among states, New Mexico recorded the highest teen pregnancy rate with 9%, followed by Nevada, Arizona, Texas and Mississippi. The states with the lowest pregnancy rates were New Hampshire, Vermont, Maine, Minnesota and North Dakota (Allen, Reuters, 1/26). U.S. pregnancy rates are higher than those of most industrialized nations.
Experts Debate Reasons for Shift
Some experts attributed the higher teen pregnancy rate to the growth of abstinence-only sexual education programs. According to the Post, other potential factors that could contribute to the increase are higher poverty, a rise in Hispanic immigration and lax use of birth control due to complacency about HIV/AIDS (Washington Post, 1/26). Finer said, "It's interesting to note that this flattening out of the rate and the increases in the rate is happening at the same time that we've seen substantial increases in funding for abstinence-only programs." Since the late 1990s, abstinence-only programs received more than $1 billion in federal funding (Reuters, 1/26). The new data show that after a decade of heavy spending on abstinence-only, "the U.S. is lurching backwards on teen sexual health," James Wagoner of Advocates for Youth said.
President Obama cut funding for abstinence-only programs and will allocate $110 million for a teen pregnancy prevention initiative focusing on programs with proven results. However, the Senate's health reform bill (HR 3590) would restore $50 million in funding for abstinence-only programs, according to the Post. Sarah Brown, of the National Campaign To Prevent Teen and Unplanned Pregnancy, said, "One of the nation's shining success stories of the past two decades is in danger of unraveling," adding, "Clearly, the nation's collective efforts to convince teens to postpone childbearing must be more creative and more intense, and they must begin today."
Supporters of abstinence-only programs said the research illustrates the need for continued efforts to encourage teens to avoid sexual activity. Valerie Huber of the National Abstinence Education Association said, "Contributors include an over-sexualized culture, lack of involved and positive role models, and the dominant message that teen sex is expected and without consequences" (Washington Post, 1/26).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2010 The Advisory Board Company. All rights reserved.
Sunlight Exposure May Decrease Risk Of Advanced Breast Cancer
A research team from the Northern California Cancer Center, the University of Southern California, and Wake Forest University School of Medicine has found that increased exposure to sunlight which increases levels of vitamin D in the body -- may decrease the risk of advanced breast cancer.
In a study reported online this week in the American Journal of Epidemiology, the researchers found that women with high sun exposure had half the risk of developing advanced breast cancer, which is cancer that has spread beyond the breast, compared to women with low sun exposure. These findings were observed only for women with naturally light skin color. The study defined high sun exposure as having dark skin on the forehead, an area that is usually exposed to sunlight.
The scientists used a portable reflectometer to measure skin color on the underarm, an area that is usually not directly exposed to sunlight. Based on these measurements, they classified the women as having light, medium or dark natural skin color. Researchers then compared sun exposure between women with breast cancer and those without breast cancer. Sun exposure was measured as the difference in skin color between the underarm and the forehead.
In women with naturally light skin pigmentation, the group without breast cancer had significantly more sun exposure than the group with breast cancer. The fact that this difference occurred only in one group suggests that the effect was due to differences in vitamin D production and wasn't just because the women were sick and unable to go outdoors. In addition, the effect held true regardless of whether the cancer was diagnosed in the summer or in the winter. The difference was seen only in women with advanced disease, suggesting that vitamin D may be important in slowing the growth of breast cancer cells.
"We believe that sunlight helps to reduce women's risk of breast cancer because the body manufactures the active form of vitamin D from exposure to sunlight," said Esther John, Ph.D., lead researcher on the study from the Northern California Cancer Center. "It is possible that these effects were observed only among light- skinned women because sun exposure produces less vitamin D among women with naturally darker pigmentation."
These new findings about breast cancer risk and sun exposure based on skin color measurements are consistent with previous research by John and colleagues that had shown that women who reported frequent sun exposure had a lower risk of developing breast cancer than women with infrequent sun exposure.
The researchers stressed that sunlight is not the only source of vitamin D, which can be obtained from multivitamins, fatty fish and fortified foods such as milk, certain cereals and fruit juices. Women should not try to reduce their risk of breast cancer by sunbathing because of the risks of sun-induced skin cancer, they said.
"If future studies continue to show reductions in breast cancer risk associated with sun exposure, increasing vitamin D intake from diet and supplements may be the safest solution to achieve adequate levels of vitamin D," said Gary Schwartz, Ph.D., a co-researcher from the Comprehensive Cancer Center at Wake Forest University School of Medicine.
"Since many risk factors for breast cancer are not modifiable, our finding that a modifiable factor, vitamin D, may reduce risk is important," said Sue Ingles, Ph.D., a co-researcher from University of Southern California Keck School of Medicine.
The researchers compared 1,788 breast cancer patients in the San Francisco Bay area with a matched control group of 2,129 women who did not have breast cancer. They included non-Hispanic white, Hispanic and African-American women, thus women with a wide range of natural skin color and a wide range of capacity to produce vitamin D in the body. Skin color is an important factor that determines how much vitamin D is produced in the body after sun exposure. Dark-skinned individuals produce up to 10 times less vitamin D than light-skinned individuals for the same amount of time spent in the sun. People with darker skin are also more likely to be vitamin D deficient than people with lighter skin.
The research team also included Wei Wang, Ph.D., of the University of Southern California Keck School of Medicine. The work was supported by grants from the National Cancer Institute and U.S. Department of Defense Medical Research Program.
About the Northern California Cancer Center: The Northern California Cancer Center (www.nccc) is an established, nationally recognized leader dedicated to understanding the causes and prevention of cancer and to improve the quality of life for individuals living with cancer. NCCC has been working with scientists, educators, patients, clinicians, and community leaders successfully since 1974, and is an active partner with Stanford University's Comprehensive Cancer Center. NCCC is a 501(c)3 nonprofit with over 170 employees and a $15 million operating budget.
Wake Forest University Baptist Medical Center is an academic health system comprised of North Carolina Baptist Hospital and Wake Forest University Health Sciences, which operates the university's School of Medicine. U.S. News & World Report ranks Wake Forest University School of Medicine 18th in primary care and 44th in research among the nation's medical schools. It ranks 35th in research funding by the National Institutes of Health. Almost 150 members of the medical school faculty are listed in Best Doctors in America.
The USC/Norris Comprehensive Cancer Center, located in Los Angeles, is a major regional and national resource for cancer research, treatment, prevention and education. Nearly 200 basic scientists, physicians and other Keck School of Medicine of USC faculty members who are members of the USC/Norris Cancer Center investigate the complex origins and progression of cancer, develop prevention strategies and search for cures. The National Cancer Institute (NCI) has designated the USC/Norris Cancer Center as one of the nation's 39 comprehensive cancer centers, a select group of institutions providing leadership in cancer treatment, research, prevention and education.
Wake Forest University Baptist Medical Center
Medical Center Blvd.
Winston-Salem, NC 27157-1015
United States
www1.wfubmc.edu
In a study reported online this week in the American Journal of Epidemiology, the researchers found that women with high sun exposure had half the risk of developing advanced breast cancer, which is cancer that has spread beyond the breast, compared to women with low sun exposure. These findings were observed only for women with naturally light skin color. The study defined high sun exposure as having dark skin on the forehead, an area that is usually exposed to sunlight.
The scientists used a portable reflectometer to measure skin color on the underarm, an area that is usually not directly exposed to sunlight. Based on these measurements, they classified the women as having light, medium or dark natural skin color. Researchers then compared sun exposure between women with breast cancer and those without breast cancer. Sun exposure was measured as the difference in skin color between the underarm and the forehead.
In women with naturally light skin pigmentation, the group without breast cancer had significantly more sun exposure than the group with breast cancer. The fact that this difference occurred only in one group suggests that the effect was due to differences in vitamin D production and wasn't just because the women were sick and unable to go outdoors. In addition, the effect held true regardless of whether the cancer was diagnosed in the summer or in the winter. The difference was seen only in women with advanced disease, suggesting that vitamin D may be important in slowing the growth of breast cancer cells.
"We believe that sunlight helps to reduce women's risk of breast cancer because the body manufactures the active form of vitamin D from exposure to sunlight," said Esther John, Ph.D., lead researcher on the study from the Northern California Cancer Center. "It is possible that these effects were observed only among light- skinned women because sun exposure produces less vitamin D among women with naturally darker pigmentation."
These new findings about breast cancer risk and sun exposure based on skin color measurements are consistent with previous research by John and colleagues that had shown that women who reported frequent sun exposure had a lower risk of developing breast cancer than women with infrequent sun exposure.
The researchers stressed that sunlight is not the only source of vitamin D, which can be obtained from multivitamins, fatty fish and fortified foods such as milk, certain cereals and fruit juices. Women should not try to reduce their risk of breast cancer by sunbathing because of the risks of sun-induced skin cancer, they said.
"If future studies continue to show reductions in breast cancer risk associated with sun exposure, increasing vitamin D intake from diet and supplements may be the safest solution to achieve adequate levels of vitamin D," said Gary Schwartz, Ph.D., a co-researcher from the Comprehensive Cancer Center at Wake Forest University School of Medicine.
"Since many risk factors for breast cancer are not modifiable, our finding that a modifiable factor, vitamin D, may reduce risk is important," said Sue Ingles, Ph.D., a co-researcher from University of Southern California Keck School of Medicine.
The researchers compared 1,788 breast cancer patients in the San Francisco Bay area with a matched control group of 2,129 women who did not have breast cancer. They included non-Hispanic white, Hispanic and African-American women, thus women with a wide range of natural skin color and a wide range of capacity to produce vitamin D in the body. Skin color is an important factor that determines how much vitamin D is produced in the body after sun exposure. Dark-skinned individuals produce up to 10 times less vitamin D than light-skinned individuals for the same amount of time spent in the sun. People with darker skin are also more likely to be vitamin D deficient than people with lighter skin.
The research team also included Wei Wang, Ph.D., of the University of Southern California Keck School of Medicine. The work was supported by grants from the National Cancer Institute and U.S. Department of Defense Medical Research Program.
About the Northern California Cancer Center: The Northern California Cancer Center (www.nccc) is an established, nationally recognized leader dedicated to understanding the causes and prevention of cancer and to improve the quality of life for individuals living with cancer. NCCC has been working with scientists, educators, patients, clinicians, and community leaders successfully since 1974, and is an active partner with Stanford University's Comprehensive Cancer Center. NCCC is a 501(c)3 nonprofit with over 170 employees and a $15 million operating budget.
Wake Forest University Baptist Medical Center is an academic health system comprised of North Carolina Baptist Hospital and Wake Forest University Health Sciences, which operates the university's School of Medicine. U.S. News & World Report ranks Wake Forest University School of Medicine 18th in primary care and 44th in research among the nation's medical schools. It ranks 35th in research funding by the National Institutes of Health. Almost 150 members of the medical school faculty are listed in Best Doctors in America.
The USC/Norris Comprehensive Cancer Center, located in Los Angeles, is a major regional and national resource for cancer research, treatment, prevention and education. Nearly 200 basic scientists, physicians and other Keck School of Medicine of USC faculty members who are members of the USC/Norris Cancer Center investigate the complex origins and progression of cancer, develop prevention strategies and search for cures. The National Cancer Institute (NCI) has designated the USC/Norris Cancer Center as one of the nation's 39 comprehensive cancer centers, a select group of institutions providing leadership in cancer treatment, research, prevention and education.
Wake Forest University Baptist Medical Center
Medical Center Blvd.
Winston-Salem, NC 27157-1015
United States
www1.wfubmc.edu
Couple Awarded $1.5m After Prempro Caused Breast Cancer
Mary Daniel, who developed breast cancer after taking Prempro, a hormone-replacement drug, was awarded $1 million in compensatory damages, while her husband, Tom Daniel was awarded $500,000. A jury also found Wyeth, the makers of Prempro, guilty of acting with malice - this could pave the way for further punitive damages.
Mary had been taking Prempro for the treatment of hot flashes. After radiation and chemotherapy treatment, she no longer has cancer.
According to her legal representative, Zoe Littlepage, Wyeth had been informed that there was an association between Pempro and cancer. Even though the company had known for decades that postmenopausal drugs can cause breast cancer, Zoe Littlepage said Wyeth deliberately failed to do studies to understand or quantify that risk - and accused the company of choosing to protect their bottom dollar rather than protecting patients.
The trial, which took place in Philadelphia, lasted three weeks. The jury took two days to reach a verdict.
So far, three lawsuits against Prempro have reached a jury, of which Wyeth one the first, the second was declared a mistrial.
Written by: Christian
View drug information on Prempro.
Mary had been taking Prempro for the treatment of hot flashes. After radiation and chemotherapy treatment, she no longer has cancer.
According to her legal representative, Zoe Littlepage, Wyeth had been informed that there was an association between Pempro and cancer. Even though the company had known for decades that postmenopausal drugs can cause breast cancer, Zoe Littlepage said Wyeth deliberately failed to do studies to understand or quantify that risk - and accused the company of choosing to protect their bottom dollar rather than protecting patients.
The trial, which took place in Philadelphia, lasted three weeks. The jury took two days to reach a verdict.
So far, three lawsuits against Prempro have reached a jury, of which Wyeth one the first, the second was declared a mistrial.
Written by: Christian
View drug information on Prempro.
Elderly Women At Higher Risk For Unnecessary Urinary Catheterization, Study Reports
Elderly women are at high risk for inappropriate urinary catheter utilization in emergency departments, according to a new study in the November issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).
The study was conducted at St John Hospital and Medical Center, a 769-bed tertiary care teaching hospital in Detroit, Mich. The authors examined 532 instances in which urinary catheters were placed in emergency room patients over a 12-week study period. After reviewing whether the catheter's placement conformed to established guidelines, the authors determined that half of the female patients 80 years or older who were subjected to urinary tract catheterization did not meet institutional guidelines. Women were 1.9 times more likely than men, and the very elderly (greater than 80 years) were 2.9 times more likely than those 50 years and younger, to have a urinary catheter inappropriately placed.
"We found that it was twice as likely for women to have a non-indicated UC [urinary catheter] placement compared to men," the authors conclude. "Our results confirm what has been reported in previous studies, and underscore the significant risk of the very elderly (80 years or older) for inappropriate UC utilization."
The study's findings point to an area of concern among healthcare professionals tackling preventable hospital infections. Urinary tract catheterization is a major risk factor for developing urinary tract infections. The researchers note that at present, urinary tract infections account for more than one-third of all hospital-acquired infections. If urinary catheters are inappropriately placed at high rate in very elderly women, this vulnerable group of patients is at increased risk for developing an infection, according to the investigators.
"The inappropriate UC [urinary catheter] utilization has been a ubiquitous problem in the hospital setting," say the study's authors. "This translates to additional preventable or avoidable urinary tract infections and other complications related to UCs."
The federal government's Centers for Medicare & Medicaid Services considers catheter-associated urinary tract infections to be reasonably preventable through application of evidence-based best practices and as such no longer reimburses for these hospital-acquired infections. The authors noted that the majority of U.S. hospitals do not have formal systems to monitor urinary catheter utilization.
"Because more than half of hospital admissions come through the ED [emergency department], it is important that the ED be seen as the focus for efforts to reduce unnecessary UC utilization," say the authors.
The study was conducted by a multidisciplinary team from St John Hospital and Medical Center and Wayne State University School of Medicine. The study's authors include: Mohamad G. Fakih, MD, MPH; Stephen P. Shemes, BS; Margarita E. Pena, MD; Nicholas Dyc, MD; Janice E. Rey, MT (ASCP); Susan M. Szpunar, PhD, and Louis D. Saravolatz, MD.
Sources: Elsevier, AlphaGalileo Foundation.
The study was conducted at St John Hospital and Medical Center, a 769-bed tertiary care teaching hospital in Detroit, Mich. The authors examined 532 instances in which urinary catheters were placed in emergency room patients over a 12-week study period. After reviewing whether the catheter's placement conformed to established guidelines, the authors determined that half of the female patients 80 years or older who were subjected to urinary tract catheterization did not meet institutional guidelines. Women were 1.9 times more likely than men, and the very elderly (greater than 80 years) were 2.9 times more likely than those 50 years and younger, to have a urinary catheter inappropriately placed.
"We found that it was twice as likely for women to have a non-indicated UC [urinary catheter] placement compared to men," the authors conclude. "Our results confirm what has been reported in previous studies, and underscore the significant risk of the very elderly (80 years or older) for inappropriate UC utilization."
The study's findings point to an area of concern among healthcare professionals tackling preventable hospital infections. Urinary tract catheterization is a major risk factor for developing urinary tract infections. The researchers note that at present, urinary tract infections account for more than one-third of all hospital-acquired infections. If urinary catheters are inappropriately placed at high rate in very elderly women, this vulnerable group of patients is at increased risk for developing an infection, according to the investigators.
"The inappropriate UC [urinary catheter] utilization has been a ubiquitous problem in the hospital setting," say the study's authors. "This translates to additional preventable or avoidable urinary tract infections and other complications related to UCs."
The federal government's Centers for Medicare & Medicaid Services considers catheter-associated urinary tract infections to be reasonably preventable through application of evidence-based best practices and as such no longer reimburses for these hospital-acquired infections. The authors noted that the majority of U.S. hospitals do not have formal systems to monitor urinary catheter utilization.
"Because more than half of hospital admissions come through the ED [emergency department], it is important that the ED be seen as the focus for efforts to reduce unnecessary UC utilization," say the authors.
The study was conducted by a multidisciplinary team from St John Hospital and Medical Center and Wayne State University School of Medicine. The study's authors include: Mohamad G. Fakih, MD, MPH; Stephen P. Shemes, BS; Margarita E. Pena, MD; Nicholas Dyc, MD; Janice E. Rey, MT (ASCP); Susan M. Szpunar, PhD, and Louis D. Saravolatz, MD.
Sources: Elsevier, AlphaGalileo Foundation.
Blogs Comment On House Health Reform Bill, Obama Nominees, Other Topics
The following summarizes selected women's health-related blog entries.
"The Big Question: Could Abortion Be a Deal-Breaker on Health Care Reform?" Mary Ann Dreas/Tony Romm, The Hill's "Congress Blog": Dreas and Romm asked eight policymakers and advocates if abortion coverage could be a "deal-breaker" in attempts to enact health reform legislation. House Energy and Commerce Committee Chair Henry Waxman (D-Calif.) said that while abortion coverage is "an issue that divides people," he does not think it will be a deal-breaker because there are "a lot of pro-life members who ... feel we've done what's appropriate to ensure American people that we are using their taxpayer dollars well." Suzanne Poppema, board chair of the Physicians for Reproductive Choice and Health, also said the issue "shouldn't be a deal-breaker" because "women will always need abortion." She added that abortion services "should be treated like any other medical service -- not singled out for special attention." However, abortion-rights opponents Tom McClusky, senior vice president of FRC Action; John McManus, executive director of the John Birch Society; and Douglas Johnson, legislative director of the National Right to Life Committee, all said the issue should be a deal-breaker. Rep. Raul Grijalva (D-Ariz.) said that both abortion and immigration "are issues that are seen as potentially very decisive," while Rep. Brett Guthrie (R-Ky.) said he "would be seriously concerned if any bill passed the government that didn't protect the life of the unborn." Michael Wilson, executive director of Americans for Democratic Action, said abortion won't be a deal-breaker, adding that while he would like "a system that is as robust as possible with as much improvement as we can get, we know this is not the place to resolve the issue of choice" (Dreas/Romm, "Congress Blog," The Hill, 10/29).
"Does Focus on the Family Fund Abortions?" Amy Sullivan, Time? s ? "Swampland": Antiabortion-rights groups have used a "fungibility" argument against abortion coverage under health reform, Sullivan writes. She adds that as these groups see it, if an insurer that covers abortion enters the health insurance exchange, then tax-payer supported premiums paid to the plan "help support that abortion coverage even if individual abortion procedures are paid for out of a separate pool of privately paid premium dollars." She asks, "But are those pro-life organizations holding themselves to the same strict standard?" Sullivan reports that Focus on the Family provides employees with health insurance from Principal, a company that covers abortion services. Even if the specific plan that Focus on the Family uses does not cover abortion services, its employees "still pay premiums to a company that funds abortions," Sullivan writes. She says, "If health reform proposals have a fungibility problem, then Focus does as well" (Sullivan, "Swampland," Time, 10/28).
"10 Reasons Abortion Must Be Covered," Lynn Harris, Salon? 's "Broadsheet": "[F]or right reasons or wrong, there is a question" of why abortion services should be covered under health care reform legislation, Harris writes. Harris offers 10 reasons to include abortion coverage in health reform, including that it is "legal medical care" and that is "one of the most common surgical procedures in America." Abortion services are "already broadly covered" under private insurance plans, she continues. The abortion rate will not increase by covering the procedure, and covering abortion services "makes abortion safer" and is "what the people want," Harris writes. In addition, "[e]xcluding abortion from coverage sends us down a slippery 'moral' slope," she writes, adding that Frances Kissling recently said that federal policies based on the idea that people "should not be forced to see their premiums used to cover things they consider immoral" would bring the U.S. back to the time when individual plans for unmarried women did not include contraception or maternity coverage. In addition, while some opponents argue that abortion is an "elective" procedure, they ignore the many other procedures that are covered without the need for any moral debate or proof of medical necessity. Harris continues that "[w]ithout coverage there is no 'choice,'" adding, "Even with the best prevention measures, there will be unintended pregnancies." She concludes with a quote from Megan Carpentier, news and politics editor for Air America Radio, who said that abortion should be covered because "sometimes abortion is medically necessary, and the government shouldn't be writing regulations from Washington that tell a woman in Kansas when that is." Carpentier added that "eliminating coverage that currently exists through federal law is just another back-door way for the antiabortion movement to make it more difficult and expensive for women to get a legal medical procedure, since they can't convince women not to have abortions on the 'merits' of their arguments" (Harris, "Broadsheet," Salon, 10/28).
"Stupak Still Unhappy With Health Care Reform, Abortion Provision," Tony Romm, The Hill? s ? "Blog Briefing Room": Rep. Bart Stupak (D-Mich.), who is threatening to block the House health reform bill (HR 3962) unless Democrats allow a vote on an amendment that would add language further restricting abortion coverage, is not satisfied with progress on the issue, Romm writes. In a statement released Thursday, Stupak said the bill "still does not do enough to prevent federal funding from going to abortion services." He also said he is "disappointed" that the Capps amendment language is included in the bill. Romm writes, "All eyes have been on Stupak since he announced he had the support of 39 other lawmakers and would scuttle attempts to bring health care reform to the House floor unless the Democratic leadership addressed his concerns." Romm adds, "Both sides have tried to negotiate that dilemma for some time now, but they have not been able to strike a deal. It is still unclear whether a vote on Stupak's amendment will even take place" (Romm, "Blog Briefing Room," The Hill, 10/29).
"Senate Leader Blasts Holdup o[f] Obama's Nominees," Kate Phillips, New York Times? ' "The Caucus": On Thursday, Senate Majority Leader Harry Reid (D-Nev.) "slammed Republicans for slowing down, and in some cases, blocking the confirmation of nominees for various posts in the Obama administration," Phillips states. Reid noted that several top health care posts at the federal level had yet to be filled. According to the Phillips, nine HHS nominees have been confirmed and eight are awaiting confirmation. Phillips reports that the confirmations of several other "high-profile nominees ... have been stalled or waylaid," including Department of Justice nominee Dawn Johnsen, whose "nomination by our count seems to be one of the longest delayed." Johnsen is nominated for deputy attorney general for the Office of Legal Counsel, "which offers critical advice to the president on everything, ranging from executive authority to interrogation methods," Phillips says. However, "Republicans have long objected to the fact that she served as legal counsel for an abortion-rights organization years ago, among other duties, and have taken issue with views they find controversial," she writes (Phillips, "The Caucus," New York Times, 10/29).
"What Catholics Want in Health Care Reform: Should We Cover Some People, Some Parts of People, or All Parts of Everybody?" Jon O'Brien/Sara Morello, Washington Post? 's "On Faith": There is a "curious divide" in the health reform debate "about what exactly health care is or what it should be" and "who and what should be left out of the final plan," according to O'Brien and Morello, Catholics for Choice's president and vice president, respectively. While these are "not unreasonable questions," the "answers that some people, who claim to speak for American Catholics, provide are not reflective of what Catholics in the United States believe," they write, noting that a poll of nearly 1,000 U.S. Catholics found that most "think providing health care to all people who need it is a matter of social justice." The poll respondents said that "their understanding of social justice includes extending health care to the whole person, not just some parts of people," including covering reproductive health services and abortion. Catholics for Choice "believe[s] that all people should have access to the health care they need," and 73% of the poll's respondents agreed and more than 60% believe contraception should be covered by insurance, O'Brien and Morello write. "We believe that abortion should be covered by insurance -- whether private or government subsidized," they continue. "Depending on the circumstances, as many as 84% agree with us, and when the question really comes down to respecting a woman's conscience in regard to her own health, a full half of Catholics polled agree that abortion should be covered whenever a woman and her doctor decide she needs it," according to O'Brien and Morello. They write that their "instinct" tells them that "Catholics are far more progressive than their bishops, ... and our poll results prove it" (O'Brien/Morello, "On Faith," Washington Post, 10/29).
"Rehearsal for an Anti-Choice Protest: 'Okay, You Stand Here and She's Gonna Whip You With This Whip,'" Amanda Terkel, ThinkProgress: Randall Terry, founder of the antiabortion-rights group Operation Rescue, recently encouraged supporters to film videos of themselves burning effigies of House Speaker Nancy Pelosi (D-Calif.) and Senate Majority Leader Harry Reid (D-Nev.), Terkel says. She writes that ThinkProgress spotted Terry on Capitol Hill this week with signs and costumes, conversing with congressional staffers as they entered their offices. Terry, as he was "preparing for his charade this morning," told followers, "'Okay, you stand here and she's gonna whip you with this whip,'" according to Terkel. Organizers say the protest is the first of a series that will continue until Nov. 12 (Terkel, ThinkProgress, 10/29).
"Peru's Highest Court Rules Against EC," Elizabeth Westley, Below the Waist: Peru's Constitutional Court ruled last week to block the Ministry of Health from distributing no-cost emergency contraception, Westley, coordinator of the International Consortium for Emergency Contraception, writes. The court said that the Ministry of Health failed to prove "the inexistence of the abortifacient effect, the inhibition of the implantation of the fertilized ovum in the endometrium," thus concluding that EC could cause abortion and violate Peru's Constitution. Westley writes that the ruling contradicts a growing body of literature -- including from ICEC and the World Health Organization -- "that shows delaying or preventing ovulation is the most likely and perhaps only mechanism by which EC effectively prevents pregnancy." EC can continue to be sold in Peru but only with a package insert warning that it might cause an abortion. "This Peru case is very similar to ones in Ecuador and Chile, and may represent a trend toward protecting the rights of the 'conceived' using weak science as a strategy to limit access to EC," Westley writes. "Clearly, some Latin American courts are now considering that life begins at conception and not at implantation," she adds (Westley, Below the Waist, 10/27).
"The Gender Gap, Around the World," Catherine Rampell, New York Times? ' "Economix": The World Economic Forum on Tuesday released its annual Global Gender Gap Report, and the U.S. "was ranked No. 31, three spots lower than it was last year," Rampell writes. The report "tries to assess how well countries 'are dividing their resources and opportunities among their male and female populations, regardless of the overall levels of these resources and opportunities.'" Four Nordic countries -- Iceland, Norway, Finland and Sweden -- topped the list. The assessments are based on four components: economic participation and opportunity, educational attainment, political empowerment, and health and survival. The organization says the report is intended to show the percentage of a nation's gender gap that has closed, meaning that a high score represents a society with greater gender parity (Rampell, "Economix," New York Times, 10/28).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
"The Big Question: Could Abortion Be a Deal-Breaker on Health Care Reform?" Mary Ann Dreas/Tony Romm, The Hill's "Congress Blog": Dreas and Romm asked eight policymakers and advocates if abortion coverage could be a "deal-breaker" in attempts to enact health reform legislation. House Energy and Commerce Committee Chair Henry Waxman (D-Calif.) said that while abortion coverage is "an issue that divides people," he does not think it will be a deal-breaker because there are "a lot of pro-life members who ... feel we've done what's appropriate to ensure American people that we are using their taxpayer dollars well." Suzanne Poppema, board chair of the Physicians for Reproductive Choice and Health, also said the issue "shouldn't be a deal-breaker" because "women will always need abortion." She added that abortion services "should be treated like any other medical service -- not singled out for special attention." However, abortion-rights opponents Tom McClusky, senior vice president of FRC Action; John McManus, executive director of the John Birch Society; and Douglas Johnson, legislative director of the National Right to Life Committee, all said the issue should be a deal-breaker. Rep. Raul Grijalva (D-Ariz.) said that both abortion and immigration "are issues that are seen as potentially very decisive," while Rep. Brett Guthrie (R-Ky.) said he "would be seriously concerned if any bill passed the government that didn't protect the life of the unborn." Michael Wilson, executive director of Americans for Democratic Action, said abortion won't be a deal-breaker, adding that while he would like "a system that is as robust as possible with as much improvement as we can get, we know this is not the place to resolve the issue of choice" (Dreas/Romm, "Congress Blog," The Hill, 10/29).
"Does Focus on the Family Fund Abortions?" Amy Sullivan, Time? s ? "Swampland": Antiabortion-rights groups have used a "fungibility" argument against abortion coverage under health reform, Sullivan writes. She adds that as these groups see it, if an insurer that covers abortion enters the health insurance exchange, then tax-payer supported premiums paid to the plan "help support that abortion coverage even if individual abortion procedures are paid for out of a separate pool of privately paid premium dollars." She asks, "But are those pro-life organizations holding themselves to the same strict standard?" Sullivan reports that Focus on the Family provides employees with health insurance from Principal, a company that covers abortion services. Even if the specific plan that Focus on the Family uses does not cover abortion services, its employees "still pay premiums to a company that funds abortions," Sullivan writes. She says, "If health reform proposals have a fungibility problem, then Focus does as well" (Sullivan, "Swampland," Time, 10/28).
"10 Reasons Abortion Must Be Covered," Lynn Harris, Salon? 's "Broadsheet": "[F]or right reasons or wrong, there is a question" of why abortion services should be covered under health care reform legislation, Harris writes. Harris offers 10 reasons to include abortion coverage in health reform, including that it is "legal medical care" and that is "one of the most common surgical procedures in America." Abortion services are "already broadly covered" under private insurance plans, she continues. The abortion rate will not increase by covering the procedure, and covering abortion services "makes abortion safer" and is "what the people want," Harris writes. In addition, "[e]xcluding abortion from coverage sends us down a slippery 'moral' slope," she writes, adding that Frances Kissling recently said that federal policies based on the idea that people "should not be forced to see their premiums used to cover things they consider immoral" would bring the U.S. back to the time when individual plans for unmarried women did not include contraception or maternity coverage. In addition, while some opponents argue that abortion is an "elective" procedure, they ignore the many other procedures that are covered without the need for any moral debate or proof of medical necessity. Harris continues that "[w]ithout coverage there is no 'choice,'" adding, "Even with the best prevention measures, there will be unintended pregnancies." She concludes with a quote from Megan Carpentier, news and politics editor for Air America Radio, who said that abortion should be covered because "sometimes abortion is medically necessary, and the government shouldn't be writing regulations from Washington that tell a woman in Kansas when that is." Carpentier added that "eliminating coverage that currently exists through federal law is just another back-door way for the antiabortion movement to make it more difficult and expensive for women to get a legal medical procedure, since they can't convince women not to have abortions on the 'merits' of their arguments" (Harris, "Broadsheet," Salon, 10/28).
"Stupak Still Unhappy With Health Care Reform, Abortion Provision," Tony Romm, The Hill? s ? "Blog Briefing Room": Rep. Bart Stupak (D-Mich.), who is threatening to block the House health reform bill (HR 3962) unless Democrats allow a vote on an amendment that would add language further restricting abortion coverage, is not satisfied with progress on the issue, Romm writes. In a statement released Thursday, Stupak said the bill "still does not do enough to prevent federal funding from going to abortion services." He also said he is "disappointed" that the Capps amendment language is included in the bill. Romm writes, "All eyes have been on Stupak since he announced he had the support of 39 other lawmakers and would scuttle attempts to bring health care reform to the House floor unless the Democratic leadership addressed his concerns." Romm adds, "Both sides have tried to negotiate that dilemma for some time now, but they have not been able to strike a deal. It is still unclear whether a vote on Stupak's amendment will even take place" (Romm, "Blog Briefing Room," The Hill, 10/29).
"Senate Leader Blasts Holdup o[f] Obama's Nominees," Kate Phillips, New York Times? ' "The Caucus": On Thursday, Senate Majority Leader Harry Reid (D-Nev.) "slammed Republicans for slowing down, and in some cases, blocking the confirmation of nominees for various posts in the Obama administration," Phillips states. Reid noted that several top health care posts at the federal level had yet to be filled. According to the Phillips, nine HHS nominees have been confirmed and eight are awaiting confirmation. Phillips reports that the confirmations of several other "high-profile nominees ... have been stalled or waylaid," including Department of Justice nominee Dawn Johnsen, whose "nomination by our count seems to be one of the longest delayed." Johnsen is nominated for deputy attorney general for the Office of Legal Counsel, "which offers critical advice to the president on everything, ranging from executive authority to interrogation methods," Phillips says. However, "Republicans have long objected to the fact that she served as legal counsel for an abortion-rights organization years ago, among other duties, and have taken issue with views they find controversial," she writes (Phillips, "The Caucus," New York Times, 10/29).
"What Catholics Want in Health Care Reform: Should We Cover Some People, Some Parts of People, or All Parts of Everybody?" Jon O'Brien/Sara Morello, Washington Post? 's "On Faith": There is a "curious divide" in the health reform debate "about what exactly health care is or what it should be" and "who and what should be left out of the final plan," according to O'Brien and Morello, Catholics for Choice's president and vice president, respectively. While these are "not unreasonable questions," the "answers that some people, who claim to speak for American Catholics, provide are not reflective of what Catholics in the United States believe," they write, noting that a poll of nearly 1,000 U.S. Catholics found that most "think providing health care to all people who need it is a matter of social justice." The poll respondents said that "their understanding of social justice includes extending health care to the whole person, not just some parts of people," including covering reproductive health services and abortion. Catholics for Choice "believe[s] that all people should have access to the health care they need," and 73% of the poll's respondents agreed and more than 60% believe contraception should be covered by insurance, O'Brien and Morello write. "We believe that abortion should be covered by insurance -- whether private or government subsidized," they continue. "Depending on the circumstances, as many as 84% agree with us, and when the question really comes down to respecting a woman's conscience in regard to her own health, a full half of Catholics polled agree that abortion should be covered whenever a woman and her doctor decide she needs it," according to O'Brien and Morello. They write that their "instinct" tells them that "Catholics are far more progressive than their bishops, ... and our poll results prove it" (O'Brien/Morello, "On Faith," Washington Post, 10/29).
"Rehearsal for an Anti-Choice Protest: 'Okay, You Stand Here and She's Gonna Whip You With This Whip,'" Amanda Terkel, ThinkProgress: Randall Terry, founder of the antiabortion-rights group Operation Rescue, recently encouraged supporters to film videos of themselves burning effigies of House Speaker Nancy Pelosi (D-Calif.) and Senate Majority Leader Harry Reid (D-Nev.), Terkel says. She writes that ThinkProgress spotted Terry on Capitol Hill this week with signs and costumes, conversing with congressional staffers as they entered their offices. Terry, as he was "preparing for his charade this morning," told followers, "'Okay, you stand here and she's gonna whip you with this whip,'" according to Terkel. Organizers say the protest is the first of a series that will continue until Nov. 12 (Terkel, ThinkProgress, 10/29).
"Peru's Highest Court Rules Against EC," Elizabeth Westley, Below the Waist: Peru's Constitutional Court ruled last week to block the Ministry of Health from distributing no-cost emergency contraception, Westley, coordinator of the International Consortium for Emergency Contraception, writes. The court said that the Ministry of Health failed to prove "the inexistence of the abortifacient effect, the inhibition of the implantation of the fertilized ovum in the endometrium," thus concluding that EC could cause abortion and violate Peru's Constitution. Westley writes that the ruling contradicts a growing body of literature -- including from ICEC and the World Health Organization -- "that shows delaying or preventing ovulation is the most likely and perhaps only mechanism by which EC effectively prevents pregnancy." EC can continue to be sold in Peru but only with a package insert warning that it might cause an abortion. "This Peru case is very similar to ones in Ecuador and Chile, and may represent a trend toward protecting the rights of the 'conceived' using weak science as a strategy to limit access to EC," Westley writes. "Clearly, some Latin American courts are now considering that life begins at conception and not at implantation," she adds (Westley, Below the Waist, 10/27).
"The Gender Gap, Around the World," Catherine Rampell, New York Times? ' "Economix": The World Economic Forum on Tuesday released its annual Global Gender Gap Report, and the U.S. "was ranked No. 31, three spots lower than it was last year," Rampell writes. The report "tries to assess how well countries 'are dividing their resources and opportunities among their male and female populations, regardless of the overall levels of these resources and opportunities.'" Four Nordic countries -- Iceland, Norway, Finland and Sweden -- topped the list. The assessments are based on four components: economic participation and opportunity, educational attainment, political empowerment, and health and survival. The organization says the report is intended to show the percentage of a nation's gender gap that has closed, meaning that a high score represents a society with greater gender parity (Rampell, "Economix," New York Times, 10/28).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
Kaisernetwork.org Offers Special Extended Coverage Of XVI International AIDS Conference
Kaisernetwork, in partnership with the International AIDS Society, this week will feature special coverage of the XVI International AIDS Conference taking place in Toronto through Aug. 18. Conference coverage will include:
Live and tape-delayed video webcasts and transcripts of the opening and closing sessions, all plenary sessions and selected other sessions and press conferences;
English-, French- and Spanish-language audio podcasts of select sessions;
Slide presentations from select sessions;
A free Daily Update e-mail providing direct access to the latest coverage (sign up here);
Summaries of conference news coverage in the Kaiser Daily HIV/AIDS Report;
Interviews with newsmakers and journalists to summarize conference developments; and
Daily video and text highlights of the day's developments (Kaiser Family Foundation release, 7/20).
Coverage of the conference is available on line at kaisernetwork/aids2006.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Live and tape-delayed video webcasts and transcripts of the opening and closing sessions, all plenary sessions and selected other sessions and press conferences;
English-, French- and Spanish-language audio podcasts of select sessions;
Slide presentations from select sessions;
A free Daily Update e-mail providing direct access to the latest coverage (sign up here);
Summaries of conference news coverage in the Kaiser Daily HIV/AIDS Report;
Interviews with newsmakers and journalists to summarize conference developments; and
Daily video and text highlights of the day's developments (Kaiser Family Foundation release, 7/20).
Coverage of the conference is available on line at kaisernetwork/aids2006.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Pope Benedict XVI Speaks Out Against Abortion, Mexico City Law Legalizing Procedure On Visit To Brazil
Pope Benedict XVI on Wednesday during a plane trip from Rome to Sao Paulo, Brazil, "seemed to suggest" the Mexico City legislators who voted for a law that allows pregnant women to obtain a legal abortion during the first three months' gestation had excommunicated themselves from the church, the New York Times reports. "Yes, the excommunication isn't something arbitrary -- it's part of the code" of church law, the pope said, adding, "The killing of an innocent human child is incompatible with going into communion in the body of Christ" (Fisher/Rohter, New York Times, 5/10).
The pope also said that Mexican bishops who supported excommunication of the legislators "simply announced publicly what is contained in the law of the church ... which expresses our appreciation for life and that human individuality, human personality is present from the first moment" (Chang, McClatchy/Miami Herald, 5/10). Marcelino Hernandez, auxiliary bishop of the Archdiocese of Mexico, last month said that if the measure passed, any lawmaker who voted in favor of the measure would be excommunicated from the Catholic Church when the first abortion is performed under the law. Felipe Aguirre Franco, archbishop of Acapulco, after the bill passed last month said lawmakers who voted to approve the measure "will get the penalty of excommunication," adding, "That is not revenge, it is just what happens in the case of serious sins" (Kaiser Daily Women's Health Policy Report, 4/25).
Benedict spokesperson Father Federico Lombardi attempted to "downplay" the pope's statement, the Los Angeles Times reports. "If the bishops haven't excommunicated anyone, it's not that the pope wants to," Lombardi said, adding, "Legislative action in favor of abortion is incompatible with participation in the Eucharist. Politicians exclude themselves from Communion" (Wilkinson, Los Angeles Times, 5/10).
According to the New York Times, church law dictates that "those who play a material role in an abortion should not receive the sacrament of holy communion" and "have automatically excommunicated themselves from sharing in communion." Within the church, the automatic excommunication is understood to apply to women who undergo abortions and medicals professionals who perform or assist in them. However, church officials are debating over whether that law also applies to politicians who support abortion-rights laws, the New York Times reports (New York Times, 5/10).
The pope also said that Mexican bishops who supported excommunication of the legislators "simply announced publicly what is contained in the law of the church ... which expresses our appreciation for life and that human individuality, human personality is present from the first moment" (Chang, McClatchy/Miami Herald, 5/10). Marcelino Hernandez, auxiliary bishop of the Archdiocese of Mexico, last month said that if the measure passed, any lawmaker who voted in favor of the measure would be excommunicated from the Catholic Church when the first abortion is performed under the law. Felipe Aguirre Franco, archbishop of Acapulco, after the bill passed last month said lawmakers who voted to approve the measure "will get the penalty of excommunication," adding, "That is not revenge, it is just what happens in the case of serious sins" (Kaiser Daily Women's Health Policy Report, 4/25).
Benedict spokesperson Father Federico Lombardi attempted to "downplay" the pope's statement, the Los Angeles Times reports. "If the bishops haven't excommunicated anyone, it's not that the pope wants to," Lombardi said, adding, "Legislative action in favor of abortion is incompatible with participation in the Eucharist. Politicians exclude themselves from Communion" (Wilkinson, Los Angeles Times, 5/10).
According to the New York Times, church law dictates that "those who play a material role in an abortion should not receive the sacrament of holy communion" and "have automatically excommunicated themselves from sharing in communion." Within the church, the automatic excommunication is understood to apply to women who undergo abortions and medicals professionals who perform or assist in them. However, church officials are debating over whether that law also applies to politicians who support abortion-rights laws, the New York Times reports (New York Times, 5/10).
Brazil Trip
The pope, who was greeted by Brazilian President Luiz Inacio da Silva in Sao Paulo, was starting his four-day visit through Latin America (New York Times, 5/10). "I know the soul of this people, as with in all of Latin America, preserves the radically Christian values that will never be canceled," the pope said upon his arrival to the city, adding that he supports "the respect for human life, from its conception to its natural decline" (McClatchy/Miami Herald, 5/10).
Da Silva on Monday in a radio interview said that although he personally opposed abortion as president he believes that "the state cannot abdicate from caring for this as a public health question, because to do so would lead to the death of many young women in this country" (New York Times, 5/9). He also said he favored "a good family-planning process of sexual education (so that) possibly we wouldn't have the quantity of undesired pregnancies that we have today" (McClatchy/Miami Herald, 5/10).
Abortion in Brazil is allowed only in limited circumstances; however, it is estimated that between one million and two million illegal abortions are performed annually in clandestine clinics, according to the New York Times. Health Minister Jose Gomes Temporao in March suggested altering legislation that calls for one- to three-years prison sentences for women convicted of having illegal abortions. On Tuesday, Temporao said that abortion is an issue that "should be treated delicately," adding that "some sectors of the church have made declarations that are very aggressive and quite distant from the teachings of Jesus" (New York Times, 5/9).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Positive Results From Clinical Trial Designed To Evaluate Safety And Efficacy Of Biodesign™ Vaginal Erosion Repair Graft
An 11-month clinical study led by Manish P. Patel, M.D., generated positive results on Cook Medical's Biodesign™ Vaginal Erosion Repair Graft for the treatment of vaginal mesh exposures, a common complication resulting from the use of synthetic mesh in pelvic floor repair, the procedure used to treat pelvic organ prolapse. The results, which confirmed the safety and efficacy of Biodesign, were presented at the 2009 Society for Urodynamics and Female Urology Winter Meeting in Las Vegas.
The study examined the efficacy of the Biodesign Vaginal Erosion Repair Graft in treating 10 women with large, symptomatic extrusions that resulted from the use of polypropylene or synthetic mesh in a previous pelvic floor reconstruction procedure. To treat the complication, the exposed synthetic mesh was completely removed and the Biodesign graft was implanted to help fully restore and repair the pelvic floor. Research findings showed that all 10 large mesh exposures were successfully repaired with the Biodesign graft with no evidence of recurrence or further complication.
According to the National Institute of Health, an estimated one-third of all U.S. women are affected by pelvic floor disorders including pelvic organ prolapse, a condition that occurs when the pelvic muscles become weakened and stretched, often as a result of childbirth. Although pelvic floor reconstruction is the most common form of treatment, synthetic mesh-based procedures have recently come under scrutiny after the FDA received more than 1,000 reports of rare but serious complications, including vaginal erosion, linked specifically to the use of synthetic mesh. Cook's Biodesign Vaginal Erosion Repair Graft will play an especially important role in treating these synthetic mesh-based complications and more.
"The surgical repair of prolapse remains one of the most difficult challenges in pelvic floor reconstruction due to the large recurrence rate and postoperative complications including foreign body reaction and mesh extrusion," said Patel, who is a physician at Piedmont Urology Associates in North Carolina. "I'm pleased that Biodesign has proven to be an effective and lasting treatment option for patients suffering from painful, large-scale vaginal mesh exposures."
The Biodesign Vaginal Erosion Repair Graft incorporates the best attributes of a biologic graft - resistance to infection and complete remodeling - with the added benefits of moderate price, ease of use and ample shelf life for on-site availability. Upon deployment, the graft reinforces the pelvic floor or vaginal wall and, over time, communicates with the patient's body, signalling surrounding tissue to grow across the scaffold where the pelvic floor needs to be repaired. Unlike synthetic mesh, Biodesign is resistant to infection, encapsulation and erosion into surrounding tissue.
"The complications associated with the use of synthetic mesh in treating pelvic organ prolapse can clearly cause a significant decrease in quality of life for women," said Andy Cron, vice president of Cook Medical's Surgery strategic business unit. "The results of this study come at a very important time, as reports continue to surface around the complications resulting from synthetic mesh treatments. We are excited by the results of Dr. Patel's research and look forward to providing many women with a natural, lasting solution."
About Cook Medical
Cook Medical was one of the first companies to help popularize interventional medicine, pioneering many of the devices now commonly used worldwide to perform minimally invasive medical procedures. Today, the company integrates minimally invasive medical device design, biopharma, gene and cell therapy, and biotech to enhance patient safety and improve clinical outcomes in the fields of aortic intervention; interventional cardiology; critical care medicine; gastroenterology; radiology, peripheral vascular, bone access and oncology; surgery and soft tissue repair; urology; and assisted reproductive technology, gynecology and high-risk obstetrics. Founded in 1963 and operated as a family-held private corporation, Cook is a past winner of the prestigious Medical Device Manufacturer of the Year Award from Medical Device & Diagnostic Industry magazine.
Cook Medical
The study examined the efficacy of the Biodesign Vaginal Erosion Repair Graft in treating 10 women with large, symptomatic extrusions that resulted from the use of polypropylene or synthetic mesh in a previous pelvic floor reconstruction procedure. To treat the complication, the exposed synthetic mesh was completely removed and the Biodesign graft was implanted to help fully restore and repair the pelvic floor. Research findings showed that all 10 large mesh exposures were successfully repaired with the Biodesign graft with no evidence of recurrence or further complication.
According to the National Institute of Health, an estimated one-third of all U.S. women are affected by pelvic floor disorders including pelvic organ prolapse, a condition that occurs when the pelvic muscles become weakened and stretched, often as a result of childbirth. Although pelvic floor reconstruction is the most common form of treatment, synthetic mesh-based procedures have recently come under scrutiny after the FDA received more than 1,000 reports of rare but serious complications, including vaginal erosion, linked specifically to the use of synthetic mesh. Cook's Biodesign Vaginal Erosion Repair Graft will play an especially important role in treating these synthetic mesh-based complications and more.
"The surgical repair of prolapse remains one of the most difficult challenges in pelvic floor reconstruction due to the large recurrence rate and postoperative complications including foreign body reaction and mesh extrusion," said Patel, who is a physician at Piedmont Urology Associates in North Carolina. "I'm pleased that Biodesign has proven to be an effective and lasting treatment option for patients suffering from painful, large-scale vaginal mesh exposures."
The Biodesign Vaginal Erosion Repair Graft incorporates the best attributes of a biologic graft - resistance to infection and complete remodeling - with the added benefits of moderate price, ease of use and ample shelf life for on-site availability. Upon deployment, the graft reinforces the pelvic floor or vaginal wall and, over time, communicates with the patient's body, signalling surrounding tissue to grow across the scaffold where the pelvic floor needs to be repaired. Unlike synthetic mesh, Biodesign is resistant to infection, encapsulation and erosion into surrounding tissue.
"The complications associated with the use of synthetic mesh in treating pelvic organ prolapse can clearly cause a significant decrease in quality of life for women," said Andy Cron, vice president of Cook Medical's Surgery strategic business unit. "The results of this study come at a very important time, as reports continue to surface around the complications resulting from synthetic mesh treatments. We are excited by the results of Dr. Patel's research and look forward to providing many women with a natural, lasting solution."
About Cook Medical
Cook Medical was one of the first companies to help popularize interventional medicine, pioneering many of the devices now commonly used worldwide to perform minimally invasive medical procedures. Today, the company integrates minimally invasive medical device design, biopharma, gene and cell therapy, and biotech to enhance patient safety and improve clinical outcomes in the fields of aortic intervention; interventional cardiology; critical care medicine; gastroenterology; radiology, peripheral vascular, bone access and oncology; surgery and soft tissue repair; urology; and assisted reproductive technology, gynecology and high-risk obstetrics. Founded in 1963 and operated as a family-held private corporation, Cook is a past winner of the prestigious Medical Device Manufacturer of the Year Award from Medical Device & Diagnostic Industry magazine.
Cook Medical
Preventive Medicine Expert Wins American Heart Association Prize For Major Studies Clarifying Women's Health Issues, Causes Of Disease
The American Heart Association awarded its Population Research Prize to JoAnn Manson, M.D., Dr.P.H., of Boston, for "exceptional achievement" as the leader of clinical trials clarifying major aspects of preventive medicine and women's health.
Manson, chief of the Division of Preventive Medicine at Brigham and Women's Hospital and Harvard Medical School in Boston, received the $5,000 prize during the opening of the American Heart Association Scientific Sessions 2010 in Chicago's McCormick Place Convention Center.
Association President Ralph Sacco, M.D., presented the award, which annually recognizes merit in cardiovascular science by the head of a major population research laboratory.
"Dr. Manson has been making historic progress expanding knowledge of heart disease and stroke risk, especially in women," Sacco said. "Her contributions are of great relevance to understanding and overcoming critical biological and generic determinants of disease. She has emphasized the role of lifestyle factors including physical activity, diet, nutrient supplementation and post-menopausal hormone therapy as predictors of cardiovascular outcomes in women."
Landmark studies led by Manson that have impacted medical care and public health include the cardiovascular component of the Nurses' Health Study; the Women's Antioxidant and Folic Acid Cardiovascular Study; the Boston site of the Women's Health Initiative, and VITAL, the first large-scale trial of vitamin D and omega 3s in the primary prevention of cardiovascular diseases and cancer.
"Indeed, JoAnn Manson has taken the study of population health and translational research to the highest level," Sacco said in presenting the AHA prize.
Manson's previous honors include election as a Fellow of the American Association for the Advancement of Science. She has been a member of Harvard's medical faculty since 1987.
Source:
American Heart Association
Manson, chief of the Division of Preventive Medicine at Brigham and Women's Hospital and Harvard Medical School in Boston, received the $5,000 prize during the opening of the American Heart Association Scientific Sessions 2010 in Chicago's McCormick Place Convention Center.
Association President Ralph Sacco, M.D., presented the award, which annually recognizes merit in cardiovascular science by the head of a major population research laboratory.
"Dr. Manson has been making historic progress expanding knowledge of heart disease and stroke risk, especially in women," Sacco said. "Her contributions are of great relevance to understanding and overcoming critical biological and generic determinants of disease. She has emphasized the role of lifestyle factors including physical activity, diet, nutrient supplementation and post-menopausal hormone therapy as predictors of cardiovascular outcomes in women."
Landmark studies led by Manson that have impacted medical care and public health include the cardiovascular component of the Nurses' Health Study; the Women's Antioxidant and Folic Acid Cardiovascular Study; the Boston site of the Women's Health Initiative, and VITAL, the first large-scale trial of vitamin D and omega 3s in the primary prevention of cardiovascular diseases and cancer.
"Indeed, JoAnn Manson has taken the study of population health and translational research to the highest level," Sacco said in presenting the AHA prize.
Manson's previous honors include election as a Fellow of the American Association for the Advancement of Science. She has been a member of Harvard's medical faculty since 1987.
Source:
American Heart Association
Obama Budget Request Increases International Global Health Funding
President Obama's fiscal year 2011 budget proposal, which was released on Monday, would increase by 9% funding for global health issues, including reducing maternal and child mortality, the Wall Street Journal reports. The budget includes a total request for global health of $9.6 billion for HHS, the State Department, the U.S. Agency for International Development and the Department of Defense. The budget enacted for FY 2010 allocated $8.8 billion for those departments, the Journal reports.
The State Department and USAID would receive $700 million to target maternal and child mortality under the proposal, an increase from the $474 million allocated in 2010. Family planning would receive a $65 million funding increase under the budget, from $525 million to $590 million.
According to the Journal, the budget proposal includes several "ambitious targets" to be reached by 2014, including reducing maternal mortality by 30% -- or about 360,000 lives saved -- and reducing mortality among children younger than age five by 35% -- or about three million lives saved -- in assisted countries. The proposed budget would aim to provide HIV/AIDS drug treatment to 1.6 million more people and cut the prevalence of malaria and tuberculosis in Africa by half.
A majority of the requested funding -- about $7 billion -- would go to the President's Emergency Plan for AIDS Relief, including $5.74 billion for bilateral HIV/AIDS programs, $251 million for bilateral TB programs, and a $1 billion contribution to the Global Fund To Fight AIDS, Tuberculosis and Malaria (McKay, Wall Street Journal, 2/1).
Both Democrats and Republicans praised the president's budget proposal for the State Department, the Washington Times reports. Senate Foreign Relations Committee Chair John Kerry (D-Mass.) said Obama's budget proposal "demonstrates the president's commitment to funding lifesaving development programs in global health, food security, climate change and global poverty." Tom Ridge, former Homeland Security secretary under President George W. Bush, said, "The programs supported by the international affairs budget are as essential to our national security as defense programs," adding, "Development and diplomacy protect our nation by addressing the root causes of terrorism and conflict" (Kralev, Washington Times, 2/2).
Programs that specifically address maternal and child mortality traditionally have attracted little funding, according to William Aldis, assistant professor at Thammasat University in Bangkok, Thailand, and a former representative of the World Health Organization. He added that he supports the idea of the U.S. working more closely with individual countries to address global health issues "as long as the U.S. pays attention to what countries want to do, and works with them respectfully and early in the planning process to get genuine national commitment country-by-country to the U.S. investment" (Randall, Bloomberg, 2/1).
NPR Examines U.S. Policy on International Family Planning
NPR's "Morning Edition" on Tuesday examined how U.S. support for international family planning has changed since Obama took office. Under the Bush administration, "conservatives opposed even the use of the term 'reproductive health services,'" according to "Morning Edition." Secretary of State Hillary Rodham Clinton said that greater access to family planning and HIV/AIDS counseling and treatment will be available to millions of women worldwide under the Obama administration (Wilson, "Morning Edition," NPR, 2/2).
Budget Proposal Includes Few Changes to HHS Budget
In related news, Obama's proposed budget includes "a few minor changes" to the HHS budget, including a $1 billion increase for NIH, an additional $290 million for community health centers and an added $1.6 billion for child care, the Washington Post reports. A majority of the department's $900 billion budget would be allocated for Medicare and Medicaid (Connolly, Washington Post, 2/1).
Also included in the budget proposal is $500 million for a new Fatherhood, Marriage and Families Innovation Fund that would extend to states competitive grants to "conduct and rigorously evaluate comprehensive responsible fatherhood programs." According to CQ HealthBeat, the proposal would also allocate a $2.5 billion emergency fund for the Temporary Assistance for Needy Families block grant (Norman, CQ HealthBeat, 2/1).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2010 The Advisory Board Company. All rights reserved.
Pelvic Pain And Surgeries In Women Before Interstitial Cystitis/Painful Bladder Syndrome - Chronic Pelvic Pain, BPS And Pelvic Surgical Procedures
UroToday - For years, bladder pain syndrome series have reported apparently high numbers of BPS patients with a history of hysterectomy and other pelvic surgeries. No study has compared cases with controls prior to onset of BPS symptoms. In the EPIC study (Events Preceding Interstitial Cystitis) John Warren's research group hypothesized that significantly more cases than controls experienced pelvic surgeries, especially just before onset of BPS symptoms. The EPIC study was a study of women exhibiting BPS symptoms for 12 months or less recruited nationally through urologists and patient support groups and controls recruited by random digit dialing and matched on sex, age, and national region.
Dr. Patricia Langenberg from Baltimore and her colleagues from around the country studied the EPIC data derived from 312 BPS cases and 313 controls that completed the study. Before their index dates, significantly more BPS cases than controls reported surgeries, including most of the specific pelvic surgeries queried. At greater than 12 months prior to the index date (onset of BPS or study entry for controls) the cases had more surgeries, including laparoscopy, D&C, nonhysterectomy uterine surgery, and "other" pelvic surgeries. Between 1 and 12 months, cases and controls did not differ. At less than 1 month, cases exceeded controls. Surgical procedures within one month of diagnosis included hysterectomies, ovarian surgeries including bilateral oophorectomies, and other pelvic surgeries.
The authors comment that more BPS cases had surgeries than matched controls and that cases had greater numbers of surgeries. Further analysis demonstrated that the associations of surgeries with BPS may have been confounded by the stronger associations of several possible indications for surgery. Specifically, inclusion of chronic pelvic pain in logistic regression analysis reduced to nonsignificance the association of surgeries with BPS. The authors strongly believe that the prior chronic pelvic pain was not simply undiagnosed BPS, and by extension that the increase of pelvic surgical procedures that preceded the diagnosis was not unnecessary surgery related to a missed diagnosis of BPS. They support this belief based on 3 foundations: 1)chronic pelvic pain began more than 12 months before onset of BPS symptoms in 73% of cases; 2)treating physicians did not consider chronic pelvic pain prior to the index date to be BPS; and 3) reviewed medical records did not support such a preexisting diagnosis.
The authors conclude that chronic pelvic pain appears to be a strong predictor of BPS. It is not clear to this correspondent that the onset of chronic pelvic pain can be reliably determined to be unrelated to onset of BPS or can be reliably separated from BPS by patient or physician given the way the syndrome is defined.
This is an excellent report from a very productive BPS center, that is highly recommended, and those interested in BPS will find it worth taking the time to review it carefully.
Langenberg PW, Wallach EE, Clauw DJ, Howard FM, Diggs CM, Wesselmann U, Greenberg P, Warren JW
Am J Obstet Gynecol. 2009 Dec 18. Epub ahead of print.
doi:10.1016/j.ajog.2009.10.866
UroToday Contributing Editor Philip M. Hanno, MD, MPH
UroToday - the only urology website with original content global urology key opinion leaders actively engaged in clinical practice. To access the latest urology news releases from UroToday, go to:
www.urotoday
Copyright © 2010 - UroToday
Dr. Patricia Langenberg from Baltimore and her colleagues from around the country studied the EPIC data derived from 312 BPS cases and 313 controls that completed the study. Before their index dates, significantly more BPS cases than controls reported surgeries, including most of the specific pelvic surgeries queried. At greater than 12 months prior to the index date (onset of BPS or study entry for controls) the cases had more surgeries, including laparoscopy, D&C, nonhysterectomy uterine surgery, and "other" pelvic surgeries. Between 1 and 12 months, cases and controls did not differ. At less than 1 month, cases exceeded controls. Surgical procedures within one month of diagnosis included hysterectomies, ovarian surgeries including bilateral oophorectomies, and other pelvic surgeries.
The authors comment that more BPS cases had surgeries than matched controls and that cases had greater numbers of surgeries. Further analysis demonstrated that the associations of surgeries with BPS may have been confounded by the stronger associations of several possible indications for surgery. Specifically, inclusion of chronic pelvic pain in logistic regression analysis reduced to nonsignificance the association of surgeries with BPS. The authors strongly believe that the prior chronic pelvic pain was not simply undiagnosed BPS, and by extension that the increase of pelvic surgical procedures that preceded the diagnosis was not unnecessary surgery related to a missed diagnosis of BPS. They support this belief based on 3 foundations: 1)chronic pelvic pain began more than 12 months before onset of BPS symptoms in 73% of cases; 2)treating physicians did not consider chronic pelvic pain prior to the index date to be BPS; and 3) reviewed medical records did not support such a preexisting diagnosis.
The authors conclude that chronic pelvic pain appears to be a strong predictor of BPS. It is not clear to this correspondent that the onset of chronic pelvic pain can be reliably determined to be unrelated to onset of BPS or can be reliably separated from BPS by patient or physician given the way the syndrome is defined.
This is an excellent report from a very productive BPS center, that is highly recommended, and those interested in BPS will find it worth taking the time to review it carefully.
Langenberg PW, Wallach EE, Clauw DJ, Howard FM, Diggs CM, Wesselmann U, Greenberg P, Warren JW
Am J Obstet Gynecol. 2009 Dec 18. Epub ahead of print.
doi:10.1016/j.ajog.2009.10.866
UroToday Contributing Editor Philip M. Hanno, MD, MPH
UroToday - the only urology website with original content global urology key opinion leaders actively engaged in clinical practice. To access the latest urology news releases from UroToday, go to:
www.urotoday
Copyright © 2010 - UroToday
Boston Scientific Announces FDA Approval Of Renegade(R) HI-FLO™ Fathom(R) Pre-Loaded System
Boston Scientific Corporation (NYSE: BSX) announced that the U.S. Food and Drug Administration (FDA) has approved its Renegade® HI-FLO™ Fathom® Pre-Loaded System for selective access and delivery of diagnostic, embolic and therapeutic materials into the peripheral vasculature. The system will primarily be used by interventional radiologists for minimally invasive procedures to treat uterine fibroids and liver cancer. The Company said it plans to launch the product immediately in the United States.
The Renegade HI-FLO Fathom Pre-Loaded System combines the turn-for-turn torque response, flexibility and high visibility of the Fathom-16 Steerable Guidewire with the clinically proven performance of the Renegade HI-FLO Microcatheter, pre-loaded in a single convenient platform. The system will be available in eight configurations to suit a broad range of peripheral embolization procedures.
"The excellent deliverability, torque transmission and flow capacity of the Renegade HI-FLO Fathom Pre-Loaded System provides physicians with the performance they need to efficiently access tortuous vessels across many types of interventional oncology procedures," said Jeff Geschwind, M.D., Professor of Radiology, Surgery and Oncology, and Director of Vascular and Interventional Radiology at the Johns Hopkins University School of Medicine. "Having the Fathom-16 Guidewire pre-loaded in the Renegade HI-FLO Microcatheter will reduce my procedural preparation time and the number of devices that my staff must manage."
The Renegade HI-FLO Fathom Pre-Loaded System complements Boston Scientific's extensive portfolio of minimally invasive access and embolization products to provide physicians with a range of diagnostic and treatment options for uterine fibroids, liver cancer and other conditions requiring interventional procedures.
"Adding the pre-loaded system to our product offerings demonstrates Boston Scientific's commitment to providing a comprehensive suite of less-invasive solutions for interventional radiologists and their patients," said Joe Fitzgerald, Senior Vice President and President of Boston Scientific's Endovascular Unit. "We will continue to bring additional technologies to market that advance the various therapies performed by specialists in vascular and interventional radiology."
About Uterine Fibroids
Uterine fibroids are non-cancerous growths that develop in the muscular wall of the uterus or cervix, and are estimated to occur in up to 40 percent of women of child-bearing age. Although most uterine fibroids are asymptomatic, some can cause heavy and painful menstrual bleeding, pelvic pressure and frequent urination. Treatment options include medication, hysterectomy, myomectomy (surgical removal of fibroids from the uterus) and uterine artery embolization (UAE). In UAE, a physician uses minimally invasive techniques under local anesthesia to access and occlude both uterine arteries, reducing or eliminating blood flow to the fibroid. Uterine fibroids are the most common benign tumors in women and are the most frequent indication for hysterectomy among pre-menopausal women.
About Liver Cancer
Liver cancer is one of the most commonly diagnosed forms of cancer worldwide, with more than 800,000 patients diagnosed annually. The average life expectancy of many patients with liver cancer is less than one year. Treatment options include surgical resection, chemotherapy, radiation, tumor ablation, and several minimally invasive options, including transarterial chemoembolization (TACE) and radioembolization. In the minimally invasive options, a physician will establish endovascular access to the hepatic artery under local anesthesia to deliver one of several acute therapies.
Source:
Boston Scientific
The Renegade HI-FLO Fathom Pre-Loaded System combines the turn-for-turn torque response, flexibility and high visibility of the Fathom-16 Steerable Guidewire with the clinically proven performance of the Renegade HI-FLO Microcatheter, pre-loaded in a single convenient platform. The system will be available in eight configurations to suit a broad range of peripheral embolization procedures.
"The excellent deliverability, torque transmission and flow capacity of the Renegade HI-FLO Fathom Pre-Loaded System provides physicians with the performance they need to efficiently access tortuous vessels across many types of interventional oncology procedures," said Jeff Geschwind, M.D., Professor of Radiology, Surgery and Oncology, and Director of Vascular and Interventional Radiology at the Johns Hopkins University School of Medicine. "Having the Fathom-16 Guidewire pre-loaded in the Renegade HI-FLO Microcatheter will reduce my procedural preparation time and the number of devices that my staff must manage."
The Renegade HI-FLO Fathom Pre-Loaded System complements Boston Scientific's extensive portfolio of minimally invasive access and embolization products to provide physicians with a range of diagnostic and treatment options for uterine fibroids, liver cancer and other conditions requiring interventional procedures.
"Adding the pre-loaded system to our product offerings demonstrates Boston Scientific's commitment to providing a comprehensive suite of less-invasive solutions for interventional radiologists and their patients," said Joe Fitzgerald, Senior Vice President and President of Boston Scientific's Endovascular Unit. "We will continue to bring additional technologies to market that advance the various therapies performed by specialists in vascular and interventional radiology."
About Uterine Fibroids
Uterine fibroids are non-cancerous growths that develop in the muscular wall of the uterus or cervix, and are estimated to occur in up to 40 percent of women of child-bearing age. Although most uterine fibroids are asymptomatic, some can cause heavy and painful menstrual bleeding, pelvic pressure and frequent urination. Treatment options include medication, hysterectomy, myomectomy (surgical removal of fibroids from the uterus) and uterine artery embolization (UAE). In UAE, a physician uses minimally invasive techniques under local anesthesia to access and occlude both uterine arteries, reducing or eliminating blood flow to the fibroid. Uterine fibroids are the most common benign tumors in women and are the most frequent indication for hysterectomy among pre-menopausal women.
About Liver Cancer
Liver cancer is one of the most commonly diagnosed forms of cancer worldwide, with more than 800,000 patients diagnosed annually. The average life expectancy of many patients with liver cancer is less than one year. Treatment options include surgical resection, chemotherapy, radiation, tumor ablation, and several minimally invasive options, including transarterial chemoembolization (TACE) and radioembolization. In the minimally invasive options, a physician will establish endovascular access to the hepatic artery under local anesthesia to deliver one of several acute therapies.
Source:
Boston Scientific
Health Canada, Eli Lilly Release Advisory That Evista Could Increase Stroke Mortality Risk Among Some Postmenopausal Women
Health Canada, the country's health ministry, and Eli Lilly on Thursday released advisories for both the public and health professionals that the bone thinning drug Evista might increase the chance of stroke mortality among postmenopausal women living with heart conditions, CBC News reports (CBC News, 5/25). Initial results of a National Cancer Institute-sponsored study released last month found that Evista, known generically as raloxifene, is as effective as the breast cancer prevention drug tamoxifen in reducing breast cancer risk for postmenopausal women already at an increased risk of developing the disease and is less likely to cause serious side effects. FDA has approved raloxifene for use as a preventive drug for osteoporosis and bone thinning but not for breast cancer (Kaiser Daily Women's Health Policy Report, 4/18). Another clinical trial involving more than 10,000 postmenopausal women with heart conditions in 26 countries finds that 2.2 per every 1,000 women taking raloxifene died of a stroke, compared with 1.5 per every 1,000 women taking a placebo. Eli Lilly and Health Canada advised women in the country to consult their physicians about the drugs (Carey, Toronto Star, 5/26).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
View drug information on Evista.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
View drug information on Evista.
Vaccination Programmes With Gardasil® Could Cost-effectively Prevent Up To 91% Of Vaccine Virus Type Related Cervical Cancer
Compared with current practice, vaccinating 70% of young girls before
the age of 12 with Gardasil® could reduce the incidence of cervical cancer due to human
papillomavirus types 16 and 18 in the entire population by 78%. Thanks to the prevention of
other human papillomavirus diseases, that start before cervical cancer and go beyond the cervix,
vaccination with Gardasil® is also expected to provide early and additional benefit compared to
the prevention of cervical cancer alone. 78% of precancerous cervical lesions (CIN*2/3) and 83%
of genital warts due to human papillomavirus types 6, 11, 16, 18 for example, could also be
prevented through vaccination with Gardasil®. Including males in the vaccination programme
would further increase effectiveness, indirectly reducing the incidence of cervical cancer,
precancerous cervical lesions (CIN**2/3), and genital warts due to human papillomavirus types 6,
11, 16, 18 by 91%, 91%, and 97%, respectively.
Combined with current screening and human papillomavirus disease treatment practice,
vaccination with Gardasil® would be cost-effective compared to other commonly accepted
healthcare programmes such as screening alone or measures to prevent heart disease.
Temporary vaccination of 50% of 12- to 24-year old girls and women with Gardasil® (catch-up
programme) would further accelerate disease reduction significantly whilst remaining cost-
effective. With a catch-up programme, vaccination against the four virus types 6, 11, 16 and 18
would be approximately twice as cost-effective as vaccination against the virus types 16 and 18
alone. With a catch-up programme, benefit from vaccination would become evident from as early
as five years after initiation of the programme.
These results come from an assessment of the epidemiologic consequences and cost-
effectiveness of different vaccination strategies with Gardasil® in a setting of organised cervical
cancer screening in the United States using a transmission dynamic model. Each vaccination
strategy was assessed over a planning horizon of 100 years. The assessment did not include
protection from additional human papillomavirus diseases that start before cervical cancer and
go beyond the cervix such as potentially precancerous cervical lesions (CIN 1), vulvar cancer
and precancerous vulvar lesions. It focussed on the four virus types (6, 11, 16, 18) directly
targeted by Gardasil® and did not include potential cross protection against additional virus types
not directly targeted by the vaccine. The results have been published in the January 2007
edition of the Emerging Infectious Diseases journal of the US Centers of Disease Control
(Elbasha E.H. et al., Volume 13, Number 1, January 2007 -
www.cdc/ncidod/EID/13/1/28.htm).
Gardasil® is the only licensed vaccine for cervical cancer and other human papillomavirus
diseases before cervical cancer and beyond the cervix. Gardasil® has been filed in 120 countries
and approved in 50 countries (all under accelerated review timelines), including the European
Union, the United States, Canada and Australia. The four virus types (6,11,16,18) tathe vaccine cause the vast majority of genital human papillomavirus diseases.
In June 2006, just three weeks after approval of Gardasil® in the US, the US health authorities
recommended the routine vaccination of 11- and 12- year-old females and the catch-up
vaccination of females aged 13 to 26 who have not previously been vaccinated and that 9- and
10- year-old females can be vaccinated at the discretion of their physicians. In the meantime,
health insurers covering approximately 94% of privately insured lives in the US have decided to
reimburse Gardasil®. In November, the authorities added Gardasil® to their Vaccines for Children
(VFC) contract for girls and women aged 9 to 18.
Just four months after gaining a license in the European Union, Gardasil® is now available in 15
European countries***. As of 1 January 2007 vaccination is recommended in Austria for girls and
boys aged 9 to 15 years as well as for women, preferably before the start of sexual activity. In
Germany and France, decisions are anticipated soon. In Germany, three large statutory health
insurance funds, which together cover almost half of the German population, have announced
immediate and full reimbursement of human papillomavirus vaccination for females even before
any recommendations by the authorities have been published. The French health authorities
have announced a decision upon reimbursement by the national social security system for the
first trimester of 2007. Three large private health insurance funds have announced immediate
partial reimbursement of human papillomavirus vaccination also even before any
recommendations by the authorities have been published. Accelerated discussions are under
way in most European countries to integrate human papillomavirus vaccination in each country's
recommendation and reimbursement programme. Assessments of vaccination strategies in
Europe are under way with results expected to be published in the near future.
* Cervical Intraepithelial Neoplasia
** Cervical Intraepithelial Neoplasia
*** Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Luxembourg, the Netherlands, Norway, Portugal,
Sweden, Switzerland and the United Kingdom. Italy will follow during the first quarter and Spain during the second quarter 2007.
Sanofi Pasteur MSD is the only European company dedicated exclusively to vaccines
sanofipasteur
View drug information on Gardasil.
the age of 12 with Gardasil® could reduce the incidence of cervical cancer due to human
papillomavirus types 16 and 18 in the entire population by 78%. Thanks to the prevention of
other human papillomavirus diseases, that start before cervical cancer and go beyond the cervix,
vaccination with Gardasil® is also expected to provide early and additional benefit compared to
the prevention of cervical cancer alone. 78% of precancerous cervical lesions (CIN*2/3) and 83%
of genital warts due to human papillomavirus types 6, 11, 16, 18 for example, could also be
prevented through vaccination with Gardasil®. Including males in the vaccination programme
would further increase effectiveness, indirectly reducing the incidence of cervical cancer,
precancerous cervical lesions (CIN**2/3), and genital warts due to human papillomavirus types 6,
11, 16, 18 by 91%, 91%, and 97%, respectively.
Combined with current screening and human papillomavirus disease treatment practice,
vaccination with Gardasil® would be cost-effective compared to other commonly accepted
healthcare programmes such as screening alone or measures to prevent heart disease.
Temporary vaccination of 50% of 12- to 24-year old girls and women with Gardasil® (catch-up
programme) would further accelerate disease reduction significantly whilst remaining cost-
effective. With a catch-up programme, vaccination against the four virus types 6, 11, 16 and 18
would be approximately twice as cost-effective as vaccination against the virus types 16 and 18
alone. With a catch-up programme, benefit from vaccination would become evident from as early
as five years after initiation of the programme.
These results come from an assessment of the epidemiologic consequences and cost-
effectiveness of different vaccination strategies with Gardasil® in a setting of organised cervical
cancer screening in the United States using a transmission dynamic model. Each vaccination
strategy was assessed over a planning horizon of 100 years. The assessment did not include
protection from additional human papillomavirus diseases that start before cervical cancer and
go beyond the cervix such as potentially precancerous cervical lesions (CIN 1), vulvar cancer
and precancerous vulvar lesions. It focussed on the four virus types (6, 11, 16, 18) directly
targeted by Gardasil® and did not include potential cross protection against additional virus types
not directly targeted by the vaccine. The results have been published in the January 2007
edition of the Emerging Infectious Diseases journal of the US Centers of Disease Control
(Elbasha E.H. et al., Volume 13, Number 1, January 2007 -
www.cdc/ncidod/EID/13/1/28.htm).
Gardasil® is the only licensed vaccine for cervical cancer and other human papillomavirus
diseases before cervical cancer and beyond the cervix. Gardasil® has been filed in 120 countries
and approved in 50 countries (all under accelerated review timelines), including the European
Union, the United States, Canada and Australia. The four virus types (6,11,16,18) tathe vaccine cause the vast majority of genital human papillomavirus diseases.
In June 2006, just three weeks after approval of Gardasil® in the US, the US health authorities
recommended the routine vaccination of 11- and 12- year-old females and the catch-up
vaccination of females aged 13 to 26 who have not previously been vaccinated and that 9- and
10- year-old females can be vaccinated at the discretion of their physicians. In the meantime,
health insurers covering approximately 94% of privately insured lives in the US have decided to
reimburse Gardasil®. In November, the authorities added Gardasil® to their Vaccines for Children
(VFC) contract for girls and women aged 9 to 18.
Just four months after gaining a license in the European Union, Gardasil® is now available in 15
European countries***. As of 1 January 2007 vaccination is recommended in Austria for girls and
boys aged 9 to 15 years as well as for women, preferably before the start of sexual activity. In
Germany and France, decisions are anticipated soon. In Germany, three large statutory health
insurance funds, which together cover almost half of the German population, have announced
immediate and full reimbursement of human papillomavirus vaccination for females even before
any recommendations by the authorities have been published. The French health authorities
have announced a decision upon reimbursement by the national social security system for the
first trimester of 2007. Three large private health insurance funds have announced immediate
partial reimbursement of human papillomavirus vaccination also even before any
recommendations by the authorities have been published. Accelerated discussions are under
way in most European countries to integrate human papillomavirus vaccination in each country's
recommendation and reimbursement programme. Assessments of vaccination strategies in
Europe are under way with results expected to be published in the near future.
* Cervical Intraepithelial Neoplasia
** Cervical Intraepithelial Neoplasia
*** Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Luxembourg, the Netherlands, Norway, Portugal,
Sweden, Switzerland and the United Kingdom. Italy will follow during the first quarter and Spain during the second quarter 2007.
Sanofi Pasteur MSD is the only European company dedicated exclusively to vaccines
sanofipasteur
View drug information on Gardasil.
Barr Pharmaceuticals Challenges Warner Chilcott Patent By Filing Application For Generic Version Of Chewable Oral Contraceptive
Warner Chilcott on Wednesday announced it has received a notice from Barr Laboratories indicating that Barr has filed an abbreviated new drug application with FDA for a generic version of the chewable oral contraceptive Femcon Fe, Reuters reports (Tickoo, Reuters, 8/15). According to a Barr release, the company is challenging Chilcott's patent for Femcon Fe, stating that it was the first to file an Abbreviated New Drug Application with FDA (Barr release, 8/15).
FDA in November 2003 approved the chewable version of Northern Ireland-based Galen Holdings' oral contraceptive Ovcon 35. The chewable pills, which Bristol-Myers Squibb manufactures, contain progestin and estrogen -- the same hormones used in standard birth control pills. The pills will be available in a 28-day regimen with 21 white tablets containing norethindrone and ethinyl estradiol, as well as seven green placebo pills that induce a menstrual period. Women will be able to chew the pills or swallow them whole; women who chew the pills must drink an eight-ounce glass of water afterward to ensure that the full dose reaches their stomachs. Femcon Fe has similar side effects to other birth control pills, such as an increased risk for blood clots, heart attack and stroke. One month's supply of the pill costs $44 wholesale (Kaiser Daily Women's Health Policy Report, 4/17).
According to the release, Barr filed the application in April and received notification of the application's acceptance for filing this month from FDA (Barr release, 8/15). Chilcott said the drug is protected by a U.S. patent that expires in 2019 and that the company "continues to have full confidence in its intellectual property protecting Femcon Fe" (Reuters, 8/15). Chilcott said that it is reviewing the details of Barr's notice (Chilcott release, 8/15).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
View drug information on Estradiol Transdermal System.
FDA in November 2003 approved the chewable version of Northern Ireland-based Galen Holdings' oral contraceptive Ovcon 35. The chewable pills, which Bristol-Myers Squibb manufactures, contain progestin and estrogen -- the same hormones used in standard birth control pills. The pills will be available in a 28-day regimen with 21 white tablets containing norethindrone and ethinyl estradiol, as well as seven green placebo pills that induce a menstrual period. Women will be able to chew the pills or swallow them whole; women who chew the pills must drink an eight-ounce glass of water afterward to ensure that the full dose reaches their stomachs. Femcon Fe has similar side effects to other birth control pills, such as an increased risk for blood clots, heart attack and stroke. One month's supply of the pill costs $44 wholesale (Kaiser Daily Women's Health Policy Report, 4/17).
According to the release, Barr filed the application in April and received notification of the application's acceptance for filing this month from FDA (Barr release, 8/15). Chilcott said the drug is protected by a U.S. patent that expires in 2019 and that the company "continues to have full confidence in its intellectual property protecting Femcon Fe" (Reuters, 8/15). Chilcott said that it is reviewing the details of Barr's notice (Chilcott release, 8/15).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
View drug information on Estradiol Transdermal System.
Coffee Drinkers Do Not Die Sooner And Some May Even Live Longer
Scientists from Spain and the US found that drinking two or three cups of coffee a day did not increase risk of death in either men or women and in fact
both caffeinated and decaffeinated coffee were linked with a slightly reduced risk of death from heart disease. However, experts cautioned
that this could be the result of something else protecting coffee drinkers that was not studied in the research.
The study, which was supported by grants from theUS National Institutes of Health, is published in the 17 June issue of the Annals of Internal
Medicine and is the work of lead author Dr Esther Lopez-Garcia of the Universidad Aut??noma de Madrid, Spain, and colleagues from the Harvard
School of Public Health, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachussetts, US.
Lopez-Garcia said:
"Coffee consumption has been linked to various beneficial and detrimental health effects, but data on its relation with death were lacking."
Lopez-Garcia and colleagues found that coffee consumption was not linked with a higher risk of death in middle aged men and women, and
suggested that:
"The possibility of a modest benefit of coffee consumption on heart disease, cancer, and other causes of death needs to be further
investigated."
For the study the authors used data from participants who were free of cancer and heart disease on enrollment in two large epidemiological studies,
one involving American women and the other involving American men. The data on women came from 84,214 women who took part in the Nurses'
Health Study and the data on men came from 41,736 men who took part in the Health Professionals Follow-up Study.
The participants filled in questionnaires every two to four years that included questions about their coffee consumption (for instance how much and
how often), other dietary habits, smoking status, and health.
Lopez-Garcia and colleagues then looked at how different kinds of coffee drinking patterns correlated with frequency of death from any cause, from
death due to heart disease, and from death due to cancer.
The results showed that:
Women who drank 2 to 3 cups of caffeinated coffee a day had a 25 per cent lower risk of death from heart disease over the follow up period
(84,214 women from 1980 to 2004), compared with women who did not drink coffee.
Women who drank 2 to 3 cups of caffeinated coffee a day also had an 18 per cent lower risk of death from causes not related to cancer or heart
disease, over the follow up period compared to women who did not drink coffee.
Men who drank 2 to 3 cups of caffeinated coffee a day showed no higher or lower risk of death during the follow up period, 41,736 men from
1986 to 2004) compared with men who did not drink coffee.
During the follow up, 2,368 of the women died from heart disease, 5,011 from cancer, and 3,716 from other causes.
2,049 of the men died from heart disease, 2,491 from cancer, and 2,348 from other causes.
Overall, taking into account other risk factors such as body size, smoking, diet, and some specific dieases, people who drank more coffee were
less likely to die during the follow up period.
The main reason for this was the lower risk of heart disease among the coffee drinkers.
There was no link between coffee drinking and death due to cancer.
In the main, there appeared to be no difference in the link to death rates between caffeinated and decaffeinated coffee, they both appeared to
have the same link with lower death rates compared with people who did not drink any coffee at all.
However, drinking decaffeinated coffee was linked to a small reduction in deaths from all causes and cardiovascular (CVD) diseases.
The authors concluded that:
"Regular coffee consumption was not associated with an increased mortality rate in either men or women. The possibility of a modest benefit of
coffee consumption on all-cause and CVD mortality needs to be further investigated."
Both the editors of the journal and the authors themselves pointed to a possible limitation of the study: the fact that the data came from self-reports,
which could mean some measurement error was present in the results.
Also, the editors wrote that the study was not designed to show a causal link, so we cannot be certain that it was coffee consumption that caused
these results, it could something else that links coffee drinkers with lower mortality.
"The Relationship of Coffee Consumption with Mortality."
Esther Lopez-Garcia, Rob M. van Dam, Tricia Y. Li, Fernando Rodriguez-Artalejo, and Frank B. Hu.
Annals of Internal Medicine 17 June 2008, Volume 148, Issue 12, Pages 904-914.
Click here for Abstract.
Sources: American College of Physicians press statement, journal abstract.
: Catharine Paddock, PhD
both caffeinated and decaffeinated coffee were linked with a slightly reduced risk of death from heart disease. However, experts cautioned
that this could be the result of something else protecting coffee drinkers that was not studied in the research.
The study, which was supported by grants from theUS National Institutes of Health, is published in the 17 June issue of the Annals of Internal
Medicine and is the work of lead author Dr Esther Lopez-Garcia of the Universidad Aut??noma de Madrid, Spain, and colleagues from the Harvard
School of Public Health, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachussetts, US.
Lopez-Garcia said:
"Coffee consumption has been linked to various beneficial and detrimental health effects, but data on its relation with death were lacking."
Lopez-Garcia and colleagues found that coffee consumption was not linked with a higher risk of death in middle aged men and women, and
suggested that:
"The possibility of a modest benefit of coffee consumption on heart disease, cancer, and other causes of death needs to be further
investigated."
For the study the authors used data from participants who were free of cancer and heart disease on enrollment in two large epidemiological studies,
one involving American women and the other involving American men. The data on women came from 84,214 women who took part in the Nurses'
Health Study and the data on men came from 41,736 men who took part in the Health Professionals Follow-up Study.
The participants filled in questionnaires every two to four years that included questions about their coffee consumption (for instance how much and
how often), other dietary habits, smoking status, and health.
Lopez-Garcia and colleagues then looked at how different kinds of coffee drinking patterns correlated with frequency of death from any cause, from
death due to heart disease, and from death due to cancer.
The results showed that:
Women who drank 2 to 3 cups of caffeinated coffee a day had a 25 per cent lower risk of death from heart disease over the follow up period
(84,214 women from 1980 to 2004), compared with women who did not drink coffee.
Women who drank 2 to 3 cups of caffeinated coffee a day also had an 18 per cent lower risk of death from causes not related to cancer or heart
disease, over the follow up period compared to women who did not drink coffee.
Men who drank 2 to 3 cups of caffeinated coffee a day showed no higher or lower risk of death during the follow up period, 41,736 men from
1986 to 2004) compared with men who did not drink coffee.
During the follow up, 2,368 of the women died from heart disease, 5,011 from cancer, and 3,716 from other causes.
2,049 of the men died from heart disease, 2,491 from cancer, and 2,348 from other causes.
Overall, taking into account other risk factors such as body size, smoking, diet, and some specific dieases, people who drank more coffee were
less likely to die during the follow up period.
The main reason for this was the lower risk of heart disease among the coffee drinkers.
There was no link between coffee drinking and death due to cancer.
In the main, there appeared to be no difference in the link to death rates between caffeinated and decaffeinated coffee, they both appeared to
have the same link with lower death rates compared with people who did not drink any coffee at all.
However, drinking decaffeinated coffee was linked to a small reduction in deaths from all causes and cardiovascular (CVD) diseases.
The authors concluded that:
"Regular coffee consumption was not associated with an increased mortality rate in either men or women. The possibility of a modest benefit of
coffee consumption on all-cause and CVD mortality needs to be further investigated."
Both the editors of the journal and the authors themselves pointed to a possible limitation of the study: the fact that the data came from self-reports,
which could mean some measurement error was present in the results.
Also, the editors wrote that the study was not designed to show a causal link, so we cannot be certain that it was coffee consumption that caused
these results, it could something else that links coffee drinkers with lower mortality.
"The Relationship of Coffee Consumption with Mortality."
Esther Lopez-Garcia, Rob M. van Dam, Tricia Y. Li, Fernando Rodriguez-Artalejo, and Frank B. Hu.
Annals of Internal Medicine 17 June 2008, Volume 148, Issue 12, Pages 904-914.
Click here for Abstract.
Sources: American College of Physicians press statement, journal abstract.
: Catharine Paddock, PhD
Several Arguments In Briefs Of Appeal Of Federal Abortion Ban Addressed To Justice Kennedy
Numerous arguments in the briefs filed with the U.S. Supreme Court for a Department of Justice appeal to uphold a federal law banning so-called "partial-birth" abortion are "clearly, if implicitly, addressed" to Justice Anthony Kennedy, the New York Times reports (Greenhouse, New York Times, 11/5). President Bush signed the Partial-Birth Abortion Ban Act (S 3) into law in November 2003. The Planned Parenthood Federation of America, the American Civil Liberties Union on behalf of the National Abortion Federation and the Center for Reproductive Rights on behalf of four abortion providers filed lawsuits alleging that the law is unconstitutional because of the absence of a health exception, and federal judges in California, Nebraska and New York each issued temporary restraining orders to prevent enforcement of the ban. In place of a health exception, the law includes a long "findings" section with medical evidence presented during congressional hearings that, according to supporters of the law, indicates the procedures banned by the law are never medically necessary. The Supreme Court is scheduled to hear arguments in two of the cases on Wednesday (Kaiser Daily Women's Health Policy Report, 10/30).
Kennedy's Role
Kennedy dissented in the Supreme Court's 5-4 ruling in the 2000 Stenberg v. Carhart case, which struck down a Nebraska law similar to Partial-Birth Abortion Ban Act as unconstitutional. However, a federal abortion restriction runs counter to Kennedy's view of federalism and states' rights, and he could stick to his belief that the court's precedents should be upheld, which likely would mean the federal abortion ban would be struck down (Kaiser Daily Women's Health Policy Report, 10/2). According to the Times, many people involved with groups challenging the law believe "their only hope of prevailing" is if they can persuade Kennedy to rule the federal law unconstitutional (New York Times, 11/5). CRR attorney Priscilla Smith said she thinks Kennedy might be convinced by evidence including the testimony of 13 medical experts saying the procedures banned by the law can be the safest method of abortion. Jay Sekulow, chief council for the American Center for Law and Justice, said, "There is not a lot of wriggle room in what Kennedy wrote" in his Sternberg dissent, adding, "It was such a powerful dissent. I don't see him moving away from that" (Sherman, AP/Detroit Free Press, 11/5). Andrew Koppelman, a professor of law and political science at Northwestern University, said how Chief Justice John Roberts will rule on the appeal "is the biggest question mark, because his views aren't particularly on record" (Peres, Chicago Tribune, 11/6).
Editorial
If the Supreme Court upholds the federal law and overturns the Sternberg ruling, it "wouldn't cause the same jolt as repudiating" Roe v. Wade -- the 1973 ruling that effectively barred state abortion bans -- or Planned Parenthood v. Casey, the 1992 ruling that reaffirmed Roe, a Los Angeles Times editorial says. However, upholding the law "would still upend a precedent and interfere with the settled expectations of women and doctors about the availability of this procedure as a medical last resort," according to the editorial (Los Angeles Times, 11/6).
NPR's "All Things Considered" on Thursday reported on the appeal of the federal abortion ban. The segment includes comments from Rep. Steve Chabot (R-Ohio), who helped write the Partial-Birth Abortion Ban Act, and Stephen Chasen, an associate professor of obstetrics and gynecology at Weill Medical College of Cornell University and plaintiff in one of three lawsuits challenging the ban (Rovner, "All Things Considered," NPR, 11/2). A transcript and audio of the segment are available online.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Mammography Rates Declining In The United States
Since 2000 mammography rates have declined significantly in the United States, according to a new study. Published in the June 15, 2007 issue of CANCER, a peer-reviewed journal of the American Cancer Society, the study by Dr. Nancy Breen from the National Cancer Institute and co-authors confirms that screening mammography rates to detect breast cancer fell by as much as four percent nationwide between 2000 and 2005. This is the first study to show that the trend is nationwide among women for whom the test is intended to reduce mortality risk.
Regular mammography is the most efficacious screening test for the early detection of breast cancer available to women today. Not only does it detect early tumors in breast tissue, but also its widespread use by women over 40 years old since the 1980s has lead to a reduction in breast cancer mortality in the United States.
After years of increasing incidence, the rate of new breast cancer diagnoses has recently declined. How much of that drop is due to changes in mammography use has been the subject of debate. Prior reports show that between 1987 and 2000, screening rates among women over 40 years old increased from just 39 percent to 70 percent. However, evidence from some states and localities suggest that mammography rates have declined, putting at risk the decline in mortality rates previously observed. Dr. Breen and her co-investigators reviewed data from the National Health Interview Survey from 1987 to 2005 to estimate mammography screening rates.
Dr. Breen found that between 1987 and 2000, there was a steady increase in the use of mammography for women over 40 years old, while rates were relatively flat from 2000 to 2003. However, in 2005 screening fell by four percent compared to rates observed in 2000. This decline was significant for women over age 50. Some of the sharpest declines were seen among women who previously reported high screening rates: women between 50 and 64 years old; and women in higher socioeconomic levels.
This decline in screening is also noted to have coincided with a decline in reported incidence of breast cancer. Dr. Breen and her co-authors say they "are concerned that some of the observed decline in incidence may be due in part to the leveling off and reduction in mammography rates." The researchers recommend "continued monitoring of trends in incidence, screening, and their underlying factors" and "consider what types of interventions would be needed should these downward trends continue."
Article:
"Reported Drop in Mammography: Is This Cause for Concern?,"
Nancy Breen, Kathleen A. Cronin, Helen I. Meissner, Stephen H. Taplin, Florence K. Tangka, Jasmin A. Tiro, Timothy S. McNeel
CANCER; Published Online: May 14, 2007 (DOI: 10.1002/cncr. 22723); Print Issue Date: June 15, 2007.
wwwncer
Regular mammography is the most efficacious screening test for the early detection of breast cancer available to women today. Not only does it detect early tumors in breast tissue, but also its widespread use by women over 40 years old since the 1980s has lead to a reduction in breast cancer mortality in the United States.
After years of increasing incidence, the rate of new breast cancer diagnoses has recently declined. How much of that drop is due to changes in mammography use has been the subject of debate. Prior reports show that between 1987 and 2000, screening rates among women over 40 years old increased from just 39 percent to 70 percent. However, evidence from some states and localities suggest that mammography rates have declined, putting at risk the decline in mortality rates previously observed. Dr. Breen and her co-investigators reviewed data from the National Health Interview Survey from 1987 to 2005 to estimate mammography screening rates.
Dr. Breen found that between 1987 and 2000, there was a steady increase in the use of mammography for women over 40 years old, while rates were relatively flat from 2000 to 2003. However, in 2005 screening fell by four percent compared to rates observed in 2000. This decline was significant for women over age 50. Some of the sharpest declines were seen among women who previously reported high screening rates: women between 50 and 64 years old; and women in higher socioeconomic levels.
This decline in screening is also noted to have coincided with a decline in reported incidence of breast cancer. Dr. Breen and her co-authors say they "are concerned that some of the observed decline in incidence may be due in part to the leveling off and reduction in mammography rates." The researchers recommend "continued monitoring of trends in incidence, screening, and their underlying factors" and "consider what types of interventions would be needed should these downward trends continue."
Article:
"Reported Drop in Mammography: Is This Cause for Concern?,"
Nancy Breen, Kathleen A. Cronin, Helen I. Meissner, Stephen H. Taplin, Florence K. Tangka, Jasmin A. Tiro, Timothy S. McNeel
CANCER; Published Online: May 14, 2007 (DOI: 10.1002/cncr. 22723); Print Issue Date: June 15, 2007.
wwwncer
African Union Adopts Reproductive Health Rights Policy, Fails To Agree On Policy Addressing Unsafe Abortions
African Union health ministers meeting in Maputo, Mozambique, last week adopted a policy framework to address sexual and reproductive health and rights but did not agree on how to address the issue of unsafe abortions, resolving to allow each member state to handle the issue separately, Lilongwe's Chronicle/AllAfrica reports. Thomas Bisika -- head of the A.U.'s Division of Health, HIV/AIDS, Nutrition, Other Related Infection Diseases and Population in the Department of Social Affairs -- said all member countries agreed that the majority of the maternal deaths in Africa result from unsafe abortions. He added that member countries during the meeting emphasized their intent to address the issue based on the social conditions in their countries. The health ministers "realized that abortion is not really a family planning method," Bisika said, adding, "The agreement is that people have to embark on programs that enhance the avoidance of unsafe abortions." According to Bisika, the ministers agreed that access to abortion services should be made available "to the full extent of the law," especially in cases of incest or where the woman's health is at risk. Bisika said that the policy framework adopted last week is for the period from 2007 through 2010 and that A.U. members aim to adopt another framework for 2011 through 2015 to coincide with evaluations of the U.N. Millennium Development Goals. The draft version of policy framework aims to reach the goal of providing universal access to comprehensive sexual and reproductive health services in Africa by 2015 (Chronicle/All Africa, 10/17).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Mississippi Gov. Signs Bill Requiring Designated Places For Women Breast-Feeding At Child-Care Facilities
Mississippi Gov. Haley Barbour (R) this week signed a bill (SB 2419) that requires child-care facilities to designate a suitable place for women to breast-feed their infants or use a breast pump, the AP/Biloxi Sun Herald reports. Under the law, the location -- which cannot be a bathroom stall -- must have a comfortable chair, an electrical outlet and access to running water. Day care centers also are required to provide a refrigerator for women to store their pumped milk and must train employees how to handle it correctly, the law says. In addition, the law says that breast-feeding in a public place cannot be considered indecent exposure or disorderly conduct. It also allows any woman who is nursing an infant younger than age one to be exempt from jury duty and requires employers to allow a woman to use her lunch break or other designated break times to pump milk. The law went into effect immediately after Barbour signed it (Wagster Pettus, AP/Biloxi Sun Herald, 4/5).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Kaiser Daily Women's Health Policy Report Highlights Issues In Various States
The following highlights recent news of state actions on women's health issues.
Abortion Regulations
Louisiana: The state Senate on Monday voted 27-0 to give final approval to a bill (SB 33) that would ban abortion in the state except when the pregnancy threatens the life of the woman or could cause her severe health problems, the New Orleans Times-Picayune reports (Anderson, New Orleans Times-Picayune, 6/6). The measure would take effect only if the U.S. Supreme Court overturns Roe v. Wade -- the 1973 Supreme Court case that effectively barred state abortion bans -- or if the U.S. Constitution is amended to allow states to ban the procedure (AP/MSNBC, 6/5). The bill, which was approved by the state House last week, would punish doctors who perform abortions with one to 10 years in prison and fines of $10,000 to $100,000, but it would not punish women who undergo the procedure. However, the legislation would allow abortions when there would be "permanent impairment of the function of a life-sustaining organ or organs or to prevent the substantial risk of a pregnant woman" (Kaiser Daily Women's Health Policy Report, 6/2). Gov. Kathleen Blanco's (D) office on Tuesday said the governor would sign the measure into law. Deputy Press Secretary Roderick Hawkins said Blanco plans to sign the bill as soon as possible. He added that even though the governor previously supported exceptions for rape and incest in abortion-related restrictions, she thinks the bill's "safety measures" that protect the life of the woman are sufficient. Hawkins said, "The governor has always been a pro-life person," adding that the bill "fits into her beliefs of supporting life and being antiabortion" (Alford, New York Times, 6/7).
Emergency Contraception
Illinois: The state Department of Financial and Professional Regulation on Friday at Southern Illinois University-Edwardsville held the last of three hearings to collect public comments on a proposed rule that would require each of Illinois' 2,700 pharmacies to post a sign informing customers that pharmacists are required to dispense prescriptions for emergency contraception, the St. Louis Post-Dispatch reports (Beder, St. Louis Post-Dispatch, 6/2). A state rule, which was proposed by Gov. Rod Blagojevich (D) and approved in August 2005 by the joint committee on rules, requires pharmacies to dispense EC -- which can prevent pregnancy if taken up to 72 hours after sexual intercourse -- if they stock any FDA-approved contraceptive or risk losing their licenses. If any prescribed contraceptive is out of stock, pharmacies must provide an alternative, order the drug, make arrangements for another local pharmacy to fill the order or return the prescription to the customer. The rule allows pharmacies to opt not to sell any contraceptives (Kaiser Daily Women's Health Policy Report, 6/2). Speakers at the hearing "overwhelmingly favored" the proposal, the Post-Dispatch reports. The proposal now moves to the state Legislature's Joint Committee on Administrative Rules for consideration (St. Louis Post-Dispatch, 6/3). Rules for professionals such as pharmacists do not need action by the full state Legislature to be approved (Kaiser Daily Women's Health Policy Report, 6/2). If the joint committee does not block it, the rule could take effect this fall, according to the Post-Dispatch (St. Louis Post-Dispatch, 6/2).
Washington state: State pharmacy regulators might be overruled or removed if they allow pharmacists to refuse because of their moral beliefs to fill prescriptions for certain medications, Gov. Christine Gregoire (D) said Monday, the AP/KOMOTV reports (Woodward, AP/KOMOTV, 6/6). The state Board of Pharmacy last week voted to approve a rule that would allow pharmacists who oppose emergency contraception -- which can prevent pregnancy if taken up to 72 hours after sexual intercourse -- to refuse to fill prescriptions for the medication. Pharmacists cannot "obstruct a patient in obtaining a lawfully prescribed drug or device," and they must make an alternative available in a timely fashion if they "cannot dispense" a prescription, according to the rule. The rule, which faces public comment before taking effect, can be altered before the board considers it for final approval, which is expected in August (Kaiser Daily Women's Health Policy Report, 6/5). Gregoire said the board needs to change the rule to protect patients' rights, adding that if the board does not change the rule, the state Legislature likely will overrule their decision. Gregoire also said that because the board members' appointments were never confirmed by lawmakers, she can remove the board membership in January if she has the state Legislature's consent. She also would be able to pre-empt the board's decision with an executive order. Pharmacy board officials on Monday did not return calls for comment, the AP/KOMOTV reports (AP/KOMOTV, 6/6).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Campaign In Mozambique Aims To Increase Awareness About Sexual Abuse Of Girls, Prevent Spread Of HIV
A campaign financed by ActionAid International called "No to Sexual Abuse of Girls in Education" has led to a network of clubs for girls in schools and communities in the Manica province of Mozambique, IRIN/PlusNews reports. The campaign's goal is to reduce sexual abuse of girls, and since 2006, 30 clubs in the province have been established that work with neighborhood watch groups to report cases of abuse to authorities. The groups also publicize laws regarding sexual abuse. According to IRIN/PlusNews, there were four cases of sexual abuse of girls reported in 2008 in the province, down from 15 cases reported in 2007. IRIN/PlusNews also profiled one of the four cases, which involved a seven-year-old girl who was raped and later tested positive for HIV (IRIN/PlusNews, 2/25).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.
© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.
© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Подписаться на:
Комментарии (Atom)