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Leading Medical Organizations Issue Revised Policy Statement On Learning Disabilities And Dyslexia
The American Academy of Ophthalmology announced that it has issued a revised policy statement on Learning Disabilities, Dyslexia, and Vision. The revised statement, which was issued jointly with the American Academy of Pediatrics (AAP), the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) and the American Association of Certified Orthoptists (AACO), expands upon the previous policy and includes extensive scientific references. The statement was also published today in Pediatrics, the journal of the AAP.
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Pledges To Reduce Health Care Costs, Spending Growth Could Violate Antitrust Laws, Lawyers Say
U.S. antitrust laws could affect health care industry groups" efforts to work together to rein in health care costs, the New York Times reports (Pear, New York Times, 5/27). In a letter sent to President Obama on May 10, a coalition of groups -- the American Medical Association, the American Hospital Association, Pharmaceutical Research and Manufacturers of America, the Advanced Medical Technology Association, America"s Health Insurance Plans and the Service Employees International Union -- pledged to reduce the annual health care spending growth rate by 1.5%. The groups did not elaborate on what specific measures they would use to achieve such reductions, but the Obama administration has requested specific plans from the groups by June 1 (Kaiser Daily Health Policy Report, 5/26). According to the Times, many of the plans being considered by the health care industry would require greater cooperation across health care providers. Robert Leibenluft, a former Federal Trade Commission official, said, "Any agreement among competitors with regard to prices or price increases -- even if they set a maximum -- would raise legal concerns." In addition, while Obama is asking for specific plans from the health care industry, the administration has not offered any relief from antitrust laws, the Times reports. Furthermore, during his campaign Obama pledged to increase enforcement of antitrust laws, according to the Times.Antitrust laws have had a negative effect on previous health reform efforts, the Times reports. In 1993, the drug industry established a voluntary cost control plan that limited each drug company"s annual increase in the average price of prescription drugs to the increase in the Consumer Price Index, but the Department of Justice ruled that the proposal would violate antitrust laws. DOJ officials said that the U.S. Supreme Court made it clear that setting price maximums was akin to setting price minimums, which is illegal. In a letter to the Senate Finance Committee, AHA wrote that uncertainty regarding the enforcement of antitrust laws "makes it difficult for a hospital and doctors to collaborate to improve care" and reduce costs. AMA has asked Congress to amend antitrust laws to allow physicians to collectively negotiate with insurers over fees and other concerns, but FTC repeatedly has designated the practice illegal price-fixing, according to the Times. FTC officials said that consumers could benefit from cooperation among health care industry groups but that cooperation also could lead to increased bargaining power for physicians and hospitals, making it easier for them to set prices and eliminate competition (New York Times, 5/27). Reform Developments
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Antibody Linked To Chemotherapy Drug Inhibits Ovarian Cancer In Lab
A novel anticancer agent, consisting of a monoclonal antibody linked to a chemotherapy drug, showed substantial antitumor activity in ovarian cancer cell lines and in mice, according to a study published online July 29 in the Journal of the National Cancer Institute.
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Promising New Treatment For Alzheimer's Suggested Based On Hebrew University Research

Research carried out at the Hebrew University of Jerusalem has resulted in a promising approach to help treat Alzheimer"s disease in a significant proportion of the population that suffers from a particularly rapid development of this disease. In the research at the Silberman Institute of Life Sciences of the Hebrew University, scientists solved a mystery as to why people who carried a mutated gene known as BChE-K were prone to more rapid development of Alzheimer"s than those who had a normal version of the gene. This mutation appears in about 20 percent of the American and Israeli populations. In theory, the carriers of the mutated gene should actually be more protected from the devastating effects of the disease, since the mutated protein (the enzyme that is the product of the gene) breaks down the neurotransmitter acetylcholine at a slower rate than in those who have the normal gene. The result is that the carriers maintain higher levels of this neurotransmitter, so they should in principle be protected from Alzheimer"s disease, in which acetylcholine levels decrease. Indeed, these carriers tend to develop the disease later than others, but when that happens, it progresses more rapidly and does not respond to medication. Therefore, the bottom line is that carriers of the mutated gene have a greater risk than others for disease progression. The reason for this anomalous situation has been a puzzle for a long time, but the studies by the Hebrew University scientists solved it by finding the explanation for this increased risk, thereby offering as well a possible new therapeutic solution. At the Wolfson Center for Structural Biology at the Hebrew University, the researchers found that the mutation in the BChE-K gene damages the very end, or tail, of the resultant mutant enzyme protein. This tail is the part of BChE which is important for protection from the Alzheimer"s disease plaques. It does this by interacting with the Alzheimer"s disease í²-amyloid protein and preventing it from precipitating and forming those brain plaques which are the neuropathological hallmark of this disease. To compare the normal protein to the K mutant, the researchers used synthetic tails of the normal and the K proteins, as well as engineered human BChE produced in the milk of transgenic goats at a U.S. company, Pharmathene. The goat- produced protein is prepared at Pharmathene for the U.S. military as protection from nerve gas poisoning (a result of earlier research at the Hebrew University). It was much more stable and efficient than the mutant protein, which suggests that the BChE-K carriers" susceptibility to Alzheimer"s could be substantially improved by treating them with the engineered normal protein that is produced in the milk of the transgenic goats. The current study was the last part in the Ph.D. work of Dr. Erez Podoly, now a post- doctoral fellow with the Nobel laureate Roger Kornberg at Stanford University. Podoly was the joint student of Prof Oded Livnah and Prof. Hermona Soreq and won a National Eshkol fellowship in Biotechnology to perform this work as well as a Kaye Innovation Award at the Hebrew University. Others who contributed to this study included Dr, Debbie Shalev and Dr. Ester Bennett from the Silberman Institute of Life Sciences, Harvey Wilgus from Pharmathene, and Dr Einor Ben-Assayag and Shani Shenhar- Tsarfati, a Ph.D. student, both from the Sourasky Medical Center in Tel aviv, where the Israeli carriers of BChE-K were identified. The project is patented and is available for licensing by the Yissum Research Development Company of the Hebrew University of Jerusalem. An article by the researchers on this work was recently selected as a Journal of Biological Chemistry (JBC) Paper of the Week and featured on the cover of the publication. Rebecca Zeffert The Hebrew University of Jerusalem


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