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Common Cancer Drug May Increase Risk Of Deadly GI Perforations
Cancer patients treated with the widely used drug bevacizumab (Avastin) in combination with chemotherapy are at greater risk of life-thereatening gastrointestinal (GI) perforations. This is the conclusion of Shenhong Wu, M.D., Ph.D., Principal Investigator, and colleagues at Stony Brook University Medical Center, in a study published online and in the June print issue of The Lancet Oncology.
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Evidence Challenges Effectiveness Of Embryo Screening For Older Women
There is growing evidence that a procedure for identifying chromosomal abnormalities in embryos prior to in vitro fertilization is ineffective at helping older women become pregnant, the Wall Street Journal reports. The procedure -- known as pre-implantation genetic screening, or PGS -- is performed in dozen of U.S. fertility clinics and sometimes marketed to older women as a way to increase the odds of a healthy live birth. PGS involves extracting a single cell from a six-cell embryo and inspecting it for chromosomal abnormalities known as aneuploidies; unaffected embryos can then be implanted through IVF. Women older than age 35 have a higher risk of aneuploidies, in which embryos have fewer or more than the usual number of 23 pairs of chromosomes. Aneuploidies can trigger early miscarriage or certain genetics conditions, such as Down syndrome. Most medical experts agree that embryo screening is capable of significantly reducing the risk of Down syndrome and other serious chromosome-related illnesses. However, evidence from several studies increasingly suggests that the procedure does not increase older women"s chances of healthy live births. The American Society for Reproductive Medicine released an initial opinion about PGS in 2007, saying that available evidence does not support the use of embryo screening to increase live birth rates in older women. Andrew La Barbera, scientific director of the society, said, "Since that time, there have been several more trials that have reached the same conclusion." Another shortcoming is that most clinics can only test for fewer than half of the 23 chromosomes, meaning that many defects can go undetected. However, medical experts say that the use of PGS has increased in the two years since ASRM issued its recommendations. According to the Journal, PGS can add more than $2,000 to the roughly $10,000 cost of one IVF cycle. Very few health insurers cover PGS, though some pay for IVF. Some experts contend that studies showing a lack of clinical benefit from PGS do not use more efficient biopsy techniques that can prevent damage to the embryo. Santiago Munne, scientific director for Reprogenetics, said that the treatment is "effective." In a 2007 study, Munne and colleagues used PGS to reduce the rate at which patients miscarried. However, the chances of a woman getting pregnant largely were unchanged, which the authors said could be attributed to the small number of study participants (Naik, Wall Street Journal, 6/1).
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Maryland County Officials Create State's First Suburban HIV/AIDS Commission
Anne Arundel County, Md., Executive John Leopold recently appointed 20 community leaders, government officials and health workers to serve on the county"s first HIV/AIDS commission, which aims to understand and develop strategies for addressing the disease, the Baltimore Sun reports. The Sun reports the commission is believed to be the first of its kind in a suburban Maryland county and similar to a commission launched in Baltimore City. Council member Daryl Jones in 2008 proposed legislation to create the commission, citing the increasing number of HIV cases in the northern part of the county, likely because of its close proximity to Baltimore. According to Jones, the commission aims to generate funds for testing and outreach services; address stigma associated with the disease; and heighten awareness of the virus among residents. The commission also will produce an annual report on HIV/AIDS-related issues in the county, Jones said. Anne Arundel County had 1,000 recorded HIV/AIDS cases in 2006, with 56 newly reported HIV cases that year, according to the Maryland AIDS Administration. "It"s pretty much what I would classify as having the potential to reach epidemic proportions," Jones said, adding that Baltimore has the second highest AIDS rate among major metropolitan areas in the country. According to Kelly Sipe Russo, a physician clinical specialist with the county health department"s division of public health, the department has identified "hot spots" in the county with high HIV/AIDS rates, including the northern area and Annapolis. Russo noted that while HIV/AIDS rates in the county are not on the rise, they also are not declining, even with programs in place to increase awareness and provide help for those living with the disease. According to the Sun, although res and staffing are limited for many programs, health department officials still believe the programs are slowly having an effect and that more outreach is needed, especially for testing and treatment. Jones said that the economic downturn could lead more people to drug or alcohol use. He also noted that the stigma surrounding the disease is a major factor behind the creation of the commission. "Part of what the commission will address is figuring out ways to take away some of the fear factor" associated with HIV testing, he said. The Sun also profiled Carolyn Massey, an HIV-positive woman appointed to the commission. She said that stigma associated with the virus still is widespread, adding, "I feel we"re doing some of the right things the right way. HIV infection is something that does not have to happen" (Dixon, Baltimore Sun, 5/18).
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Centrist Dems Say Abortion Issues Must Not Delay Health Reform; Conservatives Step Up Criticism

Five centrist House Democrats, led by antiabortion-rights Rep. Tim Ryan (Ohio), on Tuesday issued a proposal that would neither require nor ban private insurers from covering abortion services as long as federal dollars are not used, the Washington Post"s "Capitol Briefing" reports. In a letter sent to House Speaker Nancy Pelosi (D-Calif.), Ryan and Reps. Dale Kildee (Mich.), James Langevin (R.I.), Artur Davis (Ala.) and Kendrick Meek (Fla.) said that their proposal "maintains the current status quo in the private market" and would not "preempt constitutionally permissible" state restrictions related to abortion, such as parental notification laws. The representatives called their proposal a "common ground solution." Current federal law prohibits the use of federal Medicaid funds for abortion services in nearly all circumstances. The lawmakers said that they are "increasingly concerned about potential roadblocks around the issue of abortion" in the health reform debate in Congress. According to "Capitol Briefing," antiabortion-rights Democrats are concerned that health reform legislation could lead to indirect federal funding of abortion services through private insurers participating in a proposed health insurance exchange (Eggen, "Capitol Briefing," Washington Post, 7/21). In the letter, the representatives said that they would like to include language in the final health reform bill "that makes clear that no insurance company will be required to pay for an abortion except in extraordinary circumstances." In addition, insurance providers would not be prohibited from paying for abortion services "so long as health insurance plans offered in the exchange that choose to provide abortion coverage pay for those services with funds that are separate and distinct from any federal subsidies," the letter said. Ryan said he hopes the proposal will be introduced in committee on Wednesday as an amendment (Smith, Politico, 7/21).House Members Step Up Efforts To Exclude Abortion CoverageMeanwhile, antiabortion-rights House members are intensifying their efforts to exclude abortion coverage from the chamber"s health reform bill (HR 3200), which they said includes a "hidden mandate" that would allow federal money to cover the procedure, the AP/Houston Chronicle reports. Rep. Bart Stupak (D-Mich.) said that he plans to join other antiabortion-rights House members at a news conference on Wednesday to criticize the legislation. Stupak helped draft a June 25 letter to Pelosi saying that he and 19 other Democrats would not support any health reform bill "unless it explicitly excludes abortion from the scope of any government-defined or subsidized health insurance plan." The bill does not mention abortion, which supporters say means that the legislation is neutral on the issue (Alonso-Zaldivar, AP/Houston Chronicle, 7/22).Antiabortion-Rights Coalition Launches CampaignA coalition of antiabortion-rights groups this week is launching a three-week campaign aimed at excluding abortion coverage from health reform legislation, Politico reports. The coalition includes James Dobson, founder of Focus on the Family; Tony Perkins, president of the Family Research Council; Richard Land of the Southern Baptist Convention; David Bereit of 40 Days for Life; and Charmaine Yoest, president of Americans United for Life. Yoest said AUL intends to send a letter to President Obama on Thursday citing its "belief that the bills are intended to include abortion."Laurie Rubiner, vice president for public policy and advocacy at the Planned Parenthood Federation of America, said that abortion is "not mandated any more than any other service or procedure in health reform." She added that excluding abortion coverage could result in women losing the coverage they currently have under private plans. The abortion-rights opponents" demand to exclude abortion coverage "violates the first principle of health care reform, which is: Don"t make people worse off under health care reform than they are today," Rubiner said (Smith, Politico, 7/22). Reprinted with kind permission from http://www.nationalpartnership.org. 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.


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