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Expert Discusses HIV-Related Kidney Disease, Susceptibility Among Blacks
The New York Daily News profiled Paul Klotman, chair of the Samuel F. Bronfman Department of Medicine at Mount Sinai, who is "one of the world"s leading experts on the kidney diseases associated with HIV." In the article, Klotman discussed the clinical details of HIV-associated nephropathy (HIVAN), including treatment, causes and symptoms. According to the Daily News, doctors estimate that two million to four million people of African heritage have HIVAN, including between 4 percent and 12 percent of blacks with HIV in the U.S. The article continues, "In recent years, doctors have made tremendous advances in their understanding of both HIV and its associated kidney disease." Klotman said, "In thinking about a cure, we know now that we have to clean out the brain and the kidney. Those are things we have to know if we can ever achieve a cure for AIDS" (Charles, 7/22).

Annual Meeting Of American Academy Of Periodontology To Feature Keynote From Prominent Cardiologist
Nearly 75 percent of Americans suffer from some form of periodontal disease, the major cause of adult tooth loss. In addition, cardiovascular disease, the leading killer of men and women in the United States, is a major public health issue contributing to 2,400 deaths each day. And while these two conditions are seemingly unrelated, research suggests that managing one disease may reduce the risk for the other.
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'Pro-choice Community' Should Find New 'Way Of Talking About Reproductive Freedom,' Opinion Piece Says
"Most of the push-back" from antiabortion-rights advocates to a recent e-mail message from author Judy Blume on behalf of Planned Parenthood -- which asked mailing list subscribers for donations -- was generated by an article in the antiabortion-rights publication LifeNews, columnist Meghan Daum writes in a Los Angeles Times opinion piece. The article put a "heavy, misrepresentative spin" on Blume"s message, which urged donors to "do all [they] can to support" the increasing number of women turning to Planned Parenthood centers for health care during the economic downturn.The LifeNews article said, "Blume notes how more women are seeking abortions from Planned Parenthood because of the difficult economy, and she urges readers of the e-mail to use that as a reason to support the abortion business." According to Daum, "this is just the kind of thing that makes abortion-rights advocates apoplectic," noting that abortion-rights advocates "fired-back" in the "blogosphere ... imparting the statistic about abortion making up only 3% of Planned Parenthood"s services and pointing out that many of the women being yelled at by picketers in clinic parking lots aren"t even pregnant but, rather, trying to avoid getting pregnant." Daum continues that the organization, much like Blume, "occupies a clear position on the post-Roe cultural map," adding, "Generally speaking, if you"re on board with abortion rights, you"re on board with Planned Parenthood." In addition, if you are against abortion rights, the "organization is the headquarters of Godlessness," she adds. Daum writes that it is not difficult to see why Planned Parenthood enlisted Blume -- an "icon of 1970s-era feminism and its efforts on behalf of sex education and women"s health" -- because she conjures "nostalgia for the early days of the fight that makes pro-choicers want to keep fighting today."Daum writes that as she watched this "saga unfold in [her] inbox," she was "struck by a troubling question. Even though Blume may not be associated with abortion in and of itself … is there something about her persona that signals a lack of dispassion about its ramifications? Is she reminding people of a time when, in the relief of Roe being decided, there was a cultural perception that abortion was a simple procedure that needn"t come with attendant emotional baggage?"Daum adds that there is "no denying that the language and overall tone around abortion has changed. Despite what many pro-life groups seem to think, most abortion-rights advocates prefer "safe, legal and rare" to "no big deal."" According to Daum, President Obama, "pro-choice though he is, is hardly strident -- and even a little evasive -- on the issue." She adds that Obama favors language about reducing the need for abortions and "finding common ground with the other side." Daum notes that the pop cultural arena "has become downright allergic to the issue" of abortion, with a recent movie coining the term "shmashmortion" because the characters "can"t even get the word out." Daum adds that although Blume "was undoubtedly effective" at bringing in funding for Planned Parenthood, perhaps what might have been "even more radical is if the pro-choice community could find a way of talking about reproductive freedom that neither reverts to the perceived casualness of the 1970s nor panders to the "shmashmortion" dialect of today. "Safe, legal and rare" comes close. But "safe, legal, rare and a big deal" might be even better" (Daum, Los Angeles Times, 5/14).
Health Insurance

Cardiovascular Medication Costs In Canada Double

The number of prescriptions in Canada for cardiovascular medications has been increasing over the past decade, with a 200% increase in costs, found a new study in CMAJ (Canadian Medical Association Journal). In 2006, total costs of cardiovascular medications exceeded $5 billion, with statins accounting for almost 40% of the expenditure. Cardiovascular disease is the leading cause of premature death and disability in Canada, exerting a significant societal burden. Cardiovascular drugs are the most commonly prescribed medications in the country, and expenditures outpace overall drug prescription increases. If the trend continues, costs are expected to rise to approximately $10.6 billion in 2020 and could threaten the sustainability of public drug insurance programs. Canadians spent 17 cents of every healthcare dollar on medication in 2007, representing a 16% increase in proportional healthcare spending since 1997. Factors such as population growth, increasing rates of hypertension, pharmaceutical cost inflation and an ageing population only partly explain the significant increase in costs. Variations exist across provinces, with higher costs in the east. Increases in prescription volume and use of new and more expensive cardiovascular medications are also fuelling this rise. However, this practice needs to be examined as some older, established drugs may be the most cost-effective to use. "We found that the medication classes with the greatest increases in prescriptions dispensed and associated expenditures were angiotensin receptor blockers, antiplatelets, statins and angiotensin converting enzyme inhibitors," state Dr. Cynthia Jackevicius, a researcher at the Institute for Clinical Evaluative Sciences (ICES) in Toronto and Western University of Health Sciences in Ponoma, USA and coauthors from the Canadian Cardiovascular Outcomes Research Team (CCORT). Many of these medications are brand name drugs and the authors suggest that older drugs may still be the best option. The study was conducted by researchers participating in the CCORT initiative including researchers from the Institute for Clinical Evaluative Sciences, University Health Network, University of Toronto, Toronto, Ontario, Western University of Health Sciences in Ponoma, USA; Dalhousie University; Laval University; University of Ottawa Heart Institute; Statistics Canada; McGill University and University of British Columbia. "Given the magnitude of growth of the expenditures involved, ensuring the prescribing of cost-effective medications is essential," conclude the authors. In a related commentary, Dr. Robert Califf from Duke University Medical Center writes that the higher costs of cardiovascular medication prescribing might result in a health benefit that would be worth the increases in spending. He notes that accurate information, such as including prescribing information in electronic medical records, could provide rapid evidence about the best medications for patient conditions and be incorporated into practice. Kim Barnhardt Canadian Medical Association Journal


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